DEPRESSION - SUICIDE Dr.Gregory A. Hudnall Associate Superintendent Provo City School District
Many are giving up heart for the battle of life... as the showdown between good and evil approaches with its accompanying trials and tribulations. Satan is increasingly striving to overcome the Saints with despair, discouragement, despondency and depression. President Ezra Taft Benson
What is depression? A medical disorder that causes a person to feel persistently sad, low or disinterested in daily activities. Feeling sad or blue continues over an extended period of time. Symptoms are caused by an illness with complex genetic and environmental origins - not by flawed attitude or personality.
What does depression look like in children? At Home: Persistent sadness, downcast expression, low mood Persistently decreased interest in activities Sleep & appetite disturbances Feelings of worthlessness Increased fatigue & irritability Increased physical complaints Preoccupation with death or hurting oneself Experimentation with alcohol or drugs
What does depression look like in children? At School: Difficulty concentrating - forgetfulness Impaired ability to plan or use abstract reasoning Social isolation Problem behaviors Heightened sensitivity to perceived criticism Anxiety disorders Learning disorders
Psychological Interventions Individual psychotherapy: can help reduce symptoms Cognitive Behavior Therapy (CBT): teaches new skills to reduce negative thoughts or feelings Parent guidance sessions: help parents manage their child s illness Group psychotherapy: provides safe place to talk with other children School-based counseling: effective in helping the child navigate the demands from school
Biological Interventions (Medicines) Antidepressants Antipsychotic medications Medications should only be started, stopped, or adjusted under the direct supervision of a trained clinician. There is no best medicine to treat depression - all medicines usually reduce rather eliminate symptoms.
Interventions at Home Adjust expectations until symptoms improve Simplify home life Listen to the child s feelings Small steps can make a difference Address comments about suicide Talk as a family about what to say to people outside of the family Help prevent relapse
Depression & Suicide Major depression is the psychiatric diagnosis most commonly associated with suicide. About 2/3 of people who complete suicide are depressed at the time of their death. American Association of Suicidology
2009 Youth Suicides by States 15-24 years Rate per 100,000 population Rank State Rate Rank State Rate 1 Alaska 33.3 26 Missouri 10.5 2 South Dakota 30.5 27 Nevada 10.4 3 Montana 26.5 27 Kansas 10.4 4 New Mexico 24.8 27 South Carolina 10.4 5 Wyoming 23.3 30 Mississippi 10.1 6 North Dakota 20.2 30 Delaware 10.1 7 Colorado 18.4 30 North Carolina 10.1 8 Hawaii 15.1 33 Nebraska 10 9 Utah 14.5 34 Florida 9.7 10 Arkansas 14.1 34 Pennsylvania 9.7 11 Idaho 14 36 Michigan 9.4 12 Arizona 13.7 37 Virginia 9.3 13 Tennessee 13.4 38 Ohio 9.1 14 Iowa 13.3 38 Rhode Island 9.1 15 Kentucky 13.1 38 Maryland 9.1 16 Oklahoma 12.8 41 Georgia 8.9 17 Washington 12.7 42 Connecticut 8.6 18 Indiana 12 43 Louisiana 8.4 19 New Hampshire 11.9 44 Maine 8.2 19 Wisconsin 11.9 45 Illinois 7.6 21 Texas 11.5 46 California 7.4 22 West Virginia 11.4 47 New York 6.8 23 Minnesota 11.3 48 New Jersey 6 24 Oregon 11.1 49 Massachusetts 5.7 25 Alabama 10.8
2009 Suicide Rates - all ages (All rates are per 100,000 population) Rank State Rate Rank State Rate 1 Montana 22.5 27 Mississippi 12.9 2 Alaska 20.5 27 Indiana 12.9 3 Wyoming 20.4 27 Pennsylvania 12.9 4 Idaho 19.7 30 Wisconsin 12.8 5 Nevada 19.1 31 New Hampshire 12.5 6 New Mexico 18.7 31 North Carolina 12.5 6 Colorado 18.7 33 Virginia 12.2 8 Oregon 16.8 34 Delaware 12.1 9 Arizona 16.1 35 Iowa 12 9 Utah 16.1 36 Michigan 11.7 11 South Dakota 15.9 37 Georgia 11.5 12 Oklahoma 15.4 38 Texas 11.3 12 Florida 15.4 39 Rhode Island 11.2 14 Tennessee 15 40 Minnesota 11.1 15 Maine 14.9 41 Louisiana 10.9 16 Arkansas 14.6 42 California 10.3 17 Missouri 14.4 43 Ohio 10.2 18 Alabama 14.3 44 Maryland 9.7 19 Vermont 14 45 Nebraska 9.5 20 West Virginia 13.9 46 Illinois 9.1 20 North Dakota 13.9 47 Connecticut 9 21 Washington 13.8 48 Massachusetts 8 23 Kentucky 13.7 49 New York 7.3 24 Kansas 13.6 50 New Jersey 6.4 24 South Carolina 13.6 51 District of Columbia 4.8 26 Hawaii 13.5
School problems, family history of suicidal behavior and poor parent/child communication were the most notable among adolescents who died from suicide.
Many adolescent suicides occur in the context of a stressful life event, such as a loss, a disciplinary action or romantic breakup. While these stressors are experienced by most teens, they may be the final straw for teens at risk for suicide.
Persons subject to great stresses may lose control of themselves and become mentally clouded to the point that they are no longer accountable for their acts. Such are not to be condemned for taking their own lives. It should also be remembered that judgment is the Lord s. Elder Bruce R. McConkie
What to watch for: Is Path Warm I S P A T H W A R M Ideation: threatening to hurt self; seeking access to weapons; writing, talking or drawing about death Substance abuse: increased Purposelessness: no reason for living Anxiety: agitation, too much/little sleep Trapped: there s no way out Hopelessness Withdrawal: from friends, family & society Anger: rage, uncontrolled anger, seeking revenge Recklessness: engaging in risk activities Mood Change: dramatic mood changes
Verbal Warnings I don t want to be a burden. I m going to end it all. I can t stand it any longer. People would be better off without me.
What to say. Ask. If they have been unhappy lately If they are thinking of hurting themselves If they have plan To describe plan If they have access to pills or a weapon - ALWAYS CONTACT PARENTS -
Determine Risk Level Ask: How would you take your life? Describe the plan. Where is the gun, pills, etc.? Low risk: No real plan No access to gun, pills, etc. High risk: Has detailed plan Access to gun, pills, etc.
When to get help Call 9-1-1 or seek immediate help from a mental health provider when you hear, say or see any one of these behaviors: Someone threatening to hurt themselves Someone looking for ways to kill themselves: seeking access to pills, weapons, or other means Someone talking or writing about death, dying or suicide Call Statewide CrisisLine 1-801-587-3000 National Suicide Prevention LifeLine 1-800-273-TALK (8255) for a referral if person exhibits one or more behaviors
Where to get help School Counselor/Psychologist Family Doctor Local Therapist Clergy Emergency Room Wasatch Mental Health
How Ward Members May Help Train leaders on what to watch for Coach youth to help peers with isolation Teach youth to share concerns with an adult Take any signs or threats seriously Do not be afraid to share concerns with parents
Suicide is a sin - a very grievous one, yet the Lord will not judge the person who commits that sin strictly by the act itself. The Lord will look at that person s circumstances and the degree of his accountability at the time of the act. Elder M. Russell Ballard Ensign, Oct. 1987
Utah County HOPE Task Force Support Programs Educational presentations School programs - HOPE Squads Survivor Group Nondenominational clergy training Statewide suicide prevention conference Annual suicide awareness walk Media training
Provo City School District Statistics Year Attempts & Threats Hospitalized Completions 1999-2000 75 9th grade student & 1 male teacher 2000-2001 Elementary Middle Secondary 3 46 62 No completions 2001-2002 Elementary Middle Secondary 16 33 61 4th grade student & 8th grade student 2002-2003 Elementary Middle Secondary 13 7 23 12 No completions 2003-2004 Elementary Middle Secondary 15 17 21 6 9th grade student & 11th grade student 2004-2005 Elementary Middle Secondary 33 13 88 9 9th grade student
Provo City School District Statistics Year Attempts & Threats Hospitalized Completions 2005-2006 2006-2007 2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 Elementary Middle Secondary Elementary Middle Secondary Elementary Middle Secondary Elementary Middle Secondary Elementary Middle Secondary Elementary Middle Secondary Elementary Middle Secondary 8 18 30 19 8 43 10 6 16 0 8 16 6 3 14 2 7 30 7 7 25 8 No completions 7 No completions 5 No completions 2 No completions 5 No completions 9 No completions 5 No completions
Not long ago I was asked to speak at the funeral of a dear friend who had committed suicide... I know that any fully rational person who contemplates suicide must realize what a terribly selfish act this is. Peace came to me only when I recognized that only the Lord could administer fair judgment. He alone had all the facts, and only He would know the intent of the heart of my friend. M. Russell Ballard Ensign, Oct. 1987