Bullying and Youth Suicide Prevention

Judith Springer, Psy. D. Clinical and Professional Board Member, SPTS

• Provide basic information about suicide and suicide prevention.

Discuss relationship between suicide prevention and bullying prevention.

Define educators’ crucial, although limited, role in schools’ suicide prevention efforts

• Review the roles of parents and students in suicide prevention.

Workshop Objectives

Each year, there are approximately 10 youth suicides for every 100,000 youths

in the United States.Each day, there are approximately 11 youth suicides in our country.Every 2 hours and 11 minutes one person under the age of 25 completes

suicide.

One preventable death is one toomany.

A Personal PerspectiveThe other side of facts and figures

Stephanie’s Story

SUICIDAL BEHAVIOR

Attempt to solve a problem of intense

pain with impaired skills

Attempt to solve a problem of intense

pain with impaired skills

CHARACTERISTICS OF SUICIDE

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– (Shneideman, 1985)

Youth Suicide is a Preventable Mental Health Problem

– Research shows that clues or warning signs can be detected by others.

– Research has demonstrated that restriction of lethal means can reduce attempts.

– Clinical evidence identifies suicidal thinking as crisis thinking that can be altered by crisis intervention techniques.

– Evidence demonstrates the effectiveness of medication & cognitive behavioral treatment for symptoms of depression.

• Awareness

• Education about Identification

• Support and Response

Suicide Prevention Strategies

What is a “Competent” Prevention Community?

• Concern for youth suicide prevention is shared by all community members.

• All members can recognize signs of risk.

• The community has a coordinated fabric of prevention activities that are integrated into established community services.

• All members know how and where to get help when a community member is in need, and are willing and able to do so .

THE SCHOOL

Essential Partner in Prevention:

A Limited but Critical Role

What educators need to be able to do

Understand basic information about suicide

Know their role in their school’s suicide prevention strategy

Recognize students who may be at risk

Understand crucial, but limited, role of identification and referral

Red: Warning Signs

Yellow: Risk Factors

Green: Protective Factors

Risk Factors: Non-Clinical• Age• Sex • Race• Sexual orientation• “Giftedness”• Family

– History of suicide– Abuse

• Exposure – To death of peer

• Recent Stressors– Loss– Trouble- E.g. being bullied or bullying others– Change – transition– Access to means

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How can Bullying Affect Students Who are Targeted?

Short-term– Sadness, fear, anger, pain, loneliness, and

embarrassment– School avoidance; academic problems

Long-term– Internal expressions like depression and

eating disorders– External expressions may include poor

grades, aggression and violence– Very rarely but tragically, suicide

attempts and completions; homicide.17

Is Bullying a Suicide Risk Factor?

• What research tells us aboutconnections between bullying and suicidal ideation– Targeted students are 2-9x more likely

to report suicidal thoughts than non-bullied peers.– Students who bully are also at increased

risk for suicidal behavior.– Students who both bully and are bullied are at the highest risk.

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Vulnerabilities for Bullying

• Most common targets:– Sexual orientation– Race– Body Size– Gender presentation

• Other targets: depressed, learning disabled, socially awkward, developmentally delayed, obese

• BOTTOM LINE? These are also risk factors for suicide.

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Association between LGBTQ and Bullying and Suicide

• Rate of suicidal ideation and attempts are higher for sexual minority youth – LGB youth about 3x more likely to make

attempt or ideate than non-LGB youth (Silenzio et al, 2007)

• 50% of sexual minority youth get bullied, threatened, assaulted by peers (D’Augelli, 1998;

Freedman, 2011)

Victimization-Suicidality Pathway

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Clinical Risk Factors

• Psychiatric diagnosis

• Drug / alcohol use

• Previous attempt

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Most Common Diagnoses in Teen Suicide

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MALE FEMALE(N=213) (N=46)

Depression 50% 69%

Conduct Disorder 43% 24%

Anxiety 19% 48%

Substance Abuse 38% 17%18- to 19-year olds* 60–67% 13%

Brent et al. 1999, Shaffer et al. 1996

Access to Means…

Most Preventable Risk Factor

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When Risk Factors Converge

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Demographic

Family

Stressors

Clinical

Exposure

Accessto Means

F = Feelings

A = Actions

C =Changes

T = Threats

S= Situations

Warning Signs

Feelings

• Hopelessness• Anger• Worthlessness• Emptiness• Excessive worry

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Actions• Trying to get access to guns or

pills• Risky or dangerous behaviors• Increasing drug/alcohol use• Getting into fights• Writing suicidal messages on

social networking sites28

Changes

• One of the most significant warning signs in adolescents

• Changes in moods, actions or behaviors

• Recent prescription, change in psychiatric medication

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Threats• Specific verbal statements :I

want to die, I want to kill myself

• Worrisome innuendos• Themes of death /destruction

in school assignments

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Situations• Situations that may serve as a

trigger- when a student’s coping skills are really challenged, especially:–Loss – e.g. family death or divorce; breakup

–Change–Getting into trouble

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• Personal, behavioral,

or situational characteristics that help students become

resilient despite risks.

Protective Factors

• Caring relationship with at least one trusted adult

• Sense of connection/meaningfulparticipation in school

• Positive self-esteem and good coping skills

• Access to care for emotional/physical problems, substance abuse

• Cultural/religious beliefs that discourage suicide and promote self-preservation

Protective Factors

Fostering Protective Factors

• Teach students it is okay to ask for help.

• Give students permission to talk abouttraumatic events like suicide.

• Help students identify trusted adults.

• Encourage participation inschool & community activities

• Acknowledge student efforts

• Be a good listener, as often as you can

Making it Real…

DEALING WITH AT-RISK STUDENTS

BRAD

James

Elena

Conner

Helping At-Risk Students

• Pay attention to who your students are, not just how they perform academically– Notice their appearance– Observe their social skills / relationships– Monitor their behavior changes

Making it Real…DEALING WITH AT-RISK STUDENTS

Brad

James

ELENA

Conner

What About Elementary School Students?

• Suicide by children is very rare.

• About four children in 500,000 kill themselves

every year.

• The suicide rate for 10-14 year olds is on the rise. 

What About Suicide Prevention for Elementary Students?

 

1. Don’t teach “Don’t tattle.’

2. Do teach , “Ask for help if you or someone else is getting hurt” and “Friends help friends.”

3. Focus on promoting helpful behavior and preventing bullying and hurtful behavior.

4. Encourage children to identify least one trusted school adult.

5 Teach social emotional skills – e.g. self-calming and problem-solving skills.

Educators’ Role in Review

• Learningsigns of risk in students

• Identifyingat-risk students

• Referringto appropriate resources

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What About Parents?

Parents need to be able to:

• Understand school’s policies and procedures• Recognize signs of trouble in their children• Know what to do and where to go for resources• Understand how to respond to other at-risk youth

Do Students Have a Role in Suicide Prevention?

• Awareness of warning signs

• Strategies for getting help • personally

• Knowledge of ways to help peers

• Awareness of school and community resources

• Identification of caring adults

Frequently Asked Questionsnswering Common Questions

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Is there any crossover between bullying prevention programs and suicide prevention programs?

Are School Programs That Address Suicide Safe?

Frequently Asked Questions

Frequently Asked Questions

Is Talking about Suicide Just a Way for Someone to Get Attention?

Frequently Asked Questions

Can Talking about Suicide Plant the Idea in the Minds of Vulnerable Teens?

Stacy’s Story

FREE Resources for the Competent Community

• Teacher training online• Parent video- “Not My Kid”• Available free at:

www.sptsusa.org

www.sprc.orgSuicide Prevention Resource CenterNational resource

www.afsp.orgAmerican Foundation for Suicide PreventionPrinted materials & resources

www.suicidology.orgAmerican Association of SuicidologyData, resources, links

www.maine.gov/suicideMaine Youth Suicide Prevention ProgramExtensive resources and information on youth suicide 

Additional Resources

It’s in the Shelter of Each Other…