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Suicide
The Last Great Stigma

Judy Gabert, M.Ed., MA Counseling
Suicide Prevention Action Network of Idaho
501 (c)3, only statewide suicide prevention group
www.spanidaho.org


Information about Assessment and the
Nature of Suicide are cheerfully
Stolen from Dr. Thomas Joiner, FSU
Dr. David Rudd, U of T, formerly U of U
Most information on pre-,post- and
intervention are at www.spanidaho.org
Objectives
Idaho and suicide
Understand what is known about suicide
Youth Suicide
Warning signs and risk and protective factors
Schools and suicide (pre-, inter-, and postvention)
Assessment
Workplace Activities
Resources


Myth sheet, what do you know about suicide?
Take a few minutes to fill it out. When we
finish, we will compare changes in your ideas
about suicide.


Please let us know if at any time you become
too uncomfortable with this subject.
A psychologist returned home from a
conference in Aspen, where all the
psychologists were permitted to ski for
free. Her husband asked her how it
went. She replied, "Fine, but I've never
seen so many Freudians slips."
General Information
Suicide is preventable.
It is a permanent solution to temporary
problems.
Prevention is everyones responsibility.
Idaho has a Suicide Prevention Plan, available
at spanidaho.org
The US rolled out its newest strategy in June,
as more than 40,000 people died by suicide
in 2010.
National Suicide Prevention Day is Sept. 10.
Idaho Suicide Data
In 2010 Idaho had the 6th highest suicide
rate in the nation--49% higher than the
national average. In 2009, we were 4
th
in the
nation.
Canyon County had the highest county per
capita rate for deaths by suicide in 2011 with
37 deaths.
Note that the years are different on stats as
SPAN re-does stats yearly.

Why are Idahos rates high?
Generally Idaho is in the top ten for
deaths by suicide as are Wyoming,
Montana, Alaska, Arizona, and Nevada.
In 2010, Oregon joined us at 7th.
Washington no longer dwells in the top
10. Other high rate states are Colorado,
Utah, and New Mexico.
Why?
Much rural/frontier area, aloneness
Attitude about mental health (stigma and
rugged individualism)
Access to affordable mental health
High numbers of gun ownership; most lethal
means (In 2011, 59% of deaths in Idaho were
by firearm)
Also, tend to have more males per capita in
rural areas.


US Suicide rates

Although suicide is rare--in 2011, 284 people died by suicide--its
impacts are powerful, affecting family, friends, communities,
and work places and/or schools. However, if a 747 fell from the
sky once a year killing this many people, how would we
respond?
Idaho ranks 50th in the number of doctors per capita. From 40-
45% of suicide victims see their primary care physician in the
two months before they die. Its debated that 70% see mental
health clinicians in the year before they die.
Idaho ranks 51
st
for dollars spent on mental health.
All of us are more likely to know someone who has died by suicide
than someone who died in a car accident; we are more likely to
know someone who has made a serious attempt than someone
who is seriously injured in a car accident.



Dr. Joiners Interpersonal
Explanation of Suicide
Desire to Die

Perceived
burdensomeness
Thwarted belongingness
Acquired Ability to Self-
harm (habituation to pain)
Learned ability
Repeated self-harm--
whether accidental or
intentional
Witnessing repeated
emotional or physical pain
Abuse, especially when
young
Sketch of Interpersonal Explanation for Suicide
Perceived
Burdensomeness
Thwarted
Belongingness
Those Who Are Capable of Suicide
Acquired Ability
for Self-Harm
Habituation to Physical Pain
Serious Attempt or Death by Suicide
Those Who Desire Suicide
Derived from Sketch of a Theory
Power Point presentation, 2009
Thomas Joiner, PhD
People really dont want to die; they want an end to
pain--emotional or physical.
Most people (about 90%) who die by suicide have a
treatable mental health issue, usually depression.
There are about 20-25 attempts for every death by
suicide.
Although suicide is relatively rare, a family, friends,
community and workplace (and/or school) are
affected by a single death.
Suicide is a public health issue resolved by easily
accessible, affordable, and culturally-appropriate
mental health help.


Suicide is complex;
it is not the result of one action or interaction or
one single factor.

It is a bit like the
property of cohesion:
a glass doesnt run
over even when water
goes above the rim.
However, one more
drop (action) can
make the difference.

Even so, drops can be
removed with help
and hope.

Youth Suicide
Suicide is the 2nd leading cause of death for
adolescents and young adults in Idaho, which
became true nationwide in 2011.
From 2007-2011, 78 school-age children (to
age 18) died by suicide in Idaho.
Nation-wide youth suicide (15-24) occurs
twice as frequently as it did 50 years ago.


Youth Suicide in Idaho
Idaho has a 58% higher number of suicides for youth
(age 10-24) per capita than the national average.[i]
In the most recent five-years for which national data
is available (2006-2010), the suicide rate for youth
age 10-24 nationally was 7 per 100k, and Idahos
rate was nearly 11.2. Between 2007-2011, Idaho
youth suicides increased 9% over the previous five-
years 2006-2010.

[i] Data are calculated from CDC WISQARS.
Retrieved May 24, 2013.
General info
Suicide is often attributed to a mental health issue
and adolescents are more at risk for suicide at the
onset of these disorders..
Every time someone is treated for a mental health or
a non-specific health issue, suicide ideation should be
addressed.
Most college/university mental and physical health
programs do not include suicide
assessment/prevention as part of the curricula.
(Washington state is now a happy exception.)
Up to 70% of suicidal people had visited a mental
health professional in the year before their death;
about 40-45% had seen their general health
practitioner for a physical ailment in the two months
before their death.

What Youth Report
The "2011 Idaho Youth Risk Behavior Survey (YRBS): A Healthy Look
at Idaho Youth" is based on a survey of 1,702 9th through 12th-
graders in 48 public high schools across the state in the spring of 2011.
27.3% of high school students reported that in the previous 12 months
they felt so sad or hopeless almost every day for two weeks or more
that they stopped doing some usual activities, over in in 4.
One in seven high school students and one in four 9th grade females
reported seriously considering suicide in the previous 12 months
During the previous year 13.2% of high school students reported
having actually made a plan about how they would attempt suicide.
8.1% of high school females and 4.6% of high school males reported
making a suicide attempt one or more times during the previous 12
months

An estimated 1 in 5 adolescents suffer from serious depression.
Suicide Warning Signs
(indicate suicide may be imminent)
Threatening to, talking or writing about suicide
Previous suicide attempt
Seeking methods to kill oneself (sudden interest in guns)
Feeling hopeless or trapped
Withdrawing from friends, family, or society
Dramatic mood changes
Increased alcohol or drug use
Inability to sleep or sleeping all the time
Nightmares

Warning signs, continued
Changes in weight or eating habits
Withdrawal from friends or family or activities
Agitation or anxiety or raging or risk-taking (fights)
Giving away favorite things or making final plans
Neglecting school work or personal appearance
Chronic headaches, stomach aches, fatigue (stress)
Recent loss of a friend, family member, or significant
relationship
Sudden unexpected loss of freedom or fear of
punishment/humilation



Warning Signs in Youth

Youth may exhibit depression as anger
or aggression.
Sometimes risk-taking behaviors can
include acts of aggression, gunplay, and
alcohol/substance abuse. While teens
may not act depressed, their behavior
suggests that they are not concerned
about their own safety.
REMEMBER
Any one sign alone doesnt necessarily
indicate a person is suicidal. However, all
signs are reason for concern and several
signals may be cause for concern of
suicide. Warning signs are especially
important if the person has attempted suicide
in the past, isnt sleeping, or is especially
agitated or anxious.
For Youngsters and Beyond
Self-injury behaviors are warning signs for
young children as well as teenagers. Common
self-destructive behaviors include running into
traffic, jumping from heights, and scratching
or cutting or marking the body. (Adolescent
cutters are generally no more at risk than
peers for suicide but still should have their
issue addressed by competent mental health
clinicians.)
Early Trauma May
Increase Risk
Trauma disrupts development of the brain
Changes in ability to handle stress
Overreaction to situations: fight or flight
Underreact: seem numb or paralyzed
seek ways to hide
Disruption of trust in adults or others

Extra Concern for Teens
Continued trouble at school or work
Incarceration or court-related problems
Inability to deal with problems or
disappointment (low emotional
intelligence)
Raging or extremely angry reactions
Shame or embarrassment within peer
groups or public settings

Bio-psychosocial Risk Factors
Mental disorders
Alcohol and other substance use disorders
Impulsive and/or aggressive tendencies
Hopelessness
History of trauma or abuse
Some major physical illnesses
Previous suicide attempt
Family history of suicide

Environmental Risk Factors
Job or financial loss
Relationship or social loss
Easy access to lethal means
Local clusters of suicide that have a
contagious influence

Psycho-social Risk Factors
Lack of social support
Sense of isolation
Stigma associated with seeking help
Barriers to accessing mental health care and
substance abuse treatment
Certain cultural and religious beliefs (those
that believe suicide is noble)
Exposure to, and influence of others who
have died by suicide

Harvard Study Information
Adolescents (36% in the study) are more likely to die
the same day of a crisis. Number lowers to 24% for
those in twenties.
In postmortem of 76% of decedents, only 4% of
youth had drug/alcohol in system; 36 % for adults.
(This study is being replicated, and these numbers
seem to be holding close)
In 41% of cases, death investigation reports noted
the youths had either made a prior attempt (21%)
and/or told someone they were thinking of suicide in
the days preceding their death (31%).

Youth and Means
Nationally, 45% of suicide deaths in young
adults (to age 24) are by firearm, and 43%
are by strangulation (biggest means in Idaho for youth)
Most young people who die by firearm use
one found in the home, stored unlocked,
though death reports show that adolescents
often knew where to find the key or the
combination numbers or broke the glass on
the gun storage.

Most people die by firearms;
women generally choose pills.


People who die by suicide are ambivalent
until the last second. (bridge stories)
Often when the means are taken out of the
suicide plan, the person chooses to live.
People who were restrained from jumping off
the Golden Gate Bridge rarely went on to die
by suicide. Ninety-four percent never
attempted suicide again; 99% are still alive.
When barriers were placed on a Washington
DC bridge, suicides did not go up at the sister
bridge a mile away.


Humor time
My therapist told me the way to achieve
true inner peace is to finish what I
start. So far today, I have finished two
bags of chips and a chocolate cake. I
feel better already.
A 2010 study of Idaho high school and Jr.
high school counselors and social workers
showed that while 97% of respondents had
experienced a potentially suicidal student,
only 55% felt well prepared to handle such a
student. The same study stated that 64% of
school counselors felt ill prepared to deal with
the aftermath of a student suicide, or
postvention.
Administrative Rules
IDAPA 08.02.03.160 SAFE ENVIRONMENT
AND DISCIPLINE

Each school district will have a comprehensive
district wide policy and procedure encompassing the
following:
School Climate
Discipline
Student Health
Violence Prevention
Gun-free Schools
Substance Abuse - Tobacco, Alcohol, and Other Drugs
Suicide Prevention
Student Harassment
Drug-free School Zones
Building Safety including Evacuation Drills
Districts will conduct an annual review of these
policies and procedures.
TITLE 33
EDUCATION
CHAPTER 5
DISTRICT TRUSTEES
33-512B.Suicidal tendencies -- Duty to warn.
(1) Notwithstanding the provisions of section 33-512(4),
Idaho Code, neither a teacher nor a school district
shall have a duty to warn of the suicidal
tendencies of a student absent the teachers
knowledge of direct evidence of such suicidal
tendencies.
(2) "Direct evidence" means evidence which directly
proves a fact without inference and which in itself,
if true, conclusively establishes that fact. Direct
evidence would include unequivocal and
unambiguous oral or written statements by a
student which would not cause a reasonable
teacher to speculate regarding the existence of the
fact in question; it would not include equivocal or
ambiguous oral or written statements by a student
which would cause a reasonable teacher to
speculate regarding the existence of the fact in
question.
(3) The existence of the teachers knowledge of the
direct evidence referred to in subsections (1) and
(2) of this section shall be determined by the court
as a matter of law.
Prevention
Everyone learns the warning signs
All staff and interested parents trained as
gatekeepers and have protocols for reporting
Students learn that the code of silence doesnt apply
School climate of inclusion and opportunity to
succeed
Curriculum delivered as part of mental health unit in
small groups is best with at least two adults
Parents are forewarned and know warning signs
No assemblies presented by previously
suicidal youth; no work done on prevention
other than gatekeeper training within a year
of death by suicide in the school community
Always have hope messages and ways for
students to have easy access to help
Message that suicide is rare and result of
easily treated mental health issue

Intervention
Know easily accessible, competent mental health (tip
off mental health clinician about the student)
Protocols to include community actions (EMT/police), how
parents will be notified, what to do if parent/guardian
cannot be located, and pre-screened mental health
professionals
Student never left alone nor sent home
Home cleared of means
Culturally-appropriate and confidentiality protocols
Documentation of all actions taken
De-briefing of those involved
Follow up with parent and mental health (permission)



Postvention
Use the protocols on website (IMPORTANT for
liability)
School teams are available
Students are especially vulnerable after
a death of a classmate
The school day should be kept as
normal as possible; do not let students
leave unless their parents come to pick
them up (not advisable)



Remember to monitor social media
Announcement made within classrooms
Be very aware of students reactions and
offer safe place to talk
Prescreen close friends and vulnerable youth
No memorial at locker
Counselor or other professional to monitor
classrooms throughout the day and bus after
school


De-brief and self-care meetings for staff during the
days after the death
Continue to monitor friends of deceased and other
vulnerable students/staff
No permanent memorials; ask students to write notes
to the family (pre-read), take up a collection for
flowers or for the family, or other such activities
Contact family about coming to get personal items
after the funeral
Have at least one school representative at the
funeral; have mental health people available after
Encourage the family to have the funeral after school
Laughter as Medicine
APsychology Today article entitled Happily
Ever Laughter cites a study which shows
that the average child in kindergarten laughs
some 300 times a day whereas the typical
adult laughs a measly 17 times a day. If you
havent laughed in awhile maybe it is time
you did. There is much research to show that
laughter really is the best medicine for a lot
of different types of maladies including
depression.
Humor Time
A young woman took her troubles to a
psychiatrist. "Doctor, you must help me," she
pleaded. "It's gotten so that every time I date
a nice guy, I end up in bed with him. And
then afterward, I feel guilty and depressed
for a week." "I see," nodded the psychiatrist.
"And you, no doubt, want me to strengthen
your will power and resolve in this matter."
"For goodness sake, NO!" exclaimed the
woman. "I want you to fix it so I won't feel
guilty and depressed afterward."
For Clinicians:
1. Complete a comprehensive assessment for every patient
where suicidality is an issue.
2. A thorough diagnostic interview and history must be
completed as a part of the assessment process.
3. Always cover the targeted domains identified including:
precipitant(s), suicidal thinking and past behavior,
symptom presentation, hopelessness, impulsivity and self-
control, and protective factors.
4. The use of simple 1-10 patient ratings are useful to gauge
the patient--not only current severity across identified
symptoms but also can be used to monitor a
patient's functioning.
5. Be sure to consider co-morbidity.

Liability Issues
DOCUMENT, DOCUMENT, DOCUMENT
Write the clients words specifically as you
can.
CONFER, COLLABORATE
Interview collateral sources
Read and memorize Dr. Rudds The
Assessment and Management of Suicidality
available by pdf request to Linda Haroldson
or me.

Be Aware
Many people kill themselves in the first
few days after an emergency room
evaluation for suicide or after getting
out of in-patient treatment or after a
mental health diagnosis
Provide a crisis plan to your clients
ahead of time for this occurrence


The Nature of Suicide Intent
Current ideation frequency, intensity,
and duration (FID)
Presence of suicidal plan (increased
risk with specificity-European vacation idea)
Availability of means
Lethality of means
Active suicidal behaviors
Explicit suicidal intent

Previous Suicidal Behavior
Frequency and context of previously suicidal
behaviors
Perceived lethality and outcome
Opportunity for rescue and help-seeking
How did you save yourself before?
What can you do next time you feel this way?
Preparatory behaviors

Emotional Regulation
Objective self-controlsubstance
abuse, aggressive behavior, impulsivity,
control of others, co-dependence on
others
Subjective self-controlability to self-
adjust at advent of a precipitating event
and to modify thinking

Emotional Regulation Tactics
Relaxation training

Mindfulness training

Reasons for living list

Survival kit (Hope Kit) Including Reasons for Living

Sleep hygiene / stimulus control

If someone, especially youth, is
highly suicidal, she or he may
be unable to self-regulate. At
this point, 911, ER, or other
emergency services should be
involved. Never leave someone
alone in this state.
Protective Factors
Presence of social support. Support needs to
be both present and accessible.
Make sure the relationships are healthy.
Problem-solving skills and history of coping
skills
Active participation in treatment
Presence of hopefulness
Parents/children present in the home
Religious commitment or spiritual beliefs

Protective factors continued
Intact reality-testing
Fear of suicide or death. This suggests
that the patient has not yet habituated
to the idea of death, a very good sign.
Feeling hopeful and capable
Doing well in several activities/school
Strong wish not to let others down
No access to means



Humor Time
A guy goes to a psychiatrist. "Doc, I
keep having these alternating recurring
dreams. First I'm a teepee; then I'm a
wigwam; then I'm a teepee; then I'm a
wigwam. It's driving me crazy. What's
wrong with me?" The doctor replies:
"It's very simple. You're two tents."
NO NO-SUICIDE CONTRACTS
Instead use Commitment to Treatment Statements (CTS) and
Safety Plan
Here is an example of a CTS (Rudd, Joiner, & Rajab, 2004). It is
necessarily brief and straightforward and probably best handwritten
with the client.
I, ________________ agree to make a commitment to the treatment
process. I understand that this means that I have agreed to be
actively involved in all aspects of treatment including:
1) attending sessions (or letting my therapist know when I cant make
it),
2) setting goals,
3) voicing my opinions, thoughts, and feelings honestly and openly
with my therapist (whether they are negative or positive, but most
importantly my negative feelings),
4) being actively involved during sessions,
5) completing homework assignments,

6) taking my medications as prescribed,
7) experimenting with new behaviors and new ways of doings things,
8) and implementing my crisis response plan when needed (see the attached
crisis response plan card for details).
I also understand and acknowledge that, to a large degree, a successful
treatment outcome depends on the amount of energy and effort I make. If
I feel like treatment is not working, I agree to discuss it with my therapist
and attempt to come to a common
understanding as to what the problems are and identify potential solutions. In
short, I agree to make a commitment to living. This agreement will
apply for the next three months, at which time it will be reviewed and
modified.
Signed: ____________________________
Date: _____________________________
Witness: _____________________________

As should be evident, this agreement is very different
than the notion of an informed consent statement.
It targets the patients motivation and commitment to
the treatment process, outlining core elements and
expectations.
The CTS can be as brief as the one noted above or
more detailed, depending on the patient and the
context.
In many ways, it is a living document, one that changes
as the patient makes progress in treatment
and the dynamics of therapy evolve.

Defined as a commitment to Living

Treatment and care incorporates a
crisis management or response plan

Specifically identifies responsibilities of
patient and clinician

Elements of Good Agreements
Defined as a commitment to Living

Treatment and care incorporates a
crisis management or response plan

Specifically identifies responsibilities of
patient and clinician

Safety Plan
Connection with family/friends (may need a consent form)
Crisis Response Card (3x5 handwritten) include at
least three or four of the most powerful reasons for living
Hope/Survival Kit (must be monitored with therapist)
Contains copy of crisis response card
Photos of those cared for including pets
Reasons for living
Items that generate hopeful, productive thoughts
and feelings


Practice use of Survival Kit
Review each item and ask patient to
describe and tell a little about it
What is the client thinking?
What is the client feeling?
How much more hopeful does each item
make the client feel?

Crisis Plan
When Im acting on my suicidal thoughts by trying to find a gun
(or another method to kill myself), I agree to take the following steps:
Step 1. I will try to identify specifically whats upsetting me.
Step 2. Write out and review more reasonable responses to my suicidal thoughts,
including thoughts about myself, others, and the future.
Step 3. Review all the conclusions Ive come to about these thoughts in the past in my
treatment log. For example, that the sexual abuse wasnt my fault and I dont have
anything to feel ashamed of.
Step 4. Try and do the things that help me feel better for at least 30 minutes (listening to
music, going to work out, calling my best friend).
Step 5. Repeat all of the above at least one more time.
Step 6. If the thoughts continue, get specific, and I find myself preparing to do
something, Ill call the emergency call person at (phone number: XXXXXXX).
Step 7. If I still feel suicidal and dont feel like I can control my behavior, Ill go to the
emergency room located at XXXXXXX, phone number; XXXXXXX.

Signed

Thought Self-Correction Diary
Triggering event
Thoughts about that event and severity and duration
Feelings (anger, frustration, etc.)
Severity and Duration
Behavioral Response
New Belief and how much I believe it

Forms are free at
http://media.psychologytools.org/Worksheets/En
glish/CBT_Thought_Record.pdf

Treatment Journals
Journals have been demonstrated to be a useful intervention in treatment,
particularly to improve self-awareness, understanding of change over time and
as tool for relapse prevention. Your journal will provide an easy and ready
reference for what youve done in treatment, identifying whats worked and
what has not, with an emphasis on becoming more efficient and effective in
problem solving, regardless of the situation. Here are the ground rules for
keeping your journal:

Journal for 15-30 minutes per day. Try to do it at the same time each day, its
important to make this part of your daily routine. I want you to write only as
much as I can reasonably read and cover with you in treatment. This is
particularly important early in the treatment process. Ill make copies of your
journal to keep and review.

For the first month Id like for you to journal about things that are important to you.
That is, whats on your mind? Whats upsetting you? How are you feeling about
yourself? How are you feeling about other people? When you write about these
things, please try to identify specifically what the problem is so that we can
target it in treatment. Well talk about a specific approach to problem solving.



If you write about suicidal thoughts, feelings and plans, well target
these directly in treatment. If you write about reasons for dying,
Im going to ask you to always include your reasons for living. If
you have trouble identifying them, Ill help you.
Within the first couple of weeks, Im going to ask you to identify
the problem specifically when you write, generate and write
about alternative responses, practice implementing the
alternatives (well role play these to help you), evaluate whether
or not its working, and if its not, identify a new one and try
again.
Finally, Im going to ask you to always close your writing each day
by adding a single sentence about what your hopeful about in
treatment and life.


What Parents/Adults Can Do
Listen nonjudgmentally (take walks, go for drives)
Learn the warning signs
Ask your child if he or she has considered suicide
Analyze how much pressure the student feels
Request that your family doctor or mental health provider
assesses for depression (tip them off)
Be sure your child finds success at some things
Be sure that your child knows that she or he is never a burden
Prepare and eat dinner together at least 4-5 times a week
Rid your house of means--bank guns, lock away extra medication
but avoid statistics or means discussion with children.


Parents and Schools
Get to know your childs teachers/principal
Be sure that you alert them if your child is
bullied and follow up to see that it ends
Check to see what the school does to ensure
that all students feel as if they belong
If your child is struggling with school, find out
why. Ask the school for help.
Make sure your child and his or her friends
know not to keep the code of silence.

For Men For Sure; Others, Too
Yoga helps with PTSD symptoms and depression
Outdoor exercise for everyone: walk, bike, or run
Men learning to build relationships may be of import
(Lonely at the Top by Dr. Joiner)
Calling someone dailyfriend or family member
Being responsible to plan a small event
Learning a new skillcooking--with a group of men (bbq;
gardening)
Reading group to discuss a book or movie
Volunteerism, especially with animals and children
Back to nature: find peaceful activities together

Workplace and Suicide

Know the warning signs
Other signs in the workplace
Absenteeism
General malaise
Disconnectedness, inability to concentrate
Anger, Anxiety, and/or Unusual Irritability
Revenge statements
Ask the worker if he or she is considering suicide
In case of a suicide death, go to
http://www.suicidology.org/c/document_library/get_f
ile?folderId=272&name=DLFE-822.pdf for a
comprehensive best practice guide
Workplace, continued
Promote mental health as health.
Advertise EAPs and health insurance benefits
for mental health
Have the expectation that people will seek
mental health help.
Promise and insure confidentiality.
Provide healthful options: nutritious food,
exercise, togetherness activities and
education on various helpful subjects
Communities and Prevention
Take opportunities to talk about suicide at all types of
meetings.
Provide resources (spanidaho.org)
Join mental health forums; be sure suicide prevention
is part of the discussion
Ask businesses and organizations to host suicide
awareness events
Join with mental health providers to be sure suicide is
addressed and clinicians trained
Look at activities in the State Plan (spanidaho.org)
Myths Discussed
T or F 1. Suicide deaths spike around the
holidays. ________
T or F 2. Suicide often happens on a whim.
________
T or F 3. More men than women die by
suicide. ________
T or F 4. People who die by suicide are
cowards. ________

T or F 5. Most suicidal people really want to
live. ________
T or F 6. Youth die by suicide more than
older people. ________
T or F 7. Suicide is more common among
minorities. ________
T or F 8. Poor countries have higher suicide
rates. ________
T or F 9. If people want to die, we cant
stop them. ________
T or F 10. People who die by suicide are selfish.
________
T or F 11. Most suicidal people have mental health issues.
________
T or F 12. People who attempt just want attention.
________
T or F 13. Most victims of suicide have substances in their
system. ________

T or F 14. Most victims leave notes. ________

T or F 15. Suicidal people make future plans. _______
More?
http://training.sprc.org/course/descripti
on.php#course4
On line training in areas of suicide
prevention (CEUs available)
Psychological Autopsy (perhaps the only
way to determine why)
Survivor packets and groups
Questions and comments?

Resources
Idaho Suicide Prevention Plan: A Call to Action
(spanidaho.org)
Suicide Prevention Action Network of Idaho
(spanidaho.org)
American Association on Suicidology (suicidology.org)
American Federation on Suicide Prevention (afsp.org)
Suicide Prevention Resource Center (sprc.org)
Substance Abuse and Mental Health Services Admin.
(samhsa.org)
Idaho Dept. of Health and Welfare
The Trevor Project (thetrevorproject.org)
NAMI.org
Idaho Suicide Prevention Hotline: 800-273-8255
(talk)

Thanks for caring about suicide
prevention.