notice me! understanding depression and suicide summit county suicide prevention coalition summit...

NOTICE ME!Understanding Depression

and Suicide

Summit County Suicide Prevention CoalitionSummit County ADM Board

Andrea DentonSeptember, 2011

Apr 19, 2023 Gatekeeper Training 2

WHY ARE WE HERE?

We care about what is happening to our community….our families and our friends.

We don’t want any more tragedies.

We want to make a difference.

Apr 19, 2023 Gatekeeper Training 3

AND BECAUSE…

We are some of the people that others look up to for answers when life is confusing.

We are trying to figure out why someone would find life so painful that death becomes the way to resolve the situation.

Apr 19, 2023 Gatekeeper Training 4

WHAT WE HOPE TO LEARN

The impact of suicide within the community.

The connection between depression and suicide

The myths and misconceptions about suicide.

The risk factors and signs of suicidal behavior.

Finding help for those at risk.

Apr 19, 2023 Gatekeeper Training 5

A BASIC UNDERSTANDING…Many people are uncomfortable discussing suicide.

We fear the topic.

We don’t understand it

BUT, KNOWLEDGE IS POWER!The more we know…the more we can help.

Apr 19, 2023 Gatekeeper Training 6

OUR LANGUAGE MATTERSWe can take the judgment out of our language by

using phrases like:

“died by suicide”

“death by suicide”

“completed suicide”

Instead of saying “committed suicide”

Apr 19, 2023 Gatekeeper Training 7

It ranks 11th as a cause of death in America.

As many as 25% of adolescents and 15% of adults consider suicide at some point in their lives.

More people die using firearms than by any other method.

A PERSPECTIVE ON SUICIDE

Apr 19, 2023 Gatekeeper Training 8

A suicide attempt is a desperate cry for help to end hopelessness and excruciating, unending, and overwhelming pain.

Suicidal people don’t necessarily want to die. They want their pain to end.

Apr 19, 2023 Gatekeeper Training 9

94.8 people die by suicide every day in the U.S.

34,598 people died of suicide in 2007 in the U.S.

65 people died of suicide in Summit County in 2010.

Nationally, one person dies of suicide every 15.2 minutes.

IS SUICIDE REALLY AN ISSUE?

Apr 19, 2023 Gatekeeper Training 10

These statistics are the best we have, but there may be as many as 2 to 3 times more people who complete suicide than are reported.

For every 1 homicide, 2 people complete suicide.

THE SIZE OF THE PROBLEM

Apr 19, 2023 Gatekeeper Training 11

U.S. SUICIDE STATISTICS - 2007 Rates per 100,000

National Average 11.5 Caucasian Males 20.5 African American Males 8.4 Caucasian Females 5.4 African American Females 1.7 Elderly (65+ years) 14.3 Children (5-14) .5 Youth: (15-24) 9.7

Apr 19, 2023 Gatekeeper Training 12

GENDER ISSUESFemales: Make attempts 4 times as often as men.

Their risk rises until midlife, then decreases.

Males: Complete suicide 4 times as often as women.

Their risk is always higher than women and continues to rise until end of life.

DEPRESSION AND SUICIDE

Their Relationship………..

Apr 19, 2023 Gatekeeper Training 15

THE STORY

It is estimated that as many as 90% of suicidal people suffer with a depressive illness, either diagnosed or undiagnosed.

Upon reaching puberty, statistics show girls are affected by clinical depression twice as often as boys. However, some feel that perhaps boys are just not diagnosed as quickly or easily.

Apr 19, 2023 Gatekeeper Training 16

Just as a person with diabetes has low insulin production, a person with depression suffers from the mind’s inability to function correctly.

Depression and stress can cause changes in the physical structure of the brain and damage to brain cells.

The symptoms of depression can be mild to severe for any individual person.

FAULTY WIRING

Apr 19, 2023 Gatekeeper Training 17

A moral failing A spiritual weakness “The coward’s way out” A selfish act

But, after years of brain research, we now know that the symptoms of depression have a biological basis.

SUICIDE HAS BEEN VIEWED AS…

Apr 19, 2023 Gatekeeper Training 18

Medications help to repair the damage to nerve connections. It may take 4 to 6 weeks for them to be effective.

Counseling helps to teach new coping and problem-solving skills and different ways to interpret stressful events. Counseling can change negative ways of thinking that can lead to suicidal thoughts.

TREATMENT FOR DEPRESSION

Apr 19, 2023 Gatekeeper Training 19

For most people, the best treatment is medication and counseling combined.

Some people can also benefit from group therapy, support groups and other social supports.

Treatment is designed specifically for the individual.

Watch the person carefully for at least six months.

Apr 19, 2023 Gatekeeper Training 20

WITHOUT TREATMENT?

Risk of increased alcohol and drug use.

Significant relationship issues.

Lost school days or work days and inability to plan for future.

Higher risk for suicidal thoughts, attempts and death.

Apr 19, 2023 Gatekeeper Training 21

WHAT DO WE WATCH FOR?Depressed or Irritable Appearance

Frequent crying Unhappy presentation Angry outbursts Wears dark or monotone clothing Writes, reads or listens to music with violent or

depressive themes Truancy becomes a problem

Apr 19, 2023 Gatekeeper Training 22

Withdrawal from favorite activities or people Changes in friends Poor hygiene Moves more slowly or can’t sit still Rapid changes in weight Changes in sleeping habits No energy to manage duties Physical complaints Inability to concentrate

AND……

Apr 19, 2023 Gatekeeper Training 23

MORE PROBLEM BEHAVIORS

Acting out a will

Talking about death and dying

Making verbal threats: “I’m no good to anyone”; “I can’t go on without____”; I wish I were dead.”

Looking for methods, weapons…creating a plan.

Apr 19, 2023 Gatekeeper Training 24

“What is wrong with______? He or she seems so different from the way they used to be.

If this happens, look at the patterns of behavior and see what your gut reaction tells you.

LISTEN!

Apr 19, 2023 Gatekeeper Training 25

BE ESPECIALLY WORRIED IF…

The person made a prior suicide attempt.

They lost someone to suicide.

They are using or abusing substances.

They have had a recent loss (relationship, family death, job, pet, freedom).

They are in trouble anywhere.

Apr 19, 2023 Gatekeeper Training 26

OR…

They are struggling with sexual orientation issues.

Four times higher risk for suicide than their heterosexual peers

More frequent and more lethal suicide attempts

Significantly higher rates of depression, substance abuse and suicidal ideation

Apr 19, 2023 Gatekeeper Training 27

OR……

They have an illness that makes them feel different, especially if it is newly diagnosed.

They express hopelessness about life.

They are in emotional pain and can’t see that things will improve.

RISK FACTORS

AND PROTECTIVE FACTORS

Apr 19, 2023 Gatekeeper Training 29

RISK FACTORS

GENETICS Depression can run in families. A family history of suicide increases risk by 6 times.

ENVIRONMENT People are affected by psychological trauma, abuse,

chronic illness, medications or the problem-solving techniques of others.

SITUATIONAL FACTORS Violence, illness, sudden loss or any severe shock to

the system can bring on suicidal feelings.

Apr 19, 2023 Gatekeeper Training 30

MORE SITUATIONAL FACTORS

Substance use Access to firearms or other lethal means Significant loss (like death, separation, divorce,

break up, etc.) Social isolation, feeling alone or picked on. Feeling trapped or like a burden

History of violence, aggression or impulsiveness

Apr 19, 2023 Gatekeeper Training 31

Restricted access to lethal means.

Support of family and friends. Having coping skills

Community support like belonging to church, groups or organizations.

Ongoing medical and/or mental health care relationships.

PROTECTIVE FACTORS

Apr 19, 2023 Gatekeeper Training 32

Beliefs that discourage suicide and support self-preservation

Future plans; sees self in the future

Sense of purpose

Is ambivalent (struggling with whether to live or die)

Is able to connect with people and seek help

AND…

MYTHS AND FACTS

Apr 19, 2023 Gatekeeper Training 34

MYTHS AND FACTS

Sorting out the truth……..

Knowing what to believe…..

Sharing your expertise……

Apr 19, 2023 Gatekeeper Training 35

FACT vs. MYTH…

MYTH: A person who threatens suicide won’t really follow through.

FACT: Almost 80% of people who complete suicide have talked about it with someone before they die by suicide. Students are particularly good at sharing with friends so friends need to be told to not keep someone’s suicidal feelings a secret.

Apr 19, 2023 Gatekeeper Training 36

FACT vs. MYTH…

MYTH: No one I know would do that.

FACT: Suicide is an equal opportunity killer. Rich, poor, successful, unsuccessful, beautiful, ugly, young, old, popular, and unpopular people all die of suicide.

Apr 19, 2023 Gatekeeper Training 37

FACT vs. MYTH…

MYTH: Once a person decides to die nothing can stop them. They really want to die.

FACT: Most people actually want to be stopped. Most individuals want to end the pain, not their lives. They often feel there is no hope.

Apr 19, 2023 Gatekeeper Training 38

FACT vs. MYTH…MYTH: Asking someone if they are suicidal might

cause a person to think about suicide or to attempt suicide.

FACT: It is helpful to talk openly with someone who is having suicidal thoughts. Many people are relieved at the chance to talk about the thoughts. You will not put the idea of suicide into someone’s head.

Apr 19, 2023 Gatekeeper Training 39

FACT vs. MYTH…

MYTH:

They are just trying to get attention.

FACT:

They are trying to get help. We must recognize that need and respond to it.

AMBIVALENCE

Apr 19, 2023 Gatekeeper Training 40

I’M NOT A PSYCHIATRIST…

…WHAT CAN I DO?

Apr 19, 2023 Gatekeeper Training 42

WHAT CAN I DO?

Think of depression as an illness, like heart disease.

Try to understand that the person is feeling serious pain.

Think of suicidal thoughts as a crisis in that illness, like a heart attack.

Apr 19, 2023 Gatekeeper Training 43

WHAT IF…

We weren’t afraid to ask for help for ourselves and the people we care about?

We no longer had to feel ashamed of feelings of despair and hopelessness, but recognized them as symptoms of a brain disorder?

Apr 19, 2023 Gatekeeper Training 44

WHY DON’T WE HELP? Most of us are afraid of getting a “yes” answer if

we ask about suicide. We think we don’t know how to help.

Some of us believe that suicide and depression are not our business or responsibility.

Remember that most suicidal people are very ambivalent. They want help for the pain but

don’t know how to ask for it.

Apr 19, 2023 Gatekeeper Training 45

A METHOD WE CAN USEDr. Paul Quinnett suggests learning QPR,

similar to CPR:Question Persuade

Refer

for those times when we realize that someone needs help for dealing with their pain but

they don’t know how to ask for it.

Apr 19, 2023 Gatekeeper Training 46

ASK QUESTIONS…BE CURIOUS

“You seem pretty down today.”

“Do things seem hopeless to you?”

“How do you plan to deal with your problem?

“Are you thinking about suicide?”

If you get a “yes” answer, ask more questions.

Apr 19, 2023 Gatekeeper Training 47

HOW MUCH RISK IS THERE?To find out if the person is in immediate danger. Ask or

think about…

Has the person attempted suicide before?

Does the person have a plan?

How specific is the plan?

Does the person have access to means of suicide?

Apr 19, 2023 Gatekeeper Training 48

Do remain calm, relaxed and rational.

Do look and listen for warning signs and get help early.

Do get involved and stay involved.

Do talk openly about suicide and encourage expression of feelings.

Do get the person to explain what hurts so badly.

DO…

Apr 19, 2023 Gatekeeper Training 49

Do listen with empathy; show interest and support.

Do take action and remove means.

Do offer hope that alternatives are available.

Ask if they ever felt like this before and how they got through that situation.

DO

Apr 19, 2023 Gatekeeper Training 50

DON’T..

Don’t make moral judgments.

Don’t argue, lecture, or encourage guilt.

Don’t be sworn to secrecy or make promises you can’t keep.

Don’t offer empty reassurances (“You’ll get over this”).

Apr 19, 2023 Gatekeeper Training 51

Don’t minimize the problem (“All you need is a good night’s sleep”).

Don’t keep the information secret.

Don’t dare or use reverse psychology.

Don’t leave the person alone.

Apr 19, 2023 Gatekeeper Training 52

Never Go It Alone

Family/friends School personnel Emergency room staff Law enforcement Family doctor Mental health professionals Clergy Crisis hotlines

Collaborate With Others

Apr 19, 2023 Gatekeeper Training 53

Community Resources

Know how and where to get help before a crisis happens. Have a resource list.

Find out who to go to in your agency or school. Refer the person for professional help and help them

get there. For immediate danger, call 911 for help from the police

and/or paramedics. Ask if there is a Crisis Intervention Team (CIT) officer

available.

Apr 19, 2023 Gatekeeper Training 54

If person is not in immediate danger and can be safely transported, take them to:

Children’s Hospital Medical Center (under age 18)

Any hospital emergency room or Portage Path Emergency Services (over age 18)

For guidance and support: crisis hotlines (24/7):

SUPPORT Hotline (Summit County) (330) 434-9144 Lifeline (From Anywhere) (800) 273-TALK PIRC Program (Children’s Hospital) (330) 543-7472

Apr 19, 2023 Gatekeeper Training 55

FINAL THOUGHTS You may know people with depression.

Have an open discussion about depression and suicide. Invite them to talk.

You would perform CPR if you saw a heart attack victim, remember QPR for suicide emergencies.

Don’t be afraid to “interfere” when someone is dying more slowly of depression.

Apr 19, 2023 Gatekeeper Training 56

BECAUSE OF YOUR POSITION

You might be the only person who recognizes that a person needs help.

Follow your “gut reaction.”

Help reduce the stigma placed on mental illness, suicide and depression.

Be aware of your own vulnerability to depression.

Apr 19, 2023 Gatekeeper Training 57

THE MOST IMPORTANT THING YOU CAN DO

IS TO INSTILL A FEELING OF HOPE

THAT THE PERSON WILL

GET THROUGH THIS ROUGH TIME.

Apr 19, 2023 Gatekeeper Training 58

A PERSON MAY NEVER HAVE EXPERIENCED A DIFFICULT TIME

PREVIOUSLY AND SO THIS MAY FEEL LIKE THE END OF THE WORLD.

DON’T LET IT BE.

Apr 19, 2023 Gatekeeper Training 59

THANKS SO MUCH FOR ALL YOU DO

EVERY DAY TO MAKE THIS A BETTER

WORLD FOR PEOPLE IN THESE

TURBULANT TIMES.

The world is a better place because you care.