Difficult Discussions Talking with Youth about Suicide Presented by Theresa Marinas, LCSW Director, Behavioral Health Services Kaiser Permanente, Kern.

Difficult Discussions Talking with Youth about Suicide

Presented by Theresa Marinas, LCSWDirector, Behavioral Health ServicesKaiser Permanente, Kern County

September is Suicide Prevention Month

Statistics from 2010

•31,000 people in the United States die by suicide each year

•1 million people in the world die by suicide each year

•About 650,000 people in the United States are emergently treated after a suicide attempt

•An estimated 8% of people diagnosed with Major Depression attempt suicide during their life time.

•A person dies by suicide about every 15 minutes in the United States.

•Every day, approximately 101 Americans take their own life.

3 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.April 19, 2023

First Agenda

Second Agenda

Third Agenda

Fourth Agenda

Fifth Agenda

•Ninety percent of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death.

•There are four male suicides for every female suicide, but three times as many females as males attempt suicide.

• Ninety-six percent of alcoholics who die by suicide continued their substance abuse up to the end of their lives. • Alcoholism is a factor in about 30 percent of all completed suicides.

• Approximately 7 percent of those with alcohol dependence will die by suicide.

•Data from The American Foundation for Suicide Prevention website



Suicidal thoughts Psychiatric disorders (such as

depression, impulsive aggressive

behavior, bipolar disorder and certain anxiety disorders) Drug and/or alcohol abuse and previous suicide attempts The risk is increased if there is situational stress and access to firearms.

Risk factors for suicide among the young


Learning Objectives

Take a brief attitude assessment about your thoughts about suicide

Identifying signs of at risk behavior Starting a difficult discussion Continuing a difficult discussion Taking action

Attitude AssessmentConsider whether you always agree, sometimes agree, never agree, or have no opinion:

• I think suicide is a rational choice.

• I think suicide should be prevented, no matter what.

• Because it can be so hard to talk about, I think it is important to respect confidences about suicide.

• I would do everything I could to prevent my teenager from dating someone who attempted suicide.

• I respect my child’s choice to date someone who has attempted suicide.

•Data from TeacherVision.com


Attitudes


Attitudes

Our attitudes or values about suicide are

neither right nor wrong.

Attitudes or values can guide our perception

about suicide and how we discuss this topic

with others, especially youth.

What stood out most for you in the assessment

that you took a few moments ago?


Misperceptions

Misperception #1 Misperception #2 Consequence is

We should not ask if someone is having thoughts of hurting

themselves.

The fear is that it will put the idea into a

person’s head thus we are responsible for their

actions.

The idea is already there.

We potentially miss an opportunity to help someone at risk.


Starting the Discussion/Prevention

Identify at risk behaviors

•Distinct changes in personality

•Distinct negative changes in behavior

•Possible drug/alcohol abuse

•Depression and social withdrawal

•Being a target of bullying or social ridicule

•Being or feeling different


What do I say?

•“I had noticed…you were…and I am concerned about your well being.”

•“I wondered how names teasing effected you? How are you handling the teasing?...Is there anything I can do that would help?”

•“I was curious about behavior, statement, attitude which is different from how you have responded before. Can we talk about what is different?


What do I say?

• “Have you been able to talk with anyone about this?”

• “Is there anyone who you think understands what you are feeling?”

• “What can I do that will encourage you to seek help?”

• “Is there someone I can talk to about how you are feeling/thinking?”


Reality Check

•Explain your limitations but also explain that you want to help.

•The purpose is not to blame or shame but to give the person an

opening to be heard.

•Stay calm.

•The youth’s and your own safety comes first and you are setting the

tone of the conversation.


Continuing the discussion/Intervention

•Ask if the person is having thoughts of self harm in a way that you are

comfortable with asking.

•Ask the person if they have a plan.

•If the person has a plan, do they have the weapon or method of harm available to them such as pills


What do I say?

• Have you suffered from depression, either treated or untreated?

• Have you had a previous suicide attempt?

• Is there a family history of death by suicide?

Note: 1 out of 100 suicide attempt survivors successfully die by suicide within 1 year of the

unsuccessful attempt


What do I say?

• Have you used drugs, alcohol, sex, promiscuous or dangerous behavior as a

way to feel better?

•What physical symptoms, emotions, thoughts, behaviors have you been

experiencing recently?

•What do you see for yourself past today?


What do I say?

• Is there something you are looking forward to?

•Do you have plans on seeing friends, travelling, doing something interesting?

•Is there someone or something that would miss you if you were gone?

Note: Sometimes family such as children, events such as a graduation, wedding, birth, or even a pet give a sense there

is something work living for in the future.


Reality Check

• Bottom line, listen to your instincts. If something inside of you keeps saying

something is wrong, go with your instincts.

•Be reassuring, supportive, and non-judgmental.

•You may have helped a youth take the first step towards not being part of the statistics

presented earlier.


Taking Action

•Thank the youth for opening up and taking that first step.

•Normalize that feeling anxious, afraid, angry, even stupid is not unusual. Some will

express relief that they finally said something.

•Be prepared to have some youths try to deny or bargain with you because they are

afraid someone will get angry or they will be in trouble.


Planning action

In Kern County:

•Bakersfield Police•Bakersfield Sheriff•MET – Mental Evaluation Team

are the only authorities that can place a person on a 5150 otherwise known as a 72

hour psychiatric hold.

If someone is an eminent danger, call 911 or Bakersfield Police Department.


Planning action

If a voluntary evaluation; the person can be directed to Mary Kay Shell

which is located adjacent to the Kern Medical Center Campus. It is a 24/7 facility and can also evaluate for a

5150.

Mary Kay Shell is also a psychiatric ‘holding area’ where a person can be

held for up to 23 hours for observation.


Planning action

If the person is not eminently a danger, is having thoughts but does not have a plan

or the intent to harm themselves, refer the person to a mental health practitioner for further evaluation or treatment. There may be other underlying issues that talk therapy, medication, or a combination of the two can effectively treat to help the

person deal with their life situations.



Questions?????

Difficult Discussions Talking with Youth about Suicide Presented by Theresa Marinas, LCSW Director, Behavioral Health Services Kaiser Permanente, Kern.

Documents

previous suicide

female suicide

kaiser foundation health

internal use

action slide

young slide

american foundation

kern county slide