Appendix D. HANDOUTS FOR LESSON 1: L233 version 1. This appendix contains the items listed in this table-- Title/Synopsis. SH-1, Advance Sheet

Transcription

1 Appendix D HANDOUTS FOR LESSON 1: L233 version 1 This appendix contains the items listed in this table-- SH-1, Advance Sheet Title/Synopsis SH-2, Extracted Material from Suicide Prevention Training Tip Card SH-3, Extracted Material from 805D , Determine an Individual s Suicide Potential SH-4, Extracted Material from Suicide Risk Questionnaire Pages SH-1-1 SH-2-1 thru SH-2-3 SH-3-1 thru SH-3-6 SH-4-1 thru SH-4-3 D-1

2 Advance Sheet Student Handout 1 Lesson Hours This lesson consists of two hours of group discussion. Overview This training will provide you with information and procedures in suicide prevention and intervention. Learning Objective Terminal Learning Objective (TLO). Action: Prepare Junior Leaders for Suicide Intervention. Conditions: Standards: Given the student handouts and the instruction in this lesson. Prepare junior leaders for suicide intervention by-- Analyzing suicide risks, and Explaining some valuable tools available for suicide intervention. ELO A Analyze suicide risks. ELO B Explain some valuable tools available for suicide intervention. Assignment The student assignments for this lesson are: Read SH-1 thru SH-4 Review Military Pathways Website website at: Additional Subject Area Resources None Bring to Class You must bring the following materials to class: SH-1 and SH-4 Pen or pencil and writing paper SH-1-1

3 Student Handout 2 Extracted Material from Suicide Prevention Training Tip Card This student handout contains two pages of extracted material from the following publication: TA , Suicide Prevention Training Tip Card Chapter None Page(s) SH-2-2 and SH-2-3 Disclaimer: The training developer downloaded the extracted material from TDC. The text may contain passive voice, misspellings, grammatical errors, etc., and may not be in compliance with the Army Writing Style Program. SH-2-1

4 Suicide Prevention Training Tip Card This card is to be used as a training aid for the Soldier s and leadership s Suicide Prevention awareness briefs. Most suicides and suicide attempts are reactions to intense feelings of: Loneliness - is an emotional state in which a person experiences powerful feelings of emptiness and isolation. Loneliness is more than just the feeling of wanting company or wanting to do something with another person. Loneliness is a feeling of being cut off, disconnected from the world, and alienated from other people. Worthlessness is an emotional state in which a person feels low, and they lack any feelings of being valued by others. Hopelessness - is a spiritual/relational issue. It often stems from feeling disconnected from a higher power or other people. Connection with a higher power and other people is a key to helping individuals to withstand grief and loss. This connection allows individuals to rebound from most severe disappointments of life. Helplessness is a condition or event where the Soldier thinks that they have no control over their situation and whatever they do is futile such as repeated failures, receipt of a Dear John or Dear Joan letter, etc. Guilt- is a primary emotion experienced by people who believe that they have done something wrong. Depression: Depression is considered when one of the following two elements is present for a period of at least two weeks: depressed mood or inability to experience life pleasures. If one of these elements is identified, depression is diagnosed when five symptoms from the list below are presented over a two-week period. Feelings of overwhelming sadness and/or fear, or the seeming inability to feel emotion (emptiness). A decrease in the amount of interest or pleasure in all, or almost all, daily activities. Changing appetite and marked weight gain or loss. Disturbed sleep patterns, such as insomnia, loss of REM sleep, or excessive sleep (Hypersomnia). Psychomotor agitation or retardation nearly every day. Fatigue, mental or physical, also loss of energy. Intense feelings of guilt, helplessness, hopelessness, worthlessness, isolation/loneliness and/ or anxiety. Trouble concentrating, keeping focus or making decisions or a generalized slowing and memory difficulties. Recurrent thoughts of death (not just fear of dying), desire to just "lay down and die" or "stop breathing, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. Feeling and/or fear of being abandoned by those close to the individual. For some individuals, a combination of many factors may cause depression. For others, a single factor may trigger the illness. Depression often is related to the following: Imbalance of brain chemicals called neurotransmitters - Changes in these brain chemicals may cause or contribute to clinical depression. Negative thinking patterns - People who are pessimistic, have low self-esteem, worry excessively, or feel they have little control over life events are more likely to develop clinical depression. Family history of depression A genetic history of clinical depression can increase one s risk for developing the illness. But depression also occurs in people who have had no family members with depression. SH-2-2

5 Difficult life events Events such as the death of a loved one, divorce, financial strains, history of trauma, moving to a new location or significant loss can contribute to the onset of clinical depression. Frequent and excessive alcohol consumption Drinking large amounts of alcohol on a regular basis can sometimes lead to clinical depression. Excessive alcohol consumption is also sometimes a symptom of depression. Warning Signs: When a Soldier presents with any combination of the following, the buddy or chain of command should be more vigilant. It is advised that help should be secured for the Soldier. Talk of suicide or killing someone else Giving away property or disregard for what happens to one s property Withdrawal from friends and activities Problems with girlfriend/boyfriend or spouse Acting bizarre or unusual (based on your knowledge of the person) Soldiers in trouble for misconduct (Art-15, UCMJ, etc.) Soldiers experiencing financial problems Soldiers who have lost their job at home (reservists) Those soldiers leaving the service (retirements, ETSs, etc.) When a Soldier presents with any one of these concerns, the Soldier should be seen immediately by a helping provider. Talking or hinting about suicide Formulating a plan to include acquiring the means to kill oneself Having a desire to die Obsession with death (music, poetry, artwork) Themes of death in letters and notes Finalizing personal affairs Giving away personal possessions Risk Factors: Risk factors are those things that increase the probability that difficulties could result in serious adverse behavioral or physical health. The risk factors only raise the risk of an individual being suicidal, it does not mean they are suicidal. The risk factors often associated with suicidal behavior include: Relationship problems (loss of girlfriend/boyfriend, divorce, etc.) History of previous suicide attempts Substance abuse History of depression or other mental illness Family history of suicide or violence. Work related problems Transitions (retirement, PCS, discharge, etc.) A serious medical problem Significant loss (death of loved one, loss due to natural disasters, etc.) Current/pending disciplinary or legal action Setbacks (academic, career, or personal) Severe, prolonged, and/or perceived unmanageable stress A sense of powerlessness, helplessness, and/or hopelessness Suicidal Risk Highest When: The person sees no way out and fears things may get worse. The predominant emotions are hopelessness and helplessness. Thinking is constricted with a tendency to perceive his or her situation as all bad. Judgment is impaired by use of alcohol or other substances. SH-2-3 TA

6 Student Handout 3 Extracted Material from 805D , Determine an Individual s Suicide Potential This student handout contains five pages of extracted material from the following publication: 805D , Determine an Individual Suicide Potential, 31 May 2001 Chapter None Page(s) SH-3-2 thru SH-3-6 Disclaimer: The training developer downloaded the extracted material from TDC. The text may contain passive voice, misspellings, grammatical errors, etc., and may not be in compliance with the Army Writing Style Program. SH-3-1

7 Report Date: 25 Jul 2012 Summary Report for Individual Task 805D Determine an Individual's Suicide Potential Status: Approved DISTRIBUTION RESTRICTION: Approved for public release; distribution is unlimited. DESTRUCTION NOTICE: None Page 1 SH-3-2

8 Condition: Given a soldier, family member, or other individual displaying behavior which may or may not reflect suicidal intentions or tendencies. Some iterations of this task should be performed in MOPP. Standard: Identify at least 3 major danger signs of suicidal ideation, identify the immediate steps to prevent someone from committing suicide and make appropriate referral to helping agencies. Special Condition: None Special Standards: None Special Equipment: None MOPP: Sometimes Cue: None Task Statements None DANGER None WARNING None CAUTION Remarks: None Notes: None Page 2 SH-3-3

9 Performance Steps 1. Suicide is defined as "the deliberate ending of one's own life." 2. Suicide is often associated with significant losses such as: a. The death of a loved one. b. Break up of a close relationship. c. Loss of a job or failure in school. d. Loss of social or financial status. e. Loss of support system or emotional safety. 3. Suicide is often associated with depression. a. Depression is a contributing factor in 75 to 80 percent of all suicides. b. Depression is characterized by social withdrawal, sadness, disappointment, loneliness, loss of pleasure. c. Depression is reflected in changes in behavior, such as: slowing down, neglect of appearance and responsibilities, inability to concentrate, irritability, poor memory, sudden and extreme weight loss or gain, general hopelessness. d. Depression complaints include sleeping disturbances, chronic fatigue, unexplained headaches, digestive disorders. 4. Suicide is often verbalized before a person acts upon his or her intentions. 5. The appropriate steps to take immediately when you think someone is considering suicide are: a. Take all threats seriously. Some verbalizations are subtle. b. Answer all cries for help. Better to explore your suspicions or to offer help not needed than to to regret not doing so later. c. Confront the problem directly. Don't be afraid to ask the person if he or she is considering ending his or her life. d. Tell them you care. The suicidal person feels alone, desperate, and helpless. You can give this person hope be reassuring them you care and that his or her life has purpose and value. e. Get the person professional help. Take the person to the Chaplain, Mental Health Service, or the hospital emergency room. Do not leave him or her alone. (Asterisks indicates a leader performance step.) Evaluation Preparation: Page 3 SH-3-4

10 PERFORMANCE MEASURES GO NO-GO N/A 1. Notices individuals displaying characteristics of suicidal behavior such as: a. Talking about committing suicide. b. Increases their use of alcohol or other drugs. c. Impulsive behavior. d. Depression or worsening depression. e. Explosive episodes of anger. f. Isolation and withdrawal. g. Giving away priced possessions and important belongings. h. Has trouble eating or sleeping. i. Losses interest in their personal appearance. 2. Take appropriate steps when dealing with an individual suspected of suicidal intentions: a. Seek competent help and advice (contact the chaplain, a crisis intervention professional or or qualified medical personnel). b. Take action. Remove means, such as guns, or stockpiled pills. c. Don't be sworn to secrecy. Seek support immediately. d. Do not minimized suicidal thoughts, feelings and behavior, be direct and talk openly about suicide. Also, be willing to listen and allow expressions of feelings. Accept the feelings. e. Ensure suspected drug and alcohol abuse individuals is referred for evaluation and treatment. f. Communicate support, hope and confidence to individual and reduce stress where possible. g. Resolve any conflict in a positive manner where possible. h. Establish a mutually agreed upon plan with medical personnel and other caring agencies for management to deal with any increase or reoccurrence of suicidal thoughts, feelings or behavior. 3. Refers the individual to appropriate helping agencies: a. A Chaplain b. A community mental health agency (Social Work Services) c. A suicide prevention or crisis center (Contact Army Emergency Relief). d. A private counselor or therapist e. A school counselor or psychologist f. A family physician 4. Stays with the individual until other helping/medical agencies arrive. 5. Informs the chaplain. 6. Follows up as appropriate. Supporting Reference(s): Step Number Reference ID Reference Name Required Primary AR Army Chaplain Corps Activities Yes No DA PAM Chaplain Training Strategy No No FM 1-05 Religious Support Yes No JOINT PUB 1-05 Religious Affairs in Joint Operations Yes No PAM SUICIDE PREVENTION AND No No PSYCHOLOGICAL AUTOPSY PAM US ARMY GUIDE TO THE No No PREVENTION OF SUICIDE AND SELF-DESTRUCTIVE BEHAVIOR TC 1-05 Religious Support Handbook for the Unit Ministry Team Yes No Page 4 SH-3-5

11 Environment: Environmental protection is a continual process. Always be alert to ways to protect our environment and reduce waste. Safety: In a training environment, leaders must perform a risk assessment in accordance with FM 5-19, Composite Risk Management. Leaders will complete a DA Form 7566 COMPOSITE RISK MANAGEMENT WORKSHEET during the planning and completion of each task and sub-task by assessing mission, enemy, terrain and weather, troops and support available-time available and civil considerations, (METT-TC). Note: During MOPP training, leaders must ensure personnel are monitored for potential heat injury. Local policies and procedures must be followed during times of increased heat category in order to avoid heat related injury. Consider the MOPP work/rest cycles and water replacement guidelines IAW FM , NBC Protection, FM , CBRN Decontamination. Everyone is responsible for safety. A thorough risk assessment must be completed prior to every mission or operation. Prerequisite Individual Tasks : None Supporting Individual Tasks : None Supported Individual Tasks : Task Number Title Proponent Status 805D Conduct Suicide Awareness Training 805D - Chaplain (Individual) Approved Supported Collective Tasks : Task Number Title Proponent Status Conduct Unit Religious Support 16 - Chaplain (Collective) Obsolete PROVIDE PASTORAL CARE 08 - Medical (Collective) Analysis Perform Religious Crisis Response 16 - Chaplain (Collective) Approved ICTL Data : ICTL Title MOS 56M, Chaplain Assistant Personnel Type MOS Data Enlisted MOS: 56M Page 5 SH-3-6

12 Student Handout 4 Extracted Material from Suicide Risk Questionnaire This student handout contains two pages of extracted material from the following publication: Suicide Risk Questionnaire Chapter None Page(s) SH-4-2 and SH-4-3 Disclaimer: The training developer downloaded the extracted material from litary.pdf. The text may contain passive voice, misspellings, grammatical errors, etc., and may not be in compliance with the Army Writing Style Program. SH-4-1

13 Are you worried about a friend or loved one? Did you know that Suicide Risk Questionnaire Screening for Mental Health, Inc. 70% of people who commit suicide tell someone about it in advance. Sometimes those contemplating suicide talk as if they are saying goodbye or going away forever. One study observed that nearly 50% of suicide victims had a positive blood alcohol level. Between 20 and 40 percent of people who kill themselves have previously attempted suicide. Those who have made serious suicide attempts are at much higher risk for actually taking their lives. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often is expressed instead as a loss of pleasure or withdrawal from activities that were once enjoyable. Answer the following questions for the person you are concerned about: Part I Suicide Risk Questionnaire Have you heard: Life isn t worth living My family would be better off without me Next time I ll take enough pills to do the job right Take my (prized collection, valuables) I don t need this stuff anymore I won t be around to deal with that You ll be sorry when I m gone I won t be in your way much longer I just can t deal with everything life s too hard There s nothing I can do to make it better I d be better off dead I feel there is no way out Have you observed: Getting affairs in order (paying off debts, changing a will) Giving away articles of either personal or monetary value Signs of planning a suicide such as obtaining a weapon or writing a suicide note Nobody understands me nobody feels the way I do Part II Depression Risk Questionnaire Have you noticed the following signs of depression: Depressed mood Change in sleeping patterns (too much/little, disturbances) Change in weight or appetite Speaking and/or moving with unusual speed or slowness Loss of interest or pleasure in usual activities Withdrawal from family and friends Fatigue or loss of energy Diminished ability to think or concentrate, slowed thinking or indecisiveness Feeling of worthlessness, self-reproach, or guilt Thoughts of death, suicide, or wishes to be dead If depression seems possible, have you also noticed: Extreme anxiety, agitation, irritability or risky behavior Racing thoughts, excessive energy, reduced need for sleep Excessive drug and/or alcohol use or abuse Neglect of physical health Feelings of hopelessness Turn this page over to learn what your answers may mean for your friend or loved one and what to do if you believe that you or someone you care about needs help. SH-4-2

14 Questionnaire Interpretation IF YOU CHECKED CIRCLES UNDER Part I only, Part II only, Parts I and II, your friend or loved one may be at risk for suicide and should seek professional help immediately. your friend or loved one may be suffering from depression or bipolar disorder and should seek further evaluation with a mental health professional or his or her primary care physician. the suicide risk is even higher. Strongly encourage your friend or loved one to seek professional help immediately. What to do if you suspect a friend or loved one is suicidal Do take it seriously. 70% of all people who commit suicide give some warning of their intentions to a friend or member of their family. Do be willing to listen. Even if professional help is needed, your friend or loved one will be more willing to seek help if you have listened to him or her. Do voice your concern. Take the initiative to ask what is troubling your friend or loved one, and attempt to overcome any reluctance on their part to talk about it. Do let the person know you care and understand. Reassure your friend or loved one that he or she is not alone. Explain that, although powerful, suicidal feelings are temporary, depression can be treated, and problems can be solved. Do ask if the person has a specific plan for committing suicide, and how far he or she has gone in carrying it out. (Note: asking about suicide does not cause a person to think about or commit suicide. This is a myth.) Do get professional help immediately. Bring your friend or loved one to the nearest emergency room or crisis center. (If the person is already in treatment, contact his or her clinician.) Your friend or loved one will be more likely to seek help if you accompany him or her. Do follow up on treatment. Take an active role in following up with the treatment process and medications. Be sure to notify the physician about any unexpected side effects or changes in behavior. If for any reason you are unsure, uncomfortable, or unable to take action, find a healthcare professional with whom to share your concerns or contact Military OneSource: Stateside or Overseas Whatever you choose to do, the important thing is to make the effort. Don t assume the situation will take care of itself. Don t leave the person alone. Don t be sworn to secrecy. Don t act shocked or surprised at what the person says. Don t challenge or dare. Don t argue or debate moral issues. Take an Anonymous Self-Assessment. Available 24/7. Provided by Screening for Mental Health, Inc. (SMH) With funding from the Department of Defense Office of Health Affairs Contact SMH: One Washington Street, Suite 304, Wellesley Hills MA Phone: Fax: Military@MentalHealthScreening.org Consultants: Ross J. Baldessarini, MD, Kay R. Jamison, PhD. and the American Foundation for Suicide Prevention Copyright 2006-Screening for Mental Health, Inc. All rights reserved. SH-4-3