Amy Cozad, PHN Injury Prevention Specialist Director and Founder of the Kiowa Injury and Teen Suicide Prevention Programs And Area Suicide Prevention Task Force 119 S.E. 1 st Street Suite B & C, Anadarko, OK 73005 (405) 247-5200
Introduction The act of suicide is not seen as moving TOWARD something but, as moving AWAY from unbearable pain. --Most suicidal people don t plan to die. Happily, many are suicidal for a limited time and, if saved from self-destruction, Go on to lead useful lives.
What is Happening Now? An Increase in: Alcoholism/Drugs Domestic Violence/Overall Violence Dysfunctional Relationships/Divorce Lack of Coping Skills & Problem Solving Diseases, Mental Illness, & Health issues A Decrease in: Family Structure and Support Community Care Spiritual or Faith-Based Beliefs
Oklahoma Medical Examiner Reports Suicide has been the second leading cause of death for Oklahomans age 10-24 for 18 of the past 20 years, second only to motor vehicle crashes. (insert about SAMHSA MVC) These rates have been steadily growing over the past 15 years according to this same report. 2006, was our largest year ever with 544 deaths, the amount of suicides under the age of 20 were 33. 525 475 425 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Suicides 501 534 472 512 480 505 492 529 530 523 528 480 516 534 544
Additional Information on M.E. Report The Office of the Chief Medical Examiner of the State of Oklahoma has the sole responsibility for investigating sudden, violent, unexpected and suspicious deaths. This information is supplied to the other state and federal agencies such as the Oklahoma State Department of Health and the Centers for Disease Control and Prevention in Atlanta allows information generated by the medical examiner to be utilized in epidemiological surveillance and development of public health programs. There were over 34 thousands deaths in OK for 2006, Of these deaths only 16,021 where reported to the M.E. Therefore, 46% of all deaths in OK were accurately documented by the Medical Examiner, 54% of the data is unaccounted for. The M.E./Corners/Pathologist; still uses terminology not used by the CDC or Injury Prevention Specialist; such as, Accidental- Undetermined-Inconclusive- and subjective
87 deaths each day by suicide equivalent of a fully loaded jet crash every other day 6
In Oklahoma Suicide is the 2 nd leading cause of death ages 10-34. Males account for 80% of suicides. Although, White males were the majority of these overall deaths, the Native American males ranked second only to the White males. By age, rates are highest in the 30-49 year old age group (this is not typical). Firearms are the leading cause of suicide deaths, followed by suffocation and poisoning. -Suicide Prevention Resource Center (1999-2005)-CDC (2008)
Oklahoma and Suicide For ages 10-24, the suicide death rate for Oklahoma s Native Americans is 50% higher than the rate for the U.S. for all other races (10.5 vs 7.0 per 100,000). With statistical findings from the C.D.C. report that Native American males are four times more likely to commit suicide. Oklahoma ranks 1.2 times higher than the National rate for suicides ages 9-24, in years 2000-2004. For Native Americans in this same age group they ranked 1.0 times higher than the national rate altogether.
Oklahoma Native History Oklahoma has the second highest; population of Native American Indians in the Nation. With (39) federally recognized tribes within its boundaries. Suicide Clusters are a phenomena known to occur only in Indian Country, and affect entire communities.(anadarko-(7) 2007 and (3) 2008, reported by Chief of Police.) In the beginning the entire state was a giant reservation for all of these different tribes. (This maybe the contributing factor resembling areas like Rosebud or Crow creek) Oklahoma is now considered one of the leading states for Native American Indian Suicides and highrisk youth activity.
FACTS about Suicide Survivors 6 Blood relatives are directly affected by a family member that dies by Suicide. Suicide Risk are increased in survivors (4 times greater in children of parents that die by suicide) 1 out of every 62 individuals are a suicide survivor. (Father, Mother, Brother, Sister, Aunts, Uncles, Grandparents, and Cousins) This number does not include colleagues, coworkers, friends, team or school mates, and exspouses. Roughly, 4.4 million people have died by suicide since (1975)
ATTEMPTS Most adults do not die in their attempt, an Average of 25 attempts per 1 completion this rate differs for youth and elderly Youth: 100-200 attempts per 1 completion Elderly: 4 attempts per 1 completion Reportedly Females hold larger number of attempts than males. Estimated over 5 million Americans have attempted suicide, sometime in their life. Recording of attempts are vague, depending upon area, stigmas, and method used by the individual.
Violence Prevention Suicide Prevention is Violence Prevention DV victims make more attempts at least by (20-26%), more than individuals dealing with just depression Violent Families contribute to youth suicide Violent People have a history of self-destructive behavior by (30%) Double Suicides or Murder Suicides Majority of men who has killed their wives and girlfriends usually do so in response to the women s attempt to leave. It is the #1 reason for suicide, for male youth are BREAK-Up's!
High School Behavior Every year, more than 3.5 million high school students think seriously about killing themselves Almost 2 million high school students report having made a prior suicide attempt 484, 500 students report having made an attempt that required medical attention CDC, 2005
Cutting and Piercing According to WISQUARS data base: there are 40 thousand KNOWN records, of youth 10-24 that cut or pierce their body as an act of self harm or high-risk behavior. For the state of OK, only reports 400, in this age group that cut or pierce for this reason. More teenagers and young adults die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease COMBINED
Other 4 of 5 who Suicide complete suicide Facts have talked about it before. Drugs or Alcohol are involved in 2 out of 3 suicides. High Levels of Anxiety or Anger are commonly present just prior to DEATH. -- Relief from stress-escape impossible situations Want people to know how desperate they are. ( cutting )
Depression Very common Increases risk of suicide Impairs academic, social, & work performance Can be successfully treated with psychotherapy and medication How do you know if someone is depressed?
Depressive Symptoms- in Youth & Young Adults Insomnia or sleeps all the time. Can t concentrate, preoccupied or board Weight loss or Weight gain Anhedonia (loss of Pleasure in things) No energy or hyperactive Withdrawn, apathetic, detached from family Feeling worthless, crying, sad Easily agitated, often angry, low frustration tolerance. Poor personal hygiene, feeling of don t care. Dwells on problems/morbid views
Types of Danger Signals in Youth II. Behavior Warnings The giving away of a cherished object in a casual manner. The strongest behavioral warning is an attempted suicide. Taking Risks-With Cars, Weapons, & Sex Many visits to Doctor/Hospitalization Skipping or Missing school often.
Types of Danger Signals in Youth cont d III. Trauma (Trauma related issues often lead toward suicidal ideation or behaviors) Intense conflicts, abuse at home, domestic violence. (Fights at school or Home) Rape or sexual abuse. Recent death of family or friend-(especially if that person had committed suicide, this might set off a chain reaction.) Harassment-Sexual, Racial, Sexual orientation, and Bulling (pay attention to both bully and victims)
The Code of Silence Making a Pact or a Pledge is not the way to go!!! Keeping secrets and confidentiality are two different things. Confidentiality respects the persons right to privacy, while maintaining the right to keep a friend safe. Approximately 80% of teen suicide fatalities, usually occur due to: The Code of Silence did not want to be broken.
Suicidal Crisis Episode 7 Risk is Imminent Risk Level 6 5 4 3 Initial Hazard is Encountered 2 1 Stable Crisis Begins Crisis Peaks Crisis Diminishes Stable Years Days Hours Days Years Approximately 3 weeks
Rate per 100,000 population Suicide rates by ethnicity and age group -- United States, 2000-2005 35 30 25 Eur-Amer NonLatino 20 15 Afr-Amer NonLatino Native American Asian-PI Latino 10 5 0 00-04 05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Age Group in years A recent study by the CDC-showed that Native American and Alaskan Elders hold the lowest suicide rates, but it is the complete opposite with White Elders. And for NAI/AN teens rank the highest in suicide, where the white teens are the exact opposite of this study. (factors that could contribute to these studies)
Rate/100,000 Suicide Rates by Age, Race, and Gender United States, 2003 60 50 White Male AI Male Black Male White Female AI Female Black Female 40 30 20 10 5-9 0 National Center for Health Statistics Note: Non-Hispanic Ethnicity 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Age Group (Years) 60-64 65-69 70-74 75-79 80-84 85+
Suicide Risk Factors Hopelessness Behavioral Problems School Problems Impulsivity Unemployment Withdrawal Poor Interpersonal Communication Depression Anxiety Suicidal Behavior Stigma Limited Social Support Family History Dual Diagnosis Isolation Domestic Violence Child Abuse Personal Losses Suicide Clusters
Suicide Protective Factors Life Skills Hope Healthy Peer/Adult Modeling Resources Available Access Sense of Humor Belonging Interpersonal Competence Sense of Well-being Self-Esteem Strong Group Affiliation Social Support Family Support Cultural Identity Language Help-Seeking Behavior Good Health Safety/Security Acceptance
Basic Concepts About Suicide Most always multi-determined Most want to find a way to live Ambivalence exists until the moment of death (bridge story) Prevention must involve multiple approaches The final decision rests with the individual ~ Quinnett
Resources Suicide Prevention USA National Suicide Hotlines Toll-Free / 24 hours / 7 days a week Crisis Counselors are waiting for your call. National Hopeline Network 1-800-SUICIDE 1-800-784-2433 Reach Out 1-800-522-9054 OK County Crisis Intervention Center 405-522-8100 National Suicide Prevention Lifeline 1-800-273-TALK 1-800-273-8255 COPES (918) 744-4800 Kiowa Teen Suicide Prevention Anadarko, Oklahoma Director- Amy Cozad, PHN Injury Prevention Specialist 119 S.E. 1 st Street, Suite B&C Anadarko, OK 73005 (405) 247-5200 (405) 638-0024 Cell cozad777@att.net Heart Line Oklahoma Suicide Care line 1-405-848-Care Anadarko Indian Health Clinic Dr. Marc Clanton (405) 247-2458 M-F 8-4:30PM Carnegie Indian Clinic (580) 654-1100 M-F 8-4:30PM
But How Can I Help? Start a Crisis Task Force: at School or in your Community. Mentoring Programs: To help you and others. Seek out: Suicide Prevention or Teen Leadership Training and Coping Skills (such as this one) Know your resources: of Help in the Community. Start a Support Group: Bereavement, Tutoring, Depression, ALANON/ALATEEN or Teen AA group Multi-media efforts: Suicide Prevention Ads, Puppet and Drama Troupes. Set Goals and Plans for Life: One Year-Five Year-Ten Years- Twenty Years etc Write them down and read them daily. Wake up every morning and say 3 things you are thankful for, i.e. Sun, Food, Breathe. Etc
Saving the Next Generation Amy Cozad Injury Prevention Specialist and Director of KIPP/KTSP
How can it work? Suicide Prevention Local Task Force/Adult/Teen Partnerships/ Life Skills /QPR/ASIST Trainings/Community Awareness
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