University of Oregon Division of Student Affairs Suicide Task Force Gatekeepers

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University of Oregon Division of Student Affairs
Suicide Task Force Gatekeepers

• University of Oregon
• Suicide
• Prevention on Our Campus

It Touches Us All
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Is Suicide on College Campuses a Problem?

• Is this a problem at the U of O?

University of Oregon Suicide Task Force
Gatekeepers
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Is Suicide on College Campuses a Problem?

• Second leading cause of death among college-age
  students
• Estimated 1,088 occur on campus each year

University of Oregon Suicide Task Force
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Is Suicide on College Campuses a Problem?

• Over the last 60 years, the overall rate of
  suicide among adolescents and young adults has
  tripled
• Third leading cause of death among 15-24 year
  olds

University of Oregon Suicide Task Force
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In 1998, suicide ALONE killed more teen-agers and
young adults than all these diseases COMBINED
Is Suicide on College Campuses a Problem?

• AIDS
• Cancer
• Heart Disease
• Pneumonia

• Birth Defects
• Stroke
• Influenza
• Chronic Lung Disease

University of Oregon Suicide Task Force
Gatekeepers
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Is Suicide on College Campuses a Problem?

• National College Health Risk Behavior Survey
• 10.3 of college students endorsed that they had
  seriously considered ending their own lives
  during the preceding 12 months
• 6.7 had actually made suicide plans.
• However, only 17.6 of college students
  nationwide reported that they had received
  information on suicide prevention from their
  institution

University of Oregon Suicide Task Force
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Is Suicide on College Campuses a Problem?

• We can do better than that.
• As an institution, we can make sure that every
  student on our campus has the information they
  need to prevent suicide
• Although higher education might seem an unlikely
  setting in which to commit suicide, it represents
  the ideal setting in which to prevent it (Joffe,
  2003).

University of Oregon Suicide Task Force
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Is Suicide on College Campuses a Problem?

• The good news
• Our environment is rich in resources
• Both medical and psychological
• College campuses possess many natural allies in
  the prevention of suicide.

University of Oregon Suicide Task Force
Gatekeepers
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Is Suicide on College Campuses a Problem?

• The good news
• The infrastructure of a campus is geared toward
  providing support, feedback, caring and
  assistance toward self-actualization, growth and
  maturation.

University of Oregon Suicide Task Force
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Is Suicide on College Campuses a Problem?

• The good news
• According to statistics, nearly 57 of suicides
  are carried out with a gun
• It has been speculated that campus prohibitions
  against firearm possession also plays a role in
  lowering the rate of suicide as compared to the
  national averages.

University of Oregon Suicide Task Force
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Is Suicide on College Campuses a Problem?

• The good news
• In the Big Ten Student Suicide Study
• On campuses, overall student suicide rate is 7.5
  per 100,000
• National average is 15 per 100,000.
• (Silverman, et al., 1997),

University of Oregon Suicide Task Force
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SUICIDE

• Being on a college campus cuts
• the risk of suicide for a young person
• IN HALF!!!

University of Oregon Suicide Task Force
Gatekeepers
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Myths about Suicide

• There are many commonly-held misconceptions
  about suicide. These myths of suicide often stand
  in the way of providing assistance for those who
  are at-risk.
• By dispelling the myths, those responsible for
  the care and education of young people will be in
  a better position to identify those who are
  at-risk and to provide the help that is needed.

University of Oregon Suicide Task Force
Gatekeepers
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Myths about Suicide

• MYTHMost suicidal young people never seek or
  ask for help with their problems.
• FACTEvidence shows that they often tell their
  school peers of their thoughts and plans.
• Of note, most suicidal persons visit a medical
  doctor during the three months prior to killing
  themselves.

University of Oregon Suicide Task Force
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Myths about Suicide

• MYTHIf a person attempts suicide and survives,
  they will never make a future attempt.
• FACT
• A suicide attempt is regarded as an indicator of
  possible future attempts.
• It is likely that the level of danger will
  increase with each subsequent suicide attempt.

University of Oregon Suicide Task Force
Gatekeepers
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Myths about Suicide

• MYTHThe only effective intervention for suicide
  comes from professional psychotherapists with
  extensive experience in this area.
• FACTAll people who interact with suicidal
  adolescents can help them by way of emotional
  support and encouragement.
• Psychotherapeutic interventions rely heavily on
  family and friends providing a network of support

University of Oregon Suicide Task Force
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Myths about Suicide

• MYTHPeople who threaten suicide are just
  seeking attention.
• FACT
• All suicide attempts must be treated as though
  the person has the intent to die.
• Do not dismiss a suicide attempt as simply being
  an attention-gaining device.
• It is likely that the young person has tried to
  gain attention and, therefore, this attention is
  needed.
• The attention that they get may well save their
  lives.

University of Oregon Suicide Task Force
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Myths about Suicide

• MYTHOnce a person is intent on suicide, there
  is no way of stopping them.
• FACT
• Suicides CAN be prevented. People CAN be
  helped,,
• A suicidal crisis can be relatively short-lived.
  
• Suicide is a permanent solution to what is
  usually a temporary problem.
• AND heres what you can do..

University of Oregon Suicide Task Force
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Myths about Suicide

• MYTHOnce a person is intent on suicide, there
  is no way of stopping them.
• FACT
• Give immediate, practical help
• stay with the person,
• encourage them to talk
• help them build plans for the future
• You can avert the intention to attempt or
  complete suicide.
• - After support is given, appropriate counseling
  with a helping professional to address underlying
  difficulties and lack of effective coping
  mechanisms, can then be helpful

University of Oregon Suicide Task Force
Gatekeepers
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Myths about Suicide

• MYTHSuicidal young people are always angry when
  someone intervenes and they will resent that
  person afterwards.
• FACT- While it is common for young people to be
  defensive and resist help at first, these
  behaviors are often barriers imposed to test how
  much people care and are prepared to help.
• - For most adolescents considering suicide, it
  is a relief to have someone genuinely care about
  them and to be able to share the emotional burden
  of their plight with another person.
• - When questioned some time later, the vast
  majority express gratitude for the intervention.

University of Oregon Suicide Task Force
Gatekeepers
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Myths about Suicide

• MYTHSuicidal young people are insane or
  mentally ill.
• FACT
• Although suicidal adolescents are likely to be
  extremely unhappy and may be classified as having
  a mood disorder, such as depression, most are not
  legally insane.
• However, there are small numbers of individuals
  whose mental state meets psychiatric criteria for
  mental illness and who need psychiatric help.

University of Oregon Suicide Task Force
Gatekeepers
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Suicide One more myth

• MYTHEvery death is preventable.
• FACTNo matter how well intentioned, alert and
  diligent people's efforts may be, there is no way
  of preventing all suicides from occurring

University of Oregon Suicide Task Force
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Suicide Warning Signs

• What you need to know

University of Oregon Suicide Task Force
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Suicide Warning Signs

• Depression or problems with adjustment
• The recent suicide, or death by other means, of a
  friend or relative.
• Preoccupation with themes of death or expressing
  suicidal thoughts.
• Isolation withdrawal
• Increased use of substances

University of Oregon Suicide Task Force
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Suicide Warning Signs

• Giving away of prized possessions, making a will
  or other final arrangements.
• Major changes in sleep patterns- too much or too
  little.
• Sudden and extreme changes in eating habits,
  losing or gaining weight.
• Withdrawal from friends/family or other major
  behavioral changes.

University of Oregon Suicide Task Force
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Suicide Warning Signs

• Personality changes such as nervousness,
  outbursts of anger, impulsive or reckless
  behavior, or apathy about appearance or health.
• Frequent irritability or unexplained crying.
• Lingering expressions of unworthiness or
  failure.
• Lack of interest in the future.

University of Oregon Suicide Task Force
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What you need to know about the college years

• Risky Time
• This time of life is a time at which many of the
  major mental illnesses make their first
  appearance.

University of Oregon Suicide Task Force
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Risky time.

• Onset of schizophrenia is usually in late
  adolescence
• Anorexia nervosa and bulimia are most common in
  this stage of life
• Addictions, particularly to alcohol begin
• Separation/individuation process from family
• First serious romantic relationship

University of Oregon Suicide Task Force
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Suicide Who is at risk?

• Students with pre-existing mental health
  conditions
• Students who develop mental health problems
  during the college years
• Students under the age of 21

University of Oregon Suicide Task Force
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Suicide Who is at risk?

• Malesespecially white males
• Asian and Latino males
• Sexual Minorities
• High achievers, high intelligence

University of Oregon Suicide Task Force
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Suicide Who is at risk?

• Women have more suicidal ideation, gestures and
  attempts but men are more lethal in their
  attempts, and therefore more successful
• More men than women commit suicide. The highest
  risk group of all, seems to be white, older males
• Men are less likely to ask for help, because they
  may see their problems as a sign of weakness

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Suicide statistics
University of Oregon Suicide Task Force
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Oregon Department of Human Services/Health
Statistics University of Oregon Student
Information System
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suicide gender
University Counseling Testing Center Data
Base 4 Year Comparison
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Suicide University Health Center Data

• According to the UHC survey in 2004, out of 405
  surveyed, about 13 state they have considered
  suicide in their lifetime
• Of the 13, about 35 stated they had seriously
  considered suicide in the last 12 months
• Similar to national trends, students age 21 and
  younger were more likely to consider suicide than
  21 and older (42.3 and 28.7 respectively)

University of Oregon Suicide Task Force
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suicide age
University Counseling Testing Center Data
Base 4 Year Comparison
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Suicide High Risk Indicators

• Recent break-up of a relationship
• Significant loss or threat of loss
• Feelings of alienation and isolation
• Drinking excessively or using other drugs

University of Oregon Suicide Task Force
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Suicide High Risk Indicators

• Reckless behavior
• Academic or work difficulties
• Depression
• A previous suicide attempt

University of Oregon Suicide Task Force
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Suicide High Risk Indicators

• Feelings of hopelessness and futility
• History of alcohol and/or drug abuse
• Having a plan and/or means
• Other mental illnesses

University of Oregon Suicide Task Force
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Suicide Types of suicidal/self destructive
behavior

• IDEATION
• Suicidal thoughts, thinking about hurting
  oneself wishing that I just could disappear
• With suicidal ideation, the person has a strong
  idea about suicide being an option for them

University of Oregon Suicide Task Force
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Suicide Types of suicidal/self destructive
behavior

• GESTURE
• A self-destructive act of low lethality usually
  symbolic. Sometimes can include superficial
  cutting on the extremities

University of Oregon Suicide Task Force
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Suicide Types of suicidal/self destructive
behavior

• ATTEMPT
• Serious effort to end ones life

University of Oregon Suicide Task Force
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Suicide The Signs

• More often than not, individuals who are
  considering suicide give some signs of their
  intent
• One warning sign by itself may not mean anything,
  but several signs in conjunction with depression
  lasting more than several days may indicate
  thoughts of suicide

University of Oregon Suicide Task Force
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Suicide Watch the signs...

• Excessive guilt or shame
• Extreme risk taking (usually associated with
  substance abuse)
• Changes in behaviors (i.e., a student who has
  always cared about their academic performance,
  suddenly not appearing for a final exam

University of Oregon Suicide Task Force
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Suicide Watch the signs

• Making final arrangements
• Making statements broadcasting intent (i.e., Im
  going to kill myself or I wish I were dead)
• Suddenly quitting organizations
• A sudden, unexplainable recovery from a long,
  severe depression

University of Oregon Suicide Task Force
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Suicide Situational Signs.specific to
university students

• A student may be more at risk when..
• Being expelled from school, dropped from a
  program, not getting into a program
• A recent unwanted move
• Loss of a major relationship

University of Oregon Suicide Task Force
Gatekeepers
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Suicide Situational Signs

• A student may be more at risk when..
• Loss of financial aid, or other anticipated loss
  of financial security
• Failing a test, poor grades
• Feeling like a burden or letting down parents
• Death of a parent, friend or spouse

University of Oregon Suicide Task Force
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Suicide
Depression and Alcoholwhat you need to know
University of Oregon Suicide Task Force
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Suicide A word about depression and alcohol

• Alcohol and depression do not mix!
• Over 90 of the time, a person who commits
  suicide was depressed
• Quite often, the person ingested alcohol,
  therefore lowering their inhibitions
• Alcohol makes you more depressed, reckless and
  prone to acting impulsively

University of Oregon Suicide Task Force
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Suicide As a member of the university community,
what can you do??

• Be involved
• Foster strong relationships with students
• Serve as a mentor
• If you feel a student is threatening suicide,
  take it seriously assist them getting to a
  helping professional
• Dont be afraid of doing something wrong! Even
  if they turn out to not be suicidal, it is more
  important that you checked it out then worried
  about offending them or being wrong

University of Oregon Suicide Task Force
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Suicide What can you do?

• Talk openly, candidly, and calmly
• Talk to the person alone in a private setting
• Give yourself plenty of time
• Do not promise confidentiality for any reason

University of Oregon Suicide Task Force
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Suicide What can you do?

• Do not be judgmental, appalled or too casual
• Ask are you considering harming or killing
  yourself? The person will probably be relieved
  you asked. Dont be shy about asking it very
  directly!
• If you feel uncomfortable asking, have someone
  else do it
• If you can, find out if s/he has attempted
  suicide before
• Be supportive but dont try the sunny side of
  life approach-sometimes its best to just listen
  and not try to take away the persons feelings or
  jump to problem solving too soon

University of Oregon Suicide Task Force
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Suicide An easy strategy to remember QPR

• Question
• Are you suicidal?
• Persuade
• We need to get you help, suicide is not the
  solution
• Refer
• I am going to contact the Counseling Center and
  we are going to walk you over as soon as
  possible

University of Oregon Suicide Task Force
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Suicide

• Help get the student the help they need.
• INTERVENE

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Suicide If a student is presenting with suicidal
ideation, you should

• Talk to the student, and get the details
• Ask the student directly if they are suicidal
  (Question)
• Convey caring and concern
• Insist that they receive help (Persuade)
• If necessary, walk them over to the Counseling
  Center or University Health Center (Refer) or,
  get a clear commitment from the student that they
  will go on their own to one of these agencies
• Follow up

University of Oregon Suicide Task Force
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Suicide If a student is unwilling to get help

• If a student will not seek help, but does not
  seem IMMINENT..
• 1) You should fill out a suicide report form,
  give as much information as possible
• 2)Someone from the Suicide Screening Team will
  contact you within the next 24 hours to problem
  solve and help decide if more needs to be done

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Suicide If a student is unwilling to get help

• If a student will not seek help, and they do seem
  to BE IMMINENTLY suicidal
• You should call the Counseling Center immediately
  and alert them that you have an emergency
  situation, and intervention is needed
• You can also call the Department of Student Life
  or contact the person who is on pager duty from
  Student Life (this is for after hours) who will
  provide you help and instructions about what to
  do
• If it is after hours, you can call the University
  Crisis Line, DPS or CAHOOTS

University of Oregon Suicide Task Force
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Suicide Vignette

• You receive a call from a student you advise who
  would like to see you right away. The student,
  whose name is Chen, is a 20 year old, third-year
  Asian International student majoring in Biology.
  
• As you already know, Chen has really been
  struggling this term. Normally a straight A
  student in Taiwan, Chen has experienced
  difficulty adjusting, feels like he is not doing
  well, and has been very lonely. He is surprised
  how hard the transition from Taiwan to America
  has been. He feels uncomfortable talking to you,
  but feels desperate about what to do.

University of Oregon Suicide Task Force
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Suicide Vignette

• You also know, that you received a call from
  another student, just 2 hours earlier, who is
  also worried about Chen. This student, said they
  saw Chen earlier in the morning with a bandage
  around his arm, and the student noticed there was
  blood soaking through the bandage.
• When the student asked Chen about it, he
  flippantly said, Im not even good enough to do
  that right, and walked away. The student called
  you to let you know what happened, but asked that
  her name not be used or that Chen be told that
  she told you.

University of Oregon Suicide Task Force
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Suicide Vignette..

• You also know that Chen is hoping to become a
  doctor. His parents want him to be a plastic
  surgeon but Chen really wants to study
  psychology. He is very worried that he will let
  his parents down
• When Chen comes to your office, he does not look
  good, smells of alcohol and is wearing a bandage
  which looks a little bloody.

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Suicide Questions

• What are some of the warning signs in this case?
• What steps would you take?
• What would you do about the other student who
  gave you the information?

University of Oregon Suicide Task Force
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Suicide Prevention Task Force

• A Division of Student Affairs
• University of Oregon

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Suicide Prevention Team

• We are in our third year of a major campus
  campaign to bring visibility to the issue of
  suicide on college campuses
• We will be continuing our training to staff and
  faculty, and, in addition, targeting students
  this next year
• We have update websites of UHC, UCTC, OSL,
  Housing, OIP, OMA and others to ensure good
  information about suicide prevention is included,
  as well as related links

University of Oregon Suicide Task Force
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Suicide What are we doing now?

• The front line interveners (UCTC and UHC) went
  through extensive training, and will continue to
  meet and stay abreast of the best methods to
  intervene on suicide

University of Oregon Suicide Task Force
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Suicide What are we doing now?

• We have adopted a new suicide policy which will
  provide information to all community members
  about how to Question, Persuade and Refer.
• Under our suicide policy, a suicidal student can
  be mandated to 4 professional assessment sessions
  to help get them the resources they need

University of Oregon Suicide Task Force
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Suicide What are we doing now?

• 20 gatekeepers on campus are training every
  faculty and staff member on campus over a 3 year
  periodensuring that every member of our
  community can recognize signs and symptoms of
  suicide and feel competent in
• Questioning, Persuading and Referring
• a student who may be suicidal

University of Oregon Suicide Task Force
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Suicide What are we doing now?

• We have just been awarded a three year federal
  grant, from SAMSHA, to work with in concert with
  all eight universities in the Oregon University
  System to implement suicide prevention on
  campuses state-wide.
• Oregon State
• Portland State
• Oregon Institute of Technology
• Oregon Health Sciences
• Eastern Oregon University
• Western Oregon University
• Southern Oregon University
• University of Oregon

Our partners in Suicide Prevention
University of Oregon Suicide Task Force
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Suicide Conclusion.
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Suicide Some thoughts.

• Suicide touches everyone
• Suicide is a real problem, a real issue.
• It takes all of us, and all of the caring and
  compassion that we have for others, to prevent
  this problem

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Suicide Some more thoughts

• If you are concerned about a student,
  consult/talk to others the burden should
  definitely not be yours alone
• Use the resources available to all of us on
  campus (UCTC, UHC, OSL, etc.) to help you and to
  help the person in need. Dont carry the burden
  alone!

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Get Involved

• Help us in adopting a
• Community standard of self care
• and responsibility
• Dont be afraid to intervene when needed
• Know your campus resources!!

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QUESTIONS
Suicide it touches us all
University of Oregon Suicide Task Force
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Thank you for listening..

• Suicide it touches us all

University of Oregon Suicide Task Force
Gatekeepers