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Suicide Prevention Saving Lives One Community at a Time America Foundation for Suicide Prevention Dr. Paula J. Clayton, AFSP Medical Director 120 Wall

Mar 29, 2015

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Suicide Prevention Saving Lives One Community at a Time America Foundation for Suicide Prevention Dr. Paula J. Clayton, AFSP Medical Director 120 Wall Street, 22 nd Floor New York, NY 10005 1-888-333-AFSPwww.afsp.org Slide 2 Facing the Facts An Overview of Suicide An Overview of Suicide Slide 3 3 Facing the Facts In 2007, 34,598 people in the United States died by suicide. About every 15.2 minutes someone in this country intentionally ends his/her life. In 2007, 34,598 people in the United States died by suicide. About every 15.2 minutes someone in this country intentionally ends his/her life. Although the suicide rate fell from 1992 (12 per 100,000) to 2000 (10.4 per 100,000), it has been fluctuating slightly since 2000 despite all of our new treatments. Although the suicide rate fell from 1992 (12 per 100,000) to 2000 (10.4 per 100,000), it has been fluctuating slightly since 2000 despite all of our new treatments. Slide 4 4 Facing the Facts Suicide is considered to be the second leading cause of death among college students. Suicide is considered to be the second leading cause of death among college students. Suicide is the second leading cause of death for people aged 24-34. Suicide is the second leading cause of death for people aged 24-34. Suicide is the third leading cause of death for people aged 10-24. Suicide is the third leading cause of death for people aged 10-24. Suicide is the fourth leading cause of death for adults between the ages of 18 and 65. Suicide is the fourth leading cause of death for adults between the ages of 18 and 65. Suicide is highest in white males over 85. Suicide is highest in white males over 85. (45.4/100,000, 2007) Slide 5 5 Facing the Facts The suicide rate was 11.5/100,000 in 2007. The suicide rate was 11.5/100,000 in 2007. It greatly exceeds the rate of homicide. (6.1/100,000) It greatly exceeds the rate of homicide. (6.1/100,000) From 1979-2007, 881,443 people died by suicide, whereas 550,304 died from AIDS and HIV-related diseases. From 1979-2007, 881,443 people died by suicide, whereas 550,304 died from AIDS and HIV-related diseases. Slide 6 6 Facing the Facts Suicide Communications ARE Made to Others In adolescents, 50% communicated their intent to family members* In adolescents, 50% communicated their intent to family members* In elderly, 58% communicated their intent to the primary care doctor** In elderly, 58% communicated their intent to the primary care doctor** Slide 7 7 Facing the Facts Research shows that during our lifetime: 20% of us will have a suicide within our immediate family. 20% of us will have a suicide within our immediate family. 60% of us will personally know someone who dies by suicide. 60% of us will personally know someone who dies by suicide. Slide 8 8 Prevention may be a matter of a caring person with the right knowledge being available in the right place at the right time. Prevention may be a matter of a caring person with the right knowledge being available in the right place at the right time. Slide 9 9 Risk Factors Psychiatric disorders Psychiatric disorders Past suicide attempts Past suicide attempts Symptom risk factors Symptom risk factors Sociodemographic risk factors Sociodemographic risk factors Environmental risk factors Environmental risk factors Slide 10 10 Risk Factors Psychiatric Disorders Most common psychiatric risk factors resulting in suicide: Most common psychiatric risk factors resulting in suicide: Depression* Major Depression Major Depression Bipolar Depression Bipolar Depression Alcohol abuse and dependence Drug abuse and dependence Schizophrenia *Especially when combined with alcohol and drug abuse *Especially when combined with alcohol and drug abuse Slide 11 11 Risk Factors Other psychiatric risk factors with potential to result in suicide (account for significantly fewer suicides than depression): Other psychiatric risk factors with potential to result in suicide (account for significantly fewer suicides than depression): Post Traumatic Stress Disorder (PTSD) Post Traumatic Stress Disorder (PTSD) Eating disorders Eating disorders Borderline personality disorder Borderline personality disorder Antisocial personality disorder Antisocial personality disorder Slide 12 12 Risk Factors Major physical illness, especially recent Major physical illness, especially recent Chronic physical pain Chronic physical pain History of childhood trauma or abuse, or of being bullied History of childhood trauma or abuse, or of being bullied Family history of death by suicide Family history of death by suicide Drinking/Drug use Drinking/Drug use Being a smoker Being a smoker Slide 13 13 Risk Factors Sociodemographic Risk Factors Male Male Over age 65 Over age 65 White White Separated, widowed or divorced Separated, widowed or divorced Living alone Living alone Being unemployed or retired Being unemployed or retired Occupation: health-related occupations higher (dentists, doctors, nurses, social workers) Occupation: health-related occupations higher (dentists, doctors, nurses, social workers) especially high in women physicians Slide 14 14 Risk Factors Environmental Risk Factors Easy access to lethal means Easy access to lethal means Local clusters of suicide that have a "contagious influence" Local clusters of suicide that have a "contagious influence" Slide 15 15 You Can Help! Adapted with permission from the Washington Youth Suicide Prevention Program Slide 16 16 How you can help prevent suicide Know warning signs Know warning signs Intervention Intervention Slide 17 17 You Can Help Most suicidal people don't really want to die they just want their pain to end Most suicidal people don't really want to die they just want their pain to end About 80% of the time people who kill themselves have given definite signals or talked about suicide About 80% of the time people who kill themselves have given definite signals or talked about suicide Slide 18 18 Warning Signs Observable signs of serious depression Observable signs of serious depression Unrelenting low mood Unrelenting low mood Pessimism Pessimism Hopelessness Hopelessness Desperation Desperation Anxiety, psychic pain, inner tension Anxiety, psychic pain, inner tension Withdrawal Withdrawal Sleep problems Sleep problems Increased alcohol and/or other drug use Increased alcohol and/or other drug use Recent impulsiveness and taking unnecessary risks Recent impulsiveness and taking unnecessary risks Threatening suicide or expressing strong wish to die Threatening suicide or expressing strong wish to die Making a plan Making a plan Giving away prized possessions Giving away prized possessions Purchasing a firearm Purchasing a firearm Obtaining other means of killing oneself Obtaining other means of killing oneself Unexpected rage or anger Unexpected rage or anger You Can Help Slide 19 19 Intervention Three Basic Steps: 1. Show you care 2. Ask about suicide 3. Get help You Can Help Slide 20 20 Intervention: Step One Show You Care Show You Care Be Genuine Be Genuine You Can Help Slide 21 21 Show you care Show you care Take ALL talk of suicide seriously Take ALL talk of suicide seriously If you are concerned that someone may take their life, trust your judgment! If you are concerned that someone may take their life, trust your judgment! Listen Carefully Listen Carefully Reflect what you hear Reflect what you hear Use language appropriate for age of person involved Use language appropriate for age of person involved Do not worry about doing or saying exactly the "right" thing. Your genuine interest is what is most important. Do not worry about doing or saying exactly the "right" thing. Your genuine interest is what is most important. You Can Help Slide 22 22 Be Genuine Be Genuine Let the person know you really care. Talk about your feelings and ask about his or hers. Let the person know you really care. Talk about your feelings and ask about his or hers. "I'm concerned about you how do you feel?" "I'm concerned about you how do you feel?" "Tell me about your pain." "Tell me about your pain." "You mean a lot to me and I want to help." "You mean a lot to me and I want to help." "I care about you, about how you're holding up." "I care about you, about how you're holding up." "I'm on your sidewe'll get through this." "I'm on your sidewe'll get through this." You Can Help Slide 23 23 Intervention: Step Two Ask About Suicide Ask About Suicide Be direct but non-confrontational Be direct but non-confrontational Talking with people about suicide won't put the idea in their Talking with people about suicide won't put the idea in their heads. Chances are, if you've observed any of the warning signs, heads. Chances are, if you've observed any of the warning signs, they're already thinking about it. Be direct in a caring, non- they're already thinking about it. Be direct in a caring, non- confrontational way. Get the conversation started. confrontational way. Get the conversation started. You Can Help Slide 24 24 You Can Help You do not need to solve all of the person's problems just engage them. Questions to ask: You do not need to solve all of the person's problems just engage them. Questions to ask: Are you thinking about suicide? What thoughts or plans do you have? Are you thinking about harming yourself, ending your life? How long have you been thinking about suicide? Have you thought about how you would do it? Do you have __? (Insert the lethal means they have mentioned) Do you really want to die? Or do you want the pain to go away? Slide 25 25 Ask about treatment: Ask about treatment: Do you have a therapist/doctor? Are you seeing him/her? Are you taking your medications? You Can Help Slide 26 26 Intervention: Step Three Get help, but do NOT leave the person alone Get help, but do NOT leave the person alone Know referral resources Know referral resources Reassure the person Reassure the person Encourage the person to participate in hel