Operation S.A.V.E Campus Edition 1
Suicide Prevention Introduction Objectives: By participating in this training you will learn: The scope and importance of suicide prevention The negative impact of myths and misinformation How to identify a Veteran at risk How to effectively communicate with a suicidal Veteran How to gain information to help the Veteran How to refer a Veteran for evaluation and treatment 2
Suicide Prevention Brief Overview Suicide in the U.S. (CDC, 2006) Suicide is the eleventh leading cause of death for all ages: 33,000 suicides occur each year in the U.S. 91 suicides occur each day One suicide occurs every 16 minutes Campus Suicides (CDC, 2007; SPRC, 2004) Suicide is the third leading cause of death for ages 15-24. Rate of suicides for college students: between 6.5 and 7.5 per 100,000 15% of graduate students have seriously considered suicide 15% of undergraduate students have seriously considered suicide Drum, D., Brownson, C., Denmark, A.B., Smith, S. (2009). New data on the nature of suicidal crises in college students: shifting the paradigm. Professional Psychology; Research and Practice, 40(3), 213-222. 3
The Face of Suicide in the U.S. (SAMHSA, 2009) Gender Suicide Prevention Brief Overview Men take their lives at nearly four times the rate of women. Age Suicide is the second leading cause of death among 25-34 year olds. The third leading cause among 15-24 year olds. Persons aged 65 years and older have the highest suicide rate of any age group. One older adult commits suicide every 90 minutes. Veteran Status Veterans may be at even greater risk than those in the general population. 4
Suicide Prevention Brief Overview What do the statistics mean? Veterans are at risk for suicide. We need to do more to reduce their risk. 5
Suicide Prevention Brief Overview VA National Initiatives Research in suicide prevention Best practices in identification and treatment Educating employees at every level Partnering with community based organizations and the Department of Defense Veterans Suicide Hotline Veterans Chat Suicide Prevention Coordinators Local Initiatives Community education/awareness Outreach Add specific campus initiatives Campus Counselors/faculty and advisors Fellow Veteran students 6
Suicide Prevention Myths and Misinformation Myth: Asking about suicide may lead a Veteran to commit suicide. Reality: Asking a Veteran about suicide does not create suicidal thoughts any more than asking about chest pain causes angina. The act of asking the question simply gives the Veteran permission to talk about his or her thoughts and feelings. 7
Myth: Suicide Prevention Myths and Misinformation There are talkers and there are doers. Reality: People who talk about suicide must be taken seriously. Talking about suicide is an important warning sign that further mental health evaluation is necessary. 8
Myth: Suicide Prevention Myths and Misinformation If somebody really wants to die by suicide, there is nothing you can do about it. Reality: Individuals who have survived serious suicide attempts have clearly stated that they wished someone had shown an interest. By supporting the Veteran to get help, you ve gone a long way toward saving a life. 9
Myth: Suicide Prevention Myths and Misinformation A Veteran won t commit suicide because Reality: she has young children at home he has made a verbal written promise The intent to die can override any rational thinking. A suicidal Veteran must be taken seriously and referred for evaluation and treatment. 10
Suicide Prevention General factors that may increase risks: Thoughts about harming self that may include plan & method Previous suicide attempts Alcohol and substance abuse History of mental illness Poor self-control Hopelessness Recent loss (loved one, job, relationship) Family history of suicide History of abuse Serious health problems Sexual identity concerns: especially among men 16-24 Recent discharge from hospital, group home, etc. Demographic factors: White men over 70 years of age are at increased risk 11
Suicide Prevention Veteran specific risks: Frequent deployments Deployments to hostile environments Exposure to extreme stress Physical/sexual assault while in the service (not limited to women) Service related injury 12
Suicide Prevention Operation S.A.V.E. Operation S.A.V.E. will help you act with care and compassion if you encounter a Veteran who is suicidal. The acronym S.A.V.E. helps you to remember the important steps involved in suicide prevention: Signs of suicidal thinking Ask questions Validate the Veteran s experience Encourage treatment and Expedite care 13
Operation S.A.V.E. Importance of Identification: There are a number of warning signs and symptoms. Some of the signs are obvious but others are not. When you recognize one of these sign, it s critically important to ask the Veteran if they are thinking of suicide. 14
Operation S.A.V.E. Signs of suicidal thinking Acute Warning Signs and Symptoms: Threatening to hurt or kill self Looking for ways to kill self Seeking access to pills, weapons or other means Talking or writing about death, dying or suicide Additional Important Warning Signs: Hopelessness Rage, anger, seeking revenge Acting reckless or engaging in risky activities Feeling trapped Increasing drug or alcohol use Withdrawing from family, friends, society Anxiety, agitation Dramatic changes in mood Feeling there is no reason for living, no sense of purpose in life Difficulty sleeping or sleeping all the time Giving away possessions 15
Operation S.A.V.E. Asking the question Know how to ask the most important question: Are you thinking of killing yourself? 16
Operation S.A.V.E. Asking the question DO Do ask the question if you ve identified warning signs or symptoms Do ask the question in such a way that is natural and flows with the conversation DON T Don t ask the question as though you are looking for a no answer. You aren t feeling of killing yourself are you? Don t wait to ask the question when the Veteran is halfway out the door. 17
Operation S.A.V.E. Asking the question Things to consider when you talk with the Veteran: Remain calm Listen more than you speak Maintain eye contact Act with confidence Do not argue Use open body language Limit questions let the Veteran do the talking Use supporting encouraging comments Be honest there are no quick solutions but help is always available 18
Operation S.A.V.E. Validating the Veteran s experience Validation means: Acknowledging the Veteran s feelings Showing the Veteran that you are following what they are saying Recognizing that the situation is serious Not passing judgment Reassuring that you are there to help 19
Operation S.A.V.E. Encourage treatment & Expedite getting help Reassure the Veteran that: Treatment is available There are trained professional available Getting help for suicide is like getting help for any medical problem Every Veteran has the right to care Even if they have had treatment before, it s worth it to try it again If the Veteran tells you they have had treatment before and it has not worked, try asking, What if this is the time it does work? 20
Operation S.A.V.E. Encourage treatment & Expedite getting help Tips to Expedite getting help: Know the process for getting help on your campus. If you don t know the answers to a question the Veteran asks, let them know that you will help find the answer. 21
Operation S.A.V.E. Encourage treatment & Expedite getting help Safety Issues: Never try to negotiate with a Veteran who has a gun. Call campus security at XXXXXX or list campus procedure If a Veteran has taken pills or has cut themselves Call campus security at XXXXXX or list campus procedure If you are speaking with a suicidal Veteran located at your campus - Call campus security at XXXXXXX or list campus procedure If you are speaking to a suicidal Veteran at another location Call 911 or campus security at XXXXXX or list campus procedure Know your campus process for referring Veterans for treatment. If the Veteran is uncooperative or in immediate crisis call for help 22
Operation S.A.V.E. Encourage treatment & Expedite getting help Local (campus) process for getting a student help. If a student refuses help call campus security or the campus Veteran Center or the campus mental health clinic. SPC to tailor this to the process of the individual campus. 23
24
Operation S.A.V.E. Signs of suicidal thinking Exercise #1 - Practice recognizing Signs Gather on groups of two and using the list of warning signs take turns playing the Veteran and the guide. The Veteran will use a warning sign in his/her conversation or demonstrate an act that would indicate one of the signs. The guide has to identify the sign. Keep it brief and simple as possible so each has an opportunity to play the role of Veteran and guide. 25
Operation S.A.V.E. Asking the question Exercise #2 Practice Asking the question Starting with the first row of participants, every participant will stand up and ask the instructor the following: Are you thinking of killing yourself? Discuss 26
Operation S.A.V.E. Asking the question Exercise #3 Things to consider about yourself How would you feel when interfacing with a suicidal person? What personal qualities or beliefs might you have that will assist you when interacting with a suicidal person? Take a few minutes to list at least one helping quality you have and one quality you think you may need to work on when it comes to stressful situations. Personal factors to consider: Anxiety, fear, frustrations, personal, cultural and/or religious values. 27
Operation S.A.V.E. Encourage treatment & Expedite getting help Exercise #4 Role play exercise: Pair up into groups of 3. You will be given an envelope with a scenario inside. One person will play the Veteran, one will play the guide, and one will observe. The observer will take notes on the process, to offer suggestions to the guide at the end of the role play. Each of you should take a turn in the guide role, practicing what you have learned. Just spend a few minutes in each role. 28
Operation S.A.V.E. Encourage treatment & Expedite getting help Exercise #4 Role play exercise: What have you learned? Please share your experience with the class. Was it easy or hard to use good communication skills? Do you think you were able to put the Veteran at ease enough for them to share their story? Did you feel fear or anxiety and how did you deal with it? 29
http://www.mentalhealth.va.gov/college/resources.asp 30
References Operation S.A.V.E. Guide Training VA Edition http://www.suicidepreventionlifeline.org/ http://www.cdc.gov/violenceprevention/suicide/statistics/ http://vaww.mentalhealth.va.gov/suicide.asp http://mentalhealth.samhsa.gov/suicideprevention/elderly.asp http://www.sprc.org/ 31