Information and Support for Teachers YCDSB SUICIDE PREVENTION, INTERVENTION & POSTVENTION IN SCHOOLS.

Information and Support for Teachers

YCDSB

SUICIDE PREVENTION, INTERVENTION & POSTVENTION IN SCHOOLS

SUICIDE IS A DIFFICULT TOPIC…

YORK CATHOLIC DISTRICT SCHOOL BOARD :: Collaborative Learning Inspired By Jesus 2

Most of us have been touched, professionally and/or personally, by suicide

Important to support one another as we approach this topic today

SESSION OUTLINE

1. Overview of Suicide in Children and Youth2. Risk Factors/Vulnerabilities3. Bullying and Suicide4. Triggers5. Contagion Effect6. The Role of Social Media7. Protective Factors8. Warning Signals9. School Response to Suicide:

Helpful Prevention, Intervention and Postvention Strategies

10. Self-Care11. Question/Answer

CHILD AND YOUTH

SUICIDE

BRIEF OVERVIEW

WHAT DO WE BELIEVE


in the case of suicide?

TRADITIONAL CATHOLIC TEACHING recognizes that it is both inappropriate and impossible for observers to judge the moral quality of another person’s action. It is also our teaching as noted in the Catechism of the Catholic Church, article 2282 that, “Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide.” Any factor which diminishes the freedom of a person diminishes the sinfulness of a deed: persons who die by suicide are recognized to have been under such overwhelming pressure that their freedom (and therefore the sinfulness of the act) are significantly diminished.

WHAT DO WE BELIEVE


in the case of suicide? (Cont`d)We need to always remember God’s unconditional love for us all; if the parents of someone who has died by suicide continue to love the person, we can be sure that God too remains loving and compassionate towards a person whose suffering has resulted in such calamitous action.

What gives us consolation is knowing that the individual who has died by suicide is now with God.

(Adapted in part from YCDSB Board Resource: School Crisis Response Guidelines: Depression and Suicide; Prevention and Intervention, April, 2004)

SUICIDAL BEHAVIOUR


Non-Suicidal Self-Injury

A deliberate attempt to cause injury to one’s body without the conscious intent to die

Suicidal Ideation

Suicidal thoughts that include both contemplating death by suicide and planning actions that could result in death

Suicide AttemptSelf-harming behaviour that includes an intention to die

Death by Suicide Self-harming behaviour that results in death

FACTS AND FIGURES


• 2nd leading cause of death after accidents, accounting for 17.3- 20.4% of adolescent mortality (but important to put this in context, death is relatively uncommon in this age group)

• 1.4% of all suicides occur in children under 14 years of age • Death by suicide is more prevalent in males than females

aged 15-19 • Recent Canadian epidemiological study shows overall

stable rates of suicide over the past 30 years, but trends are changing: decreasing rates for males and increasing rates for females (Skinner & McFaull, 2012)

ROLE OF TEACHERS


Awareness of need for Intervention

Identification and Referral

Supporting Vulnerable Students

Role is not to determine if student has potential to attempt suicide or not

IMPORTANCE OF TEACHERS

YORK CATHOLIC DISTRICT SCHOOL BOARD :: Collaborative Learning Inspired By Jesus

Students talk to

teachers

You make adifference

You knowDevelop-

ment

Unique position

Teachers

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THE COMPLEXITY OF RISK


RiskFactors

Triggers

RISK

ProtectiveFactors

RISK FACTORS – SELF


• Mental illness (e.g., depression, mood, anxiety, conduct disorders)

• Past suicidal behavior• Substance use• Unstable mood, high impulsivity• Rigid thinking or coping patterns• Poor physical health / chronic illness

NOTE: These risk factors are correlational and not causal; typically it is a compounding of risk factors that is associated with suicidal behavior.

RISK FACTORS – HOME


• Family history of suicides / attempts• Parental mental illness• Alcohol / substance abuse in the home• History of violence and/or abuse• Divorce, separation, other losses, death• Tension and aggression between parents• Parental lack of time; rejection; neglect

NOTE: These risk factors are correlational and not causal; typically it is a compounding of risk factors that is associated with suicidal behavior.

RISK FACTORS – SCHOOL/COMMUNITY


• Learning challenges• Disengagement from school• Lack of connectedness• Marginalization• Discontinuity in identity

(cultural, language, gender, sexual)• Some communities are at heightened

vulnerability (e.g., aboriginal, LGBTQ, homeless)

• Negative social relationships, including bullying



LONELYCONFUSED

WORTHLESS


LONELYCONFUSED

WORTHLESS


LONELYCONFUSED

WORTHLESS


LONELYCONFUSED

WORTHLESS

LAST STRAW EVENT

BULLYING AND SUICIDE


Pre-existingvulnerability VictimizationIncreases risk for bullying

New or Exacerbated:• Anxiety• Depressed mood• Diminished self-worth• Feelings of entrapment• Loneliness• Withdrawal• Sleep/earing problems• Hopelessness

Which are the risk factors for:Suicide ideationSuicide attemptDeath by suicide

Adapted Lenny Berman 2010 Bullying and Suicide 8doc.webinar American Association of Suicidology

TRIGGERS


• Break up with boy/girlfriend• Conflicts and increased arguments

with parents and/or siblings• Loss of close friend (moves, betrayal)• School related difficulties-conflicts

with teachers, classmates• School failures• Difficulties with the law• Change in parents’ financial status• Serious illness or injury in family member• Real or perceived loss of status

POSSIBLE MOTIVATIONS FOR SUICIDE


• An escape from intolerable pain• The wish to join a lost love one• Retaliation for (perceived) abandonment• To obtain love and attention (“manipulation”)• Atonement for one’s sins• Rage turned inward• Psychotic experience• A desperate attempt to take control• A last cry for help

CONTAGION


• Mimicking of suicidal behaviours

• Occurs when suicidal behavior influences an increase in the suicidal behavior of others

• Multiple suicidal behaviors/suicide deaths that occur within a geographical area or fall within an accelerated time frame may represent a potential cluster

• Although clusters are rare, they are most common amongst adolescents

THE ROLE OF CYBER/SOCIAL MEDIA


• Increasingly there are sites, chat rooms and blogs that promote suicidal ideation

• Methods of suicide are discussed on-line and some researchers have suggested that increases in particular methods in recent years may be related to this dialogue

• The rapid spread of rumours and details of deaths by suicide is difficult to manage

• Paradoxically, social media (Facebook, Twitter, etc.) may hold potential benefits for suicide prevention

(Skinner & McFaull, 2012)

PROTECTIVE FACTORS


• Problem solving, life & communication skills

• Sociability• Resilient personality• A sense of belonging

(school, community)• Secure attachment to

positive parent/family• Personal moral or religious

convictions prohibiting self-harm and supporting the value of life

• Access to other caring & supportive adults

• Prosocial peers • Appropriate discipline, limit

setting & structure • Opportunities to develop

self-esteem• Good mental health• Access to professional

services (counselling)

Youth suicide is complex and is often the result of many converging factors.

The explanations and the solutions are equally complex.

26YORK CATHOLIC DISTRICT SCHOOL BOARD :: Collaborative Learning Inspired By Jesus

SUICIDE PREVENTION,

INTERVENTION, & POSTVENTION

STRATEGIES FOR

SCHOOL RESPONSE TO SUICIDE

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Prevention Intervention Postvention

WHAT IS SUICIDE PREVENTION?

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Efforts to reduce the risk of suicidal thoughts and behavior amongst students in a systematic way

WHAT IS INTERVENTION?

• Practices involved in recognizing and responding to students with suicidal ideation or behavior

• Practices involved in supporting vulnerable students transitioning to and from mental health care


WHAT IS POSTVENTION?

Support for school communities in responding to suspected, attempted, or death by suicide


HELPFUL PREVENTION STRATEGIES• Safe and accepting school culture• Social emotional learning (coping skills,

conflict resolution, e.g., Family Life Program, Tribes, Second Steps, Restorative Practices)

• Early identification and treatment of mental health problems

• Information dissemination (staff, parents, students)


WARNING SIGNALS: BEHAVIOURAL• Loss of interest in former activities• Withdrawal from social contact• Difficulty concentrating, problems

with judgment and memory• Dramatic shift in quality of academic

performance• Feelings of sadness, emptiness and

hopelessness, often expressed in written assignments and art

• Sleep disturbances


These signals also relate to problems in mental health more generally

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WARNING SIGNALS: BEHAVIOURAL• Strong and overt expressions of anger

and rage• Excessive use of drugs and/or alcohol• Promiscuous behaviour• Uncharacteristic delinquent,

thrill-seeking behaviour• Self-mutilation (e.g., cutting, burning

hair pulling, skin picking)• Occurrence of previous suicidal

gestures or attempts• Planning for death; making final

arrangements; giving away favourite possessions


WARNING SIGNALS: COMMUNICATION• Statements revealing a desire to die, or a preoccupation

with death• Nihilistic comments: life is meaningless, filled with

misery, what’s the use of it all?

• Verbal or written threats• Sudden cheerfulness after prolonged depression may be

relief because decision has been taken

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HELPFUL INTERVENTIONS

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Know your role

Know board procedure


Current Self-Harm ProceduresTeacher Role

Admin Role

“What do I do?”Someone has a concern or student reports self-harm

“I need to…”Always take it seriously

andReport immediately to Admin (Principal/VP) and/or designate

“What do we do?”Admin consults with Guidance/SSC/Psych

Parent contact & medical evaluationOngoing communication, monitoring & follow-up

Awareness

Literacy

Expertise

HELPFUL INTERVENTION- TEACHER ROLE

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Identification & Referral

•Be aware of warning signals

•Take the warning signs/threats seriously – do not ignore

•Facilitate Assessment and Care

•Notify Administration (and guidance) immediately


DO:

HELPFUL INTERVENTION-TEACHER ROLE

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Support Vulnerable Students

• Provide immediate and calm support to the student

• Ensure safety and supervision

• Practice active listening

• Provide classroom accommodations to reduce stress


DO:

HELPFUL INTERVENTION TEACHER ROLE– DO’S

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Know your limits/Comfort level

Consult/Debrief

Work as a Team

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WHAT YOU CAN SAY

I’m glad you came to talk to me.

I know this is hard for you.

It sounds like you’re really overwhelmed but I’m so glad you shared.

I’m so proud of you because I know it took a lot of courage to come forward to share this information.

I’m concerned for your safety…part of ensuring your safety means I need to share this information with the Administration and Guidance. You are not in trouble – they will know how to get you the help you need.

WHAT NOT TO DO

• Ignore the signals• Wait• Panic• Do not promise confidentiality –

Safety first• Debate the morality of suicide• Minimize their feelings

(e.g., by telling the person to be grateful, or telling them they have too many good things going for them to feel this way)

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• Do not reassure them that everything will be fine

• Challenge the person to go ahead

• Assume the person isn’t the suicidal type. Anyone can be suicidal

• Do not leave them alone/ unsupervised

• Do not work alone


DON’T:

POSTVENTION STRATEGIES

• Create a school safety plan with the student and support staff (BRS/student support counsellor, psychologist and/or guidance)

• Follow-up with student, student’s support group, and reporting teacher

• Regular in-school monitoring by support staff (guidance, student support counselor)

• Observe student: mood, behavior, attendance, academic performance

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• Share observations with relevant staff (guidance, admin, etc)

• Provide academic accommodations as needed (e.g, extra time, reduce quantity).

• Provide atmosphere of caring, acceptance and support (e.g., encourage, recognize strengths)


Following Suicide Attempt

TAKING CARE OF YOURSELF

Suicide is a special kind of school crisis that impacts us in significant ways, professionally and personally

The School Team needs to work together, to debrief often, and to reach out when members are struggling

Members need to practice self-care deliberately

You are not alone – consult, debrief frequently

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SOURCES, WITH THANKS• MH Leader Suicide Subgroup• Ian Manion,

– Ontario Centre of Excellence for Child and Youth Mental Health

• Ian Brown, – School Mental Health ASSIST

• Stephan Roggenbaum & Katherine Lazear,– University of South Florida

• Key Resources:– SAMHSA Toolkit, Suicide Postvention Guidelines South

Australia, Principal Leadership 2009, NASP Postvention Strategies for School Personnel, Kutcher 2008


CONTACT SCHOOL MENTAL HEALTH ASSIST LEAD• Dr. Schrine Persad

– Chief Psychologist, York Catholic District School [email protected], ext. 11656


mailto:[email protected]

Q&A47YORK CATHOLIC DISTRICT SCHOOL BOARD :: Collaborative Learning Inspired By Jesus

Information and Support for Teachers YCDSB SUICIDE PREVENTION, INTERVENTION & POSTVENTION IN SCHOOLS.

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