Understanding Mental Health

Suicide

Preventing Youth Suicide

Suicide is the second leading cause of death in youth aged 10-24.  (Canadian Mental Health Association, 2012).  A common reaction to learning about a student’s suicide or attempted suicide is to try to find a simple explanation, “his girlfriend dumped him” or “her parents were getting divorced”.  While these may be contributing factors, suicide is actually a complex phenomenon involving the interaction of a variety vulnerabilities including personal, familial and psycho-social. Suicidal thoughts and behaviour represent the culmination of series of emotional stresses and losses resulting in being more fragile, vulnerable and overwhelmed with life challenges. These vulnerabilities and emotional stresses produce intense pain and suffering for the student which leads to increased irrational thinking and behaving. This irrational thinking results in the distorted conclusion that the only way to end the pain and suffering is suicide. The student is unable find reasonable solutions to their problems or recognize that suicide is not a reasonable choice.  What further complicates the situation for youth is that unlike adults, they do not have a history of life experiences where they have been successful in overcoming difficult and challenging events. As well, a common perspective and fear is that the problem will go on forever, that the pain and unhappiness will last forever and that nobody can help them.  Tragically, they may opt for a permanent solution to what may be a temporary problem.
 
Schools are called upon on a daily basis to deal with a variety of challenges and crises experienced by the members of their school communities.  The probability that a school community, teachers, students, parents and administrators will have to deal with students’ suicidal crises is very real.  Suicide is preventable as youth who are thinking of suicide frequently (over 80%) give warning signs of their distress. Teachers, parents and friends are in key positions to pick up these signs and get help.  It is crucial for all school staff to be familiar with and watchful for these signs and to create an environment where youth in distress feel safe sharing this information as well as where peers are encouraged to share their concerns for a friend in difficulty. Effective suicide prevention engages the whole school community and is embedded in a positive school climate that promotes trustful student-adult relationships.

Warning Signs of Suicide

  • Threatening to hurt or kill themselves. Threats may be direct statements (“I want to die.” “I'm going to end it all.”) or indirect comments (“Nobody would miss me.” “Everyone will be better off without me.”)

  • Death and suicidal themes. These might be present in drawings, work samples, journals or homework.

  • Preoccupation with means. Increased interest in guns, knives, pills or other means of killing themselves.

  • Depression (helplessness/hopelessness). Comments or behaviours that indicate that the student is feeling overwhelmed by sadness and expresses a pessimistic view of their future. They see no reason to live or have no sense of purpose in life. They feel trapped and that there is no way out.

  • Reckless behaviour. Engaging in risky activities in an impulsive and non-reflective manner indicating little concern for their own safety. Increased alcohol or substance abuse.

  • Making final arrangements. Putting things in order or giving away prized possessions like clothing, skateboard, I-Pods, jewellery, etc.

  • Sudden and dramatic changes in mood or personality. Changes can include withdrawal from friends and family, skipping class and loss of involvement in activities once important or enjoyed. Changes may also be seen in terms of more anger, rage, or seeking revenge.

  • Changes in physical habits and appearance. Changes include inability to sleep or sleeping all the time, sudden weight loss or gain, disinterest in appearance and hygiene, anxiety and agitation.

  • Inability to concentrate or think clearly. Such problems may be reflected in schoolwork, household chores or even in conversations.

Risk Factors

  • Mental health difficulties including depression, anxiety and trauma

  • Family stress and dysfunction

  • Experience of a major loss, such as death of a loved one, divorce and unemployment

  • Situational crises or experience of major changes in their life

  • Substance abuse

  • Exposure to suicide or previous attempts

Protective Factors

  • Family support and cohesion, including good communication

  • Peer support and close social networks

  • Cultural or religious beliefs that discourage suicide and promote healthy living

  • Adaptive coping and problem-solving skills

  • General life satisfaction, good self-esteem and sense of purpose

  • Access to effective health and mental health service

 

For more comprehensive information on youth suicide prevention, refer to:

School-Based Protocols

In order to respond effectively to troubled students who threaten or attempt suicide, development of detailed school based protocols are required. Protocols should clearly specify who is to be contacted if a student demonstrates suicidal behaviour and what specific steps need to be taken.  Protocols clearly delineate specific roles for crisis intervention for educators and mental health professionals within schools.  

A suicide is one of the most painful and disturbing events for a school community.  Development of protocols to guide interventions (postvention) in schools in the aftermath of a death by suicide outlines how to effectively provide stability and emotional support to those affected by the tragic event.  Protocols detail how to deal with misinformation and rumours that can increase distress putting other students at risk and increasing the risk of suicide contagion.  Each school can develop crisis intervention and postvention procedures and protocols consistent with their school culture and climate with the support of resources available in their school board and community. 

Guidelines for Educators

When a youth who is thinking of suicide comes to you or comes to your attention from peers or other school personnel take immediate action to keep the student safe. Under no circumstances should the student be left alone (even in the washroom).

Be aware of who can help. Schools should identify the individuals who are trained to act on all reports from teachers, other staff and students about a student who may be suicidal.
These individuals are usually the school psychologist, guidance counsellor, nurse or social worker.
 
Collaborate with colleagues. Having support and consultation from another professional or administrator is both reassuring and prudent. The steps to getting the most effective help for the student can at times be involved (who needs to be informed? what are the most effective services available? how to keep the student safe?) and extend beyond the school to home and the community.
 
Mobilize a support system. It is important for the student to feel some control over their fate. To assess the student’s support system it is sensible to ask “who do you want or who do you think can be there for you?” Solicit the student’s assistance where appropriate and inform them of what you are going to do to get them help at every step of the way.

 

For some general guidelines to consider when developing procedures and protocols, please refer to the list below: 

 

 

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