yellow ribbon - network of care...2003 yellow ribbon suicide prevention program ® rev. 6/10 6...

YYELLOW ELLOW RRIBBON IBBON YYELLOW ELLOW RRIBBON IBBON

2003 Yellow Ribbon Suicide Prevention Program2003 Yellow Ribbon Suicide Prevention Program®® Rev. 6/10Rev. 6/10 2003 Yellow Ribbon Suicide Prevention Program2003 Yellow Ribbon Suicide Prevention Program®® Rev. 6/10Rev. 6/1011

Suicide Suicide Prevention Gatekeeper Prevention Gatekeeper TrainingTrainingSuicide Suicide Prevention Gatekeeper Prevention Gatekeeper TrainingTraining

Suicide is PreventableSuicide is Preventable11Suicide is PreventableSuicide is Preventable11

BBee

LLink!ink!

AAsksk44HHelp!elp!Awareness and Training: Awareness and Training: Be a Suicide Prevention Gatekeeper, the Be a Suicide Prevention Gatekeeper, the

trusted adult or helptrusted adult or help


trusted adult or helptrusted adult or help

Readiness and Preparedness:Readiness and Preparedness:

Be a Community Leader, Advocate Be a Community Leader, Advocate

or Stakeholder or Stakeholder

Suicide is PreventableSuicide is Preventable11Suicide is PreventableSuicide is Preventable11


Goals of TrainingGoals of TrainingGoals of TrainingGoals of Training

How to Help (your role)

Who is involved (prepared and ready)


How to Be A Link!® (action steps to help)

Warning SignsWarning Signs How to talk to youth

and teens

Who should be trained?Who should be trained?

E v e r y o n eE v e r y o n e

ALLALL


ALLALL

FactsFacts

�� It is not uncommon for teens to think about suicideIt is not uncommon for teens to think about suicide

One in five teenagers in the U.S. seriously considers suicide annuallyOne in five teenagers in the U.S. seriously considers suicide annually66

�� In the past year, 3 teens (1 boy, 2 girls) in a In the past year, 3 teens (1 boy, 2 girls) in a typical typical


American Association of Suicidology 2006 , State of Colorado Fact Sheets 2006 American Association of Suicidology 2006 , State of Colorado Fact Sheets 2006

�� 3rd leading cause of death for ages 153rd leading cause of death for ages 15--242455

Youth confide more often to peers than to adultsYouth confide more often to peers than to adults66

�� 30,000+ people die by suicide yearly30,000+ people die by suicide yearly77

•••••••• A Suicide every 16 minutes in the U.SA Suicide every 16 minutes in the U.S

In the past year, 3 teens (1 boy, 2 girls) in a In the past year, 3 teens (1 boy, 2 girls) in a typical typical

high school classroom high school classroom have made a suicide attempthave made a suicide attempt44

•• Shouldn’t do suicide prevention after there has Shouldn’t do suicide prevention after there has been a suicide / suicide attempt in community.been a suicide / suicide attempt in community.

1111

MythsMyths


•• Talking about suicide will cause it to happen.Talking about suicide will cause it to happen.1313

•• Suicidal people want to die, we can’t stop them.Suicidal people want to die, we can’t stop them.1414

•• No link between drugs, alcohol and suicide.No link between drugs, alcohol and suicide.1717

British Journal of General Practice 2005, JAMA 2005, British Journal of General Practice 2005, JAMA 2005, HelpguideHelpguide, NAMI , NAMI -- National Association of Mental Illness, APANational Association of Mental Illness, APA

•• Parents or caregivers are cognizant of their child’sParents or caregivers are cognizant of their child’ssuicidal behavior.suicidal behavior.

MythsMyths


•• The behavior is just an attempt to get attention.The behavior is just an attempt to get attention.

•• It is caused by family and social stress rather thanIt is caused by family and social stress rather thanmental health issues.mental health issues.

•• People who attempt suicide get medical attention.People who attempt suicide get medical attention.

School Psychology Review, 2009, Volume 38, No.2 pp. 153School Psychology Review, 2009, Volume 38, No.2 pp. 153--167167

•• People who talk about suicide won’t really do it.People who talk about suicide won’t really do it.

•• Anyone who tries to kill him/herself must be crazy.Anyone who tries to kill him/herself must be crazy.

Common Common MisconceptionsMisconceptions


•• Anyone who tries to kill him/herself must be crazy.Anyone who tries to kill him/herself must be crazy.

•• If the person is determined to kill him/herself,If the person is determined to kill him/herself,nothing is going to stop him/her.nothing is going to stop him/her.

•• People who commit suicide are people who were People who commit suicide are people who were unwilling to seek help.unwilling to seek help.

Suicide Awareness Voices of EducationSuicide Awareness Voices of Education

Risk FactorsRisk Factors are markers; events are markers; events

and situations that can impactand situations that can impacta person’s ability to cope with lifea person’s ability to cope with life

Risk FactorsRisk Factors are markers; events are markers; events

and situations that can impactand situations that can impacta person’s ability to cope with lifea person’s ability to cope with life

Factors of SuicideFactors of Suicide


Warning SignsWarning Signs are observable clues, are observable clues, changes in behaviorchanges in behavior

Protective FactorsProtective Factors buffer individuals buffer individuals from suicidal thoughts and behaviorfrom suicidal thoughts and behavior

1818

Warning SignsWarning Signs are observable clues, are observable clues, changes in behaviorchanges in behavior

Protective FactorsProtective Factors buffer individuals buffer individuals from suicidal thoughts and behaviorfrom suicidal thoughts and behavior

1818

Centers for Disease Control and Prevention (CDC) www.cdc.govCenters for Disease Control and Prevention (CDC) www.cdc.gov

•• Trouble with the lawTrouble with the law1919

Risk FactorsRisk Factors*** Teenage Stress Factors* Teenage Stress Factors


•• Bullied, discriminationBullied, discrimination2121 --gender identity/sexual orientationgender identity/sexual orientation2222

•• Drugs and alcohol useDrugs and alcohol use2020

•• School issues, new school or failingSchool issues, new school or failing2323

Risk FactorsRisk Factors*** Teenage Stress Factors* Teenage Stress Factors


•• Recent trauma, a loss of a loved one, Recent trauma, a loss of a loved one, friend or romance, being depressed, friend or romance, being depressed, sexual abusesexual abuse25, 26, 27 25, 26, 27

•• Family issues Family issues –– divorce, divorce, money, neglect, abusemoney, neglect, abuse2424

Risk FactorsRisk Factors**

Depression can affect thoughts, Depression can affect thoughts, feelings, behaviors and health.feelings, behaviors and health.2626

Depression can affect thoughts, Depression can affect thoughts, feelings, behaviors and health.feelings, behaviors and health.2626

Depression affects an organ of Depression affects an organ of the the bbody ody –– the brain. the brain. Depression affects an organ of Depression affects an organ of the the bbody ody –– the brain. the brain.


National Association of Mental IllnessNational Association of Mental Illness

the the bbody ody –– the brain. the brain. the the bbody ody –– the brain. the brain.

The good news isThe good news is that that

over 80% of cases of over 80% of cases of

depression can be depression can be

successfully treated.successfully treated.2626

The good news isThe good news is that that

over 80% of cases of over 80% of cases of

depression can be depression can be

successfully treated.successfully treated.2626

Warning SignsWarning Signs

•• Trouble concentratingTrouble concentrating

•• Trouble with memoryTrouble with memory

•• Feeling bad about yourself Feeling bad about yourself

Signs of DepressionSigns of Depression

•• Feeling sad and hopeless.Feeling sad and hopeless.

•• Lack of energy, enthusiasm, Lack of energy, enthusiasm, and motivation.and motivation.


American Academy of Child & Adolescent Psychiatry, American Association of SuicidologyAmerican Academy of Child & Adolescent Psychiatry, American Association of Suicidology

•• Feeling bad about yourself Feeling bad about yourself or feeling guilty.or feeling guilty.

•• Feeling that you can’t Feeling that you can’t overcome the difficulties in overcome the difficulties in your life.your life.

•• Trouble functioning.Trouble functioning.

•• Trouble making decisions.Trouble making decisions.

•• Feeling restless, agitated Feeling restless, agitated and irritable.and irritable.

•• Eating more or less than Eating more or less than usual.usual.


•• Increased Increased Alcohol Alcohol and/or and/or drug usedrug use..

Observable CluesObservable Clues

•• Marked Change.Marked Change.

•• Withdrawing, isolating.Withdrawing, isolating.


American Academy of Child & Adolescent Psychiatry, American Association of SuicidologyAmerican Academy of Child & Adolescent Psychiatry, American Association of Suicidology

drug usedrug use..

•• Sleep / Not Sleep.Sleep / Not Sleep.

•• Neglect of Self.Neglect of Self.

•• Dramatic Mood Change.Dramatic Mood Change.

•• Anxiety or Anger.Anxiety or Anger.

•• Withdrawing, isolating.Withdrawing, isolating.

•• Acting reckless.Acting reckless.

•• Frequent complaints.Frequent complaints.

•• Give away possessions.Give away possessions.


•• Falling asleep in class.Falling asleep in class.

•• Poor hygiene.Poor hygiene.

Observable Observable Clues at SchoolClues at School

for at least 2 weeks for at least 2 weeks

•• Neglecting school work. Neglecting school work.

•• Morbid writing in Morbid writing in


American American Foundation for Suicide PreventionFoundation for Suicide Prevention

•• Poor hygiene.Poor hygiene.

•• Dropping out of activities.Dropping out of activities.

•• Late to class or practice.Late to class or practice.

•• Loss of interest.Loss of interest.

•• Frequent headaches, Frequent headaches, stomach achesstomach aches

•• Morbid writing in Morbid writing in assignments.assignments.

•• Rapidly dropping grades.Rapidly dropping grades.

•• Frequent absences.Frequent absences.

•• Marked loss of weight.Marked loss of weight.


Direct Verbal CluesDirect Verbal Clues

““I’m going to kill myselfI’m going to kill myself””

“I wish I were dead”“I wish I were dead”

“My family (or you) would “My family (or you) would be better off without me”be better off without me”

Indirect Verbal CluesIndirect Verbal Clues


Source: John McIntosh, Ph.D., Yellow Ribbon Program Training 2000 Source: John McIntosh, Ph.D., Yellow Ribbon Program Training 2000

“I wish I were dead”“I wish I were dead”

“I don’t want to live”“I don’t want to live”

“If “this” doesn’t happen, “If “this” doesn’t happen, I’ll kill myself” I’ll kill myself”

“Nobody needs me”“Nobody needs me”

“You won’t have to be “You won’t have to be around me much longer”around me much longer”

“I shouldn’t have been born”“I shouldn’t have been born”


Suicidal behaviorSuicidal behavior

Suicidal Ideation Suicidal Ideation –– serious thoughts of suicide viewed serious thoughts of suicide viewed as a precursor to more serious suicidal behavior.as a precursor to more serious suicidal behavior.

Suicidal intent Suicidal intent –– the intentions of the person to die.the intentions of the person to die.


Suicidal intent Suicidal intent –– the intentions of the person to die.the intentions of the person to die.

Suicide Plan Suicide Plan –– the person actually is contemplating a the person actually is contemplating a method and making a plan to act on.method and making a plan to act on.

Suicide attempt Suicide attempt –– self injurious behavior with the intent self injurious behavior with the intent to die. to die.

Suicide Suicide –– self injurious actions resulting in death.self injurious actions resulting in death.


GenderGender

FemalesFemales•• More suicidal ideation than males.More suicidal ideation than males.•• More suicide attempts.More suicide attempts.•• Engage in more protective behaviors such as Engage in more protective behaviors such as

seeking help, being aware of warning signs, having seeking help, being aware of warning signs, having


seeking help, being aware of warning signs, having seeking help, being aware of warning signs, having flexible coping skills and building effective social flexible coping skills and building effective social support systems.support systems.

MalesMales•• Higher rate of completing suicide.Higher rate of completing suicide.•• Choose more lethal methods.Choose more lethal methods.•• Engage less in protective behaviors. Engage less in protective behaviors.


Students who have a suicidal response to bullying Students who have a suicidal response to bullying behavior tend to have prebehavior tend to have pre--existing underlying existing underlying mental health problems such as depression.mental health problems such as depression.

BullyingBullying


mental health problems such as depression.mental health problems such as depression.

Both the bully and the victim are at risk.Both the bully and the victim are at risk.

WWHAT HAT CCAN AN HHELP?ELP?

�� A sense of social connectedness to A sense of social connectedness to others.others.3636

Successes Successes -- things that increase self things that increase self esteem.esteem.3636

Protective FactorsProtective Factors


Maine Youth Suicide Prevention Program, World Health Organization, National Strategy for Suicide PreventionMaine Youth Suicide Prevention Program, World Health Organization, National Strategy for Suicide Prevention

�� Successes Successes -- things that increase self things that increase self esteem.esteem.3636

�� Cultural and religious Cultural and religious beliefs.beliefs.3737

�� Access to Access to resources.resources.3737

�� Be aware, Learn lifeskillsBe aware, Learn lifeskills3939 and Be prepared and Be prepared

How you can helpHow you can help


“…evidence suggests that…openly “…evidence suggests that…openly discussing suicide with a trusted adult can discussing suicide with a trusted adult can lead to more beneficial outcomes for youth as lead to more beneficial outcomes for youth as


lead to more beneficial outcomes for youth as lead to more beneficial outcomes for youth as well as their peers who may be at risk.”well as their peers who may be at risk.”

.

School Psychology Review, 2009, Volume 38, No.2, pp. 153-167

How you can helpHow you can help


Teens have many issues they may need help Teens have many issues they may need help with. Students knowing they can ask for help with. Students knowing they can ask for help


and be taken seriously can decrease the and be taken seriously can decrease the possibility that they will become suicidal.possibility that they will become suicidal.

.

This poster identifies that you are a trusted person This poster identifies that you are a trusted person

Place thePlace theThe The Ask 4 Help!Ask 4 Help! Poster Poster

in your areain your area



This poster identifies that you are a trusted person This poster identifies that you are a trusted person that a teen can come to and Ask that a teen can come to and Ask 4 Help for 4 Help for themselves or themselves or for for a a friend.friend.

Don’t have to have a card to ask for help!Don’t have to have a card to ask for help!

THIS RIBBON IS A LIFELINE!

It carries the message that there are those who

care and will help!

If you are in need and don’t know how to ask for

help, come in, use your yellow ribbon and say:

“I NEED TO USE MY YELLOW RIBBON”


“I NEED TO USE MY YELLOW RIBBON”

The Yellow Ribbon Program is in loving memory of Michael Emme.

I support the Yellow Ribbon Program!I support the Yellow Ribbon Program!I support the Yellow Ribbon Program!I support the Yellow Ribbon Program!I support the Yellow Ribbon Program!I support the Yellow Ribbon Program!I support the Yellow Ribbon Program!I support the Yellow Ribbon Program!

Sutter -Yuba Mental Health Crisis Services 530-673-8255Yuba County Probation Victim and Program Services 530-741-6275

•• Is a tool that helps someone Is a tool that helps someone Ask 4 Help for themselves or Ask 4 Help for themselves or for a friendfor a friend

The Ask 4 Help!The Ask 4 Help! CardCard


(Front)(Front)


for a friendfor a friend

•• And a tool to know how to And a tool to know how to respond if you are asked respond if you are asked for help.for help.

To Ask 4 Help!To Ask 4 Help!®®

Don’t have to have a card to ask for help!Don’t have to have a card to ask for help!

(Back) (Back)

•• You are their lifelineYou are their lifeline



1 - STAY with the person


•• You can help save a life by You can help save a life by being there & showing you carebeing there & showing you care

•• Don’t leave them alone Don’t leave them alone (Unless there is risk of harm)(Unless there is risk of harm)

•• Remember the warning signsRemember the warning signs---- giving things away, have broken giving things away, have broken

relationship/romance, recent lossrelationship/romance, recent loss

To Be A Link!To Be A Link!®®

•• Don’t make light of the problemDon’t make light of the problem


The Ask 4 Help!The Ask 4 Help! CardCard(Back)(Back)

2 – LISTEN really listen


•• Don’t try to solve the problem, Don’t try to solve the problem, your role is to be a linkyour role is to be a link

•• Ask them if they have a planAsk them if they have a plan

•• Ask who they want to talk toAsk who they want to talk to

•• GO to the third step > > > > > GO to the third step > > > > >


Action Steps to Help Action Steps to Help


Be nonBe non--judgmental and nonjudgmental and non--confrontational.confrontational.

Be Supportive. Be gentle.Be Supportive. Be gentle.


Listen.Listen.

Validate.Validate.

.

Suicide Awareness Voices and Education.



If you see warning signs of suicide, you can begin a If you see warning signs of suicide, you can begin a dialogue by letting the student know you are worried dialogue by letting the student know you are worried about him or her. These are questions you can ask:about him or her. These are questions you can ask:


“Do you ever feel so badly that you think about “Do you ever feel so badly that you think about suicide?”suicide?”

“Do you have a plan to commit suicide or take your “Do you have a plan to commit suicide or take your life?”life?”

..

•• CALL someone listed on the CALL someone listed on the front of the cardfront of the card



3 – GET or CALL for HELP(Back)(Back)


front of the cardfront of the card

•• Notify school counselorsNotify school counselors

•• CALL the National Lifeline CALL the National Lifeline 1.800.273.TALK (8255) or 9111.800.273.TALK (8255) or 911


Don’t keep the secret!Don’t keep the secret!

Action Steps to Help Action Steps to Help ((Protocol) Protocol) summary…summary…

Peer/friend Peer/friend goes to:goes to:

Teen goes Teen goes to a peer / to a peer / friendfriend

Who goes to Trusted Help(Who goes to Trusted Help(erer):):

•• Your trusted friendYour trusted friend



•• Trusted AdultTrusted Adult

•• ParentParent

•• GrandparentGrandparent

•• TeacherTeacher

•• ClergyClergy

•• Bus Bus DriverDriver

•• CounselorCounselor

•• FriendFriend

friendfriend

•• -- ••

•• Your trusted friendYour trusted friend

•• Your clergy / counselorYour clergy / counselor

•• Their clergy / counselorTheir clergy / counselor

•• Support persons in your workSupport persons in your work

•• Community Mental HealthCommunity Mental Health

•• Contact in your SchoolContact in your School

•• School CounselorSchool Counselor

•• School PsychologistSchool Psychologist

•• School Crisis Team School Crisis Team



Student or peer of student talks with teacher.Student or peer of student talks with teacher.

Teacher talks with student.Teacher talks with student.

Teacher walks with the student to meet with one of the Teacher walks with the student to meet with one of the guidance counselors.guidance counselors.


guidance counselors.guidance counselors.

Guidance counselor will Guidance counselor will Call the police, if needed to transport to PESCall the police, if needed to transport to PESNotify CPS, if a mandated report needs to be made.Notify CPS, if a mandated report needs to be made.Call parent.Call parent.Help student with resources and connections.Help student with resources and connections.

.



If you are unable to locate the counselor, If you are unable to locate the counselor, you can call Psychiatric Emergency, if you would like to you can call Psychiatric Emergency, if you would like to discuss the situation at 673discuss the situation at 673--8255 (# on card). 8255 (# on card).


discuss the situation at 673discuss the situation at 673--8255 (# on card). 8255 (# on card).

Let them know, if it is an urgent matter. Let them know, if it is an urgent matter.

Notify the Psychiatric Emergency counselor that you are Notify the Psychiatric Emergency counselor that you are calling regarding the Yellow Ribbon Project.calling regarding the Yellow Ribbon Project.

Let the counseling office and administrators know.Let the counseling office and administrators know.



Sutter Yuba Psychiatric Emergency Services (PES) Sutter Yuba Psychiatric Emergency Services (PES) assesses for danger to self or others. They, as well as assesses for danger to self or others. They, as well as law enforcement, may place people on a 5150 hold for 72 law enforcement, may place people on a 5150 hold for 72 hours. A doctor is on staff who can release that hold. A hours. A doctor is on staff who can release that hold. A


family can also take the child home AMA (against family can also take the child home AMA (against medical advice). medical advice).

Children at high risk may be hospitalized. Most children Children at high risk may be hospitalized. Most children are assessed and sent home with a plan for safety and are assessed and sent home with a plan for safety and information about obtaining followinformation about obtaining follow--up mental health up mental health services.services.

Issues to Keep in MindIssues to Keep in Mind


Confidentiality of the student. Confidentiality of the student.

Child Abuse mandated reporting.Child Abuse mandated reporting.


Child Abuse mandated reporting.Child Abuse mandated reporting.

Talking with parent.Talking with parent.

A child 12 years or older has the right to seek treatment A child 12 years or older has the right to seek treatment without parental involvement.without parental involvement.



If you decide the student is not in danger of suicide, If you decide the student is not in danger of suicide, offer to assist them in making a connection with offer to assist them in making a connection with


offer to assist them in making a connection with offer to assist them in making a connection with resources. Be sure to follow through.resources. Be sure to follow through.


It just takes one to make a difference!It just takes one to make a difference!


Yellow Ribbon Card has no expiration date!Yellow Ribbon Card has no expiration date!

The Yellow Ribbon Suicide Prevention ProgramThe Yellow Ribbon Suicide Prevention Programis sponsored in Sutter and Yuba Counties byis sponsored in Sutter and Yuba Counties by

The Prevention and Early Intervention Program The Prevention and Early Intervention Program atatSutter Yuba Mental Health Sutter Yuba Mental Health andand

the local chapter of the local chapter of Mental Health AmericaMental Health America


the local chapter of the local chapter of Mental Health AmericaMental Health AmericaIt is also supported byIt is also supported by

Yuba County Probation Victim and Program ServicesYuba County Probation Victim and Program Services

John Floe, MAOMJohn Floe, MAOMPrevention ServicesPrevention Services

CoordinatorCoordinator

Jason RoperJason RoperProgram ManagerProgram Manager

Yuba CountyYuba County

ContactsContacts


CoordinatorCoordinatorSutter YubaSutter Yuba

Mental HealthMental Health674674--1885 ext. 1141885 ext. 114

[email protected]@co.sutter.ca.us

Yuba CountyYuba CountyVictim WitnessVictim Witness

[email protected]@co.yuba.ca.us

Yellow Ribbon Suicide Prevention ProgramYellow Ribbon Suicide Prevention Program®®

PO Box 644, Westminster, CO 80036PO Box 644, Westminster, CO 80036


(Home Office: Orchard Court School, Adams County SD 50)(Home Office: Orchard Court School, Adams County SD 50)

303.429.3530 Fax 303303.429.3530 Fax 303--426426--44964496

www.yellowribbon.org ~ www.yellowribbon.org ~ [email protected]@yellowribbon.org

Facebook and Twitter @yellowribbon1Facebook and Twitter @yellowribbon1

yellow ribbon - network of care...2003 yellow ribbon suicide prevention program ® rev. 6/10 6...

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