A Focus on Postvention Prevention Efforts: Youth Suicide Contagion

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1 A Focus on Postvention Prevention Efforts: Youth Suicide Contagion Elizabeth A. Perdue Texas A&M University International School Psychology Association Conference 2016

2 My Interests Crisis Trauma Prevention Postvention Prevention efforts Suicide Contagion

3 Marilyn Monroe Possibly one of the most iconic pop culture symbols of sex and promiscuity during the 1950s Glamorous style Impeccable fashion sense Licentious behavior Committed suicide in 1962 Nationwide suicide rate revealed dramatic 12% increase in the month following Monroe s suicide (Stack, 2003) Contagion effect Most recent public health concern regarding death of American actor and comedian, Robin Williams in 2014

4 Suicide Suicide is the second leading cause of death for year olds, and the third leading cause of death for individuals between ages of 10 and 24 (CDC, 2013) One death by suicide every 40 seconds across the globe (CDC, 2013) Suicide etiology/causes of youth suicide Brain chemistry (Arranz, Eriksson, Mellerup, Plenge & Marcusson, 1994) Depression, self-derogation, feelings of worthlessness to be mediators (Harlow, Newcomb, Bentler, 2006) Family dysfunction, intrapersonal psychopathology, stress/distress, interpersonal relationship problems, drug/alcohol abuse, societal pressures, social disadvantages (Lester & Bean, 1992) Cry of pain hypothesis (defeat, no escape, no rescue) (O Conno, 2003) Purpose/glorification of suicide act/suicide martrydom (Pedahzur, 2006) Perfect storm of factors Prevention of suicide in schools Organized programs Hotlines

5 Contagion Theory French sociology, Gustave Le Bon (1896) Communication theory hypnotic impact in crowds, distorting their attitudes, behaviors, and knowledge toward irrational actions (Communication Theory, 2010, p.1) Conformity

6 Suicide Clusters Formed by way of suicide contagion Types of clusters Mass clusters Point clusters Echo clusters Clusters can be both temporal and spatial in nature Proximity, both location and intimacy wise, has been investigated (Gould & Lake, 2013) Media plays a large impact in cluster phenomenon (Gould, Jamieson, & Romer, 2003) Most often seen in adolescent age range (Gould & Davidson, 1988; Gould, Jamieson, & Romer, 2003)

7 So what? Tremendous emphasis on suicide prevention Gap in communication in regards to preventing suicide contagion Research Question: What are the common identifying characteristics or tactics present across prevention efforts targeting suicide clusters or contagion phenomenon?

8 Method ProQuest, EbscoHost, PsychInfo Suicide cluster, crisis prevention/intervention, suicide contagion, adolescents, youth, schools, and/or suicide postvention Inclusion: elementary, middle, secondary/high school-age, successful completion of suicide Exclusion: Hypothetical exposures, celebrity or media exposures No time frame specification *Student or adult acts of suicide 11 studies Case studies

9 Themes Study population Suicide exposure Postvention interventions* Intervention effects

10 Study Population Settings varied from rural to urban to suburban Age varied from elementary (1 study) to middle school to high school Youngest: 4 th grade following teacher suicide Specific focus groups (peer group) to school wide to community wide

11 Suicide exposure Same-age or similar age-range peer, only one focused on teacher/adult suicide exposure (Kneisel & Richards, 1988) Mostly multiple suicides; only one study followed up after one suicide (Brent et. al, 1993) Varied based on number of suicides and time frame

12 Postvention Interventions Debriefings Talking through the event (sharing experiences, voicing concerns, posing questions); Prominent in efforts targeting reducing the risk of PTSD Psychiatric screenings Recognize those at higher risk for psychological distress (depression, anxiety, suicide risk) Psychoeducation Increase understanding and coping skills Counseling Grief counselors; group or individual Multi-component efforts Two or more intervention efforts

13 Intervention Effects No clear connection in connecting intervention efforts with study results Focus on presence of subsequent suicide Evaluated mental health, suicide ideation/talk, qualitative selfreport of student healing and grieving process Some showed improved reports at follow-up, some showed no change, some showed decline in mental health/increase in suicide talk, two showed occurrence of cluster suicides

14 Conclusions Multi-component interventions recommended Magical number around 3-5 components More may overwhelm the students Community engagement helps, particularly with more components Pay respects to deceased students, BUT focus should be on current students grieving process and connecting with others Avoid glorification of suicide act

15 Implications Speaks to the need for a more in-depth analysis of preventions targeting suicide contagion Trauma of death for children and adolescents Effects on school climate and student functioning (academic and mental health)

16 Future Directions Publication and evaluation of additional case studies Greater investigation into what works and identification of at-risk students Avoid the menu list of intervention components Be proactively reactive

17 Palo Alto, California Infamously known for spike in suicide clusters Third cluster within a single adolescent generation Recommended Read: The Silicon Valley Suicides: Why are so many kids with bright prospects killing themselves in Palo Alto? he-silicon-valley-suicides/413140/

18 Questions? References available upon request.