Applying Research on Suicidal College Students: A Campus Case Study in the use of a Public Health Approach to Suicide Prevention

Transcription

1 Applying Research on Suicidal College Students: A Campus Case Study in the use of a Public Health Approach to Suicide Prevention Marian Trattner, MSW University of Texas at Austin Leah (Horn) Roman, MPH, CHES Suicide Prevention Resource Center American College Health Association Annual Meeting Philadelphia, PA June 4, 2010

2 SPRC and UTA Working Together Support for Campuses Individual consultation/technical assistance Group training events Online library Best Practices Registry (BPR) College & university web pages 2

3 Session Goals Describe the prevalence and nature of suicidal behavior on college campuses. Explain elements of a public health approach to suicide prevention. Discuss how one campus applied public health principles to suicide prevention program development. 3

4 Discussion: What health data do you collect on your campus and how do you use it to inform practice? 4

5 Prevalence and Nature of Suicidal Behavior 5

6 National Suicide Statistics Rate of per 100,000* 19% of campus suicides were current or former center clients** Suicides in CC clients are 3.3 times greater than non clients*** *Silverman, et al (1997) **Gallagher, R. (2009) ***Schwartz, A. (2006) 6

7 Quick Study Characteristics Small selection of study data presented today 26,000+ undergrad and grad responses 25% response rate 70 IHEs participated Random sampling Web based survey 7

8 Demographics: Race / Ethnicity Undergraduate Graduate 4% 0% 2% 5% 4% 6% 4% 0% 11% 4% 5% 4% 79% Caucasian Asian American Latino/a African American Multiracial Alaska Native/American Indian 8 72%

9 Demographics: Sex, Age, Sexual Orientation Undergraduate n=15,010 Graduate n=11,441 Female 62% 60% Male 38% 40% Mean Age 21.5 years 29.7 years Bisexual 2% 1% Gay/Lesbian 2% 1% Heterosexual 95% 98% Questioning 1% 1% 9

10 Suicidality is widespread Which phrase best describes you: Undergrad N= 15,010 Graduate N= 11,441 I have never had suicidal thoughts. 45% 49% One period in my life of having suicidal thoughts. A few discrete periods in my life of having suicidal thoughts. Repetitive episodes of suicidal thoughts with periods in between of no suicidal thoughts. Suicidal thoughts on a regular basis for several years. Have you ever seriously considered attempting suicide? 24% 22% 23% 23% 6% 4% 2% 2% 18% 15% 10

11 Suicidality is often brief Answered by those who have seriously considered attempting suicide in past 12 months Undergrad N=910 Graduate N=411 1 hour or less Several hrs/day 1 day On average, how long did these periods of SI last? Many days 1 week Many weeks 1 month Many months or more

12 Peers are a primary source of support Of those who told others The first person they told Undergrad N= 484 Graduate N= 214 Family 18% 11% Bf/gf/partner/ spouse This person was helpful in dealing with the suicidal thoughts This person advised seeking professional help 30% 41% friend 33% 24% roommate 4% 1% professional 11% 20% 52% 52% 58% 50% 12

13 Reasons for Students Concealing Their Suicidal Thoughts Category N = 769 Percentage Low Risk % Solicitude % Privacy % Pointless % Stigma % Shame 56 7% Repercussions 54 7% Interference 51 7% Perceived Lack of Confidants 25 3% 13 Adryon Buron Denmark s Dissertation (2010)

14 Events rated as having a large impact on seriously considering suicide in the past 12 months Undergrad N=910 Emotional / physical pain Romantic relationship problems Impact of wanting to end my life School problems Friend problems Family problems Financial problems Showing others the extent of my pain Punishing others Alcohol / drug problems Sexual assault 7.82 Relationship violence 5.60 Graduate N=411 Emotional / physical pain Romantic relationship problems Impact of wanting to end my life School problems Financial problems Family problems Friend problems Showing others the extent of my pain Punishing others 8.29 Alcohol / drug problems 6.56 Relationship violence 5.85 Sexual Assault

15 Did the first person you told advise you to seek professional help? Undergraduate and Graduate n = 596 Caucasians 61% Multi Ethnic 52% Latino/a 45% Asian American 40% Alaska Native / American Indian 40% International Student 29% African American 27% Average 56% Data presented by Marty Becker in Ethnicity and Suicidality at APA Boston,

16 Student Advised To Get Help Who Did Receive Help Undergraduate and Graduate N = 331 Asian American 80% Caucasian 72% Latino/a 50% International Student 50% Alaska Native / American Indian 50% African American 43% Multi Ethnic 36% Average 69% Data presented by Marty Becker in Ethnicity and Suicidality at APA Boston,

17 This Study Leads to a Broader Understanding of the Problem Widespread and difficult to detect Thoughts tend to be brief and recurrent Peers primary source of support Groups experience suicidality and help seeking differently Comprehensive approach is needed 17

18 Questions? 18

19 A Public Health Approach to Campus Suicide Prevention 19

20 An Observation Problems occur at multiple levels Individual Interpersonal Institutional Community Society 20 Based on DeJong & Langford, 2002

21 A Logical Conclusion Treatment alone will not solve these problems Individual Interpersonal Institutional Community Society 21 Based on DeJong & Langford, 2002

22 Another Observation Consequences are experienced at multiple levels Individual Interpersonal Institutional Community Society 22 Based on DeJong & Langford, 2002

23 Another Logical Conclusion The solution must be one of the entire campus and community 23

24 Public Health Approach: Fundamentals Intervene at multiple levels Use best practices Think and plan strategically Understand the problem Set goals Evaluate 24

25 *Selected Risk Factors Mental health problems Substance use/abuse Barriers to accessing care Social isolation, or limited or lacking social support and sense of isolation Financial problems Access to lethal means 25 CSCMH, 2009; Eisenberg et al, 2007

26 *Selected Protective Factors Social support Living on campus Married or in domestic partnership Religiosity Counseling 26 CSCMH, 2009; Eisenberg et al, 2007

27 TJF/SPRC* Comprehensive Approach 27 The Jed Foundation; Suicide Prevention Resource Center, 2006

28 Questions 28

29 Discussion: What elements of strategic planning have you completed on your own campuses? E.g., Needs Assessment; Identifying Best Practices; Evaluation 29

30 Using the Public Health Approach: A Campus Case Study 30

31 The University of Texas at Austin Large, urban campus 350 acres 50,000 Students 31% Students of color 9% International Students 21,000 faculty and staff 17 colleges within UT 53 Departments 31

32 Question One HOW DO I BUILD A SUICIDE PREVENTION PROGRAM? 32

33 SPRC Technical Assistance Seminal national publications/data A comprehensive approach Networking Local data Key stakeholders 33

34 Describing the problem BASED ON MY CAMPUS S NEEDS, WHERE DID I CHOOSE TO BEGIN? 34

35 Question Two WHAT IS CONSIDERED BEST PRACTICES FOR SELECTING A TRAINING PROGRAM? 35

36 SPRC Technical Assistance Data Target audience Best practices Goals Capacity/Resources 36

37 Identifying Strategies WHAT DID WE DECIDE TO DO BASED ON OUR NEEDS? 37

38 Question Three HOW DO WE DECIDE THE NEXT STEPS OF OUR PROGRAM? 38

39 SPRC Technical Assistance Capacity Goals Priority audiences 39

40 Setting Goals HOW DID WE DEVELOP OUR COMPREHENSIVE SUICIDE PREVENTION PLAN? 40

41 Key Lessons Learned Don t re invent the wheel. Data is your friend. Build relationships Plan. Plan. And Plan some more. Familiarize yourself with campus policies. Life happens. 41

42 Final Questions 42

43 References Burton Denmark, A. Why do Suicidal Students Avoid Seeking Help? College Students Self Reported Reasons for Concealing Suicidal Ideation and Their Relationship to Attempting Suicide. Ph.d dissertation. The University of Texas at Austin, Becker, M., Ethnicity and Suicidality at APA Boston. Center for the Study of Collegiate Mental Health (2009). Pilot Study Executive Summary. Pennsylvania State University. DeJong, W.; and Langford, L. M. A Typology for Campus Based Alcohol Prevention: Moving toward Environmental Management Strategies. Journal of Studies on Alcohol, supplement no. 14: , Drum, D.J., Brownson, C., Burton Denmark, A., Smith, S.E. (2009). New Data on the Nature of Suicidal Crises in College Students: Shifting the Paradigm. Professional Psychology: Research & Practice. 40(3): Eisenberg, D., Gollust, S.E., Golberstein, E., & Hefner, J.L. (2007). Prevalence and Correlates of Depression, Anxiety and Suicidality among University Students. American Journal of Orthopsychiatry, 77(4), Gallagher, P. R. (2009). National survey of counseling center directors The American College Counseling Association (ACCA). University of Pittsburgh. Schwartz, J. A. (2006). College student suicide in the United States: Through Journal of American College Health. 54(6): Silverman, M., Meyer. P., Sloane, F., Raffel, M., & Pratt, D. (1997). The Big Ten student suicide study. Suicide and Life Threatening Behavior. 27,

44 Contact Information Marian E. Trattner, MSW Suicide Prevention Coordinator The University of Texas at Austin (512) Leah (Horn) Roman, MPH, CHES Senior Campus Prevention Specialist Suicide Prevention Resource Center (617)