Adolescent Suicide:

Prevalence; Circumstance;
and Conditions of
Recognition

Barri Sky Faucett, MA

ASPEN Project
Director
 SUICIDE

Intentional Self-Inflicted
Death
 Just the Facts
•Every 13.7 minutes another life is lost to
suicide, taking the lives of more than 38,364
Americans every year.

•Every day 105.8 Americans take their own life

•Suicide is now the 10th leading cause of

death in America; Homicide is 15th.

•For young people 15-24 years old, suicide

is the third leading cause of death.
OUR Youth
 In 2010, there were 4,600
reported youth suicides in the
United States.

 Each day there are

approximately 12 youth suicides

 Most common method is

firearms followed by
suffocations

 Males complete 4 times more

than females; females attempt
four times more than males.
 1 out of every 53 high school Suicide Attempts
students (1.9 percent)
reported having made a
suicide attempt that was
serious enough to be treated
medically (CDC, 2010a).

 Approximately 1 out of every

15 high school students
attempts suicide each year
(CDC, 2010a).

 For every completed suicide,

there are 100-200 attempts
among adolescents.
 Suicide in Adolescents
 Research shows that most adolescent
suicidesSuicide in Adolescents
occur after school hours and
in the teen’s homes
 Most adolescent suicides are
precipitated by interpersonal conflict
 Within a typical high school classroom,
it is likely that three students (one boy
and two girls) have made a suicide
attempt within the last year.
 How Does WV Compare?
•Since GLS WV ranks 40th in the nation
with a rate of 8.9/100,000 vs. the national
average of 10.5 (CDC 2010).
 WV Youth

Suicide is the 2nd

leading cause of death
for WV Youth ages 15-
24!
 Suicide: West Virginia Suicides by county
Hancock
4 (12.26) Ages 15-24
2000-2009
A PREVENTABLE Brooke
4 (12.56) Rate per 100,000 Population
DEATH IN OUR STATE Ohio
7 (10.81))
WV Average Rate 13.2/100,000
Marshall 320 Deaths by Suicide
12 (29.79)

Wetzel Monongalia Morgan

3 (15.30) 10 (3.97) 3 (18.15)
Tyler Marion Preston Berkeley
5 (46.92) 11 (12.38) 11 (9.89)
Pleasants 6 Mineral Jefferson
0 (0.00) Harrison Taylor (16.39) 7 (20.00))
Hampshire 6 (9.75)
Dodd- 13 5 (26.13) 2 (7.78)
ridge
Wood Ritchie 1 (9.88) (15.36)
10 (9.68) 4 (34.13))
Grant
Barbour Tucker 2 (16.07)
4 (19.02) 1 (13.19) Hardy
Wirt Lewis 3 (20.28)
1 (13.66) Cal- Gilmer 2 (10.22)
houn 2 (12.97) Upshur Randolph
Jackson 2 4 (10.52) 3 (8.30)
Mason 3 (9.01) (22.25)
3 (10.07) Roane Braxton Pendleton
1 (5.34) 2 (11.34)
0 (0.00)
Putnam
Clay
Webster 18.15 – 46.92
Cabell 10 (16.14) 4 (30.34)
3 (26.51)
18 (10.32) Kanawha 12.26 – 16.39
47 (20.96)) Nicholas Pocahontas
Lincoln 5 (15.89) 2 (20.60)
Wayne 4 (14.53) 10.07 – 11.34
5 (9.63) Boone
2 (6.79)
Fayette
16 (27.19) Greenbrier 0.00 – 9.89
Logan 8 (20.23))
9 (20.92) Raleigh
Mingo 10 (10.55)

3 (8.81)
Wyoming Summers Monroe
1 (3.47) 2 (13.69)
0 (0.00)
Mercer
McDowell
12 (160.5)
2 (6.68)
 2011 West Virginia
Youth Risk Behavior Survey
Percentage of students who seriously considered
attempting suicide during the 12 months before the
survey. (9th- 12th )
Year US WV
2011 15.8 13.0
Percentage of students who made a plan regarding how
they would attempt suicide
Year US WV
2011 12.8 10.1
Percentage of students who attempted suicide one or
more times during the 12 months before the survey.
Year US WV
2011 7.8 5.5
 Identity Confusion
 EricksonDevelopmental Stage-
Learning Identity Versus Identity
Confusion (Fidelity)

Learning Intimacy Versus Isolation

(Love)
 The Teenage Brain
 Adolescence is a time of
profound brain growth.
 Greatest changes to the
brain that are responsible
for impulse control,
decision making,
planning, organization,
and emotion occur in
adolescence (prefrontal
cortex).
 Do not reach full maturity
until age 25.
 What do teens deal with?
 Increased school pressures as they progress
through higher grades

 Possibly first romantic relationships

 Exploring increased independence and identity

 Experimenting with substance use

 Puberty and Hormone fluctuation

 Bullying
Peer Problems
 Several studies have found
relationships between suicidal
behavior and social isolation,
sexual orientation, and peer
rejection.

 70% of suicide completions

and attempts occur following
the loss or conflict with family
and peers.
 Sexual Identification
 Lesbian, Gay, and Bisexual
youth are 1 ½ - 7 times more
likely to have reported ideation.
 LGB Youth in multiple studies
are found to be 3-4 times more
likely to attempt suicide.
 58% of LGB youth who had
attempted suicide reported they
really hoped to die vs. 33% of
heterosexuals who attempted
and reported really hoping to
die.
 Have elevated risk factors and
lower protective factors
 Bullying:
3 defining characteristics:
1. Intentional—behavior is
deliberately harmful or
threatening
2. Repeated—a bully
targets the same victim
again and again
3 .Power Imbalanced—a
bully chooses victims he
or she perceives as
vulnerable
 YRBHS, 2011 (9th-12th)
Percentage of students who reported being bullied
on school property
Year US WV
2011 20.1 18.6
Percentage of students who have ever been
electronically bullied.

Year US WV
2011 16.2 15.5

Percentage of students felt sad or hopeless for

greater than 2 weeks so that they stopped some
general activities.
Year US WV
2011 28.5 24.5
 Cyberspace

CYBERSPACE is the new

environment where "
youth are forming
communities.
 Cyber bullying
 93% of teens ages 12-17
are on the Internet.
 75% of teens own a cell
phone.
 A typical teen sends about
>100 text messages a day.
 Most teen cell phone users
make just 1-5 calls per
day.
 82% of online teens ages
14-17 are on social
network sites
What makes Cyberbullying
different?
 Distance
 24/7
 Multiple methods
 Text messages;
video clips;
Websites; Social
Media; IM; Emails;
Chat rooms
 Anonymous
 Expanded
Audience
Bullying effects
 Withdraws socially; has few or no
friends.
 Feels isolated, alone, and sad.
 Feels picked on or persecuted.
 Feels rejected and not liked.
 Complains frequently of illness.
 Doesn’t want to go to school;
avoids some classes or skips
school.
 Brings home damaged
possessions or reports them “lost.”
 Cries easily; displays mood
swings and talks about
hopelessness. Has poor social
skills.
 Talks about running away/suicide.
 Bullying risks for suicide:
 Both victims and
 Verbal perpetrators of bullying
are at a higher risk for
 Physical suicide than their peers.
Children who are both
 Relational victims and perpetrators
of bullying are at the
highest risk
 One study found that
victims of cyberbullying
had higher levels of
depression than victims
of face-to-face bullying
 Bullying and Suicide
 Billy
 Phoebe
 Hope
 Megan
 SUICIDE: Myth or Fact

 Confronting a person about suicide will

only make them angry and increase
the risk of suicide.

• Asking someone directly about

suicidal intent lowers anxiety,
opens up communication and
lowers the risk of an impulsive act
 Myth or Fact

•Those who talk about suicide don’t do

it.

• People who talk about suicide may

try, or even complete, an act of
self-destruction.
 Myth or Fact

•If a suicidal youth tells a friend, the

friend will access help.

•Most young people do not tell an

adult
 SUICIDE- Risk Factors,
Warning Signs, Protective
Factors
•Risk Factors- characteristics that will may
it more likely that an individual will
consider, attempt, or die by suicide

•Warning Signs- behaviors that indicate

signs of immediate risk

•Protective Factors- characteristics that

make it less likely that individuals will
consider, attempt, or die by suicide.
 Risk Factors- IS PATH WARM

 Ideation
 Substance Abuse
 Purposelessness
 Anxiety
 Trapped
 Hopelessness
 Withdrawal
 Anger
 Recklessness
 Mood Changes
 Problems that increase Suicide Risk

 Prior suicide attempts

 Mental health disorders
 History of trauma or abuse
 Family history of suicide
 Lack of social support
Situations that increase suicide risk

•Major physical illnesses

•Losses
•Bullying
•Easy access to lethal
means
•Local clusters of suicide
 Access to means

 Firearms are used in 58%

of successful suicides
 The rate of completed
suicides is fives times
higher in houses with
firearms.
 Firearms are even more
prevalent in suicides
involving alcohol.
 65% of WV homes have
firearms.
 Warning Signs:
 Acquiring a gun or stockpiling pills
 Talking about wanting to die or kill oneself
 Impulsivity/increased risk taking
 Giving away prized possessions
 Self-destructive acts (i.e., cutting)
 Increased drug or alcohol abuse
 Talking about no reason to live
 Protective Factors
•Treatment for MH/SA, physical disorders
•Increased access to interventions
•Restricted access to highly lethal means
•Strong connections to family and community
support
•Strong problem-solving and conflict resolution
skills
•Cultural and religious beliefs that discourage
suicide and support self-preservation.
 Indirect or “Coded” Verbal
Clues:

 “I’m tired of life, I just can’t go on.”

 “My family would be better off without me.”
 “Who cares if I’m dead anyway.”
 “I just want out.”
 “I won’t be around much longer.”
 “Pretty soon you won’t have to worry about
me.”
 What to Do for the Individual
Take it seriously
Almost 80% of all suicides had
given some warning of their
intentions
Ask Directly
If you think that someone is
suicidal, ask them about it
 Tips for Asking the Question
 If in doubt, don’t wait, ask the question
 If the person is reluctant, be persistent
 Talk to the person alone in a private setting
 Allow the person to talk freely
 Give yourself plenty of time
 Have your resources handy; QPR Card, phone numbers,
counselor’s name and any other information that might help

Remember: How you ask the question is less

important than that you ask it
 What to do – Be Genuine
Be Genuine
•Listen and don’t show shock or
disapproval

•Show that you care, it is more

important
than saying “the right thing.”

•Avoid trying to explain away the

feelings…(saying things like “you have
a lot to live for” or “you are just
confused right now”)
 What to Do

Stay There
 Don’t leave them alone.

Seek Help -Be actively

involved in seeking
professional help
 Plan for Safety
 KEEP SAFE Agreement
 Safety Contact (s)
 Safe/no use of alcohol
and drugs
 Link to resources
 Disable the suicide plan
 Link to services
 Plan for Life
 Potential Assessments
 Patient
Health Questionnaire Modified for
Teens (PHQ-9 Modified)
 12-18 years of age
 Less than five minutes to complete and score
 Adolescent Suicide Assessment Protocol
(ASAP-20)
 Semi- structured clinical interview
 Addresses 20 items associated with suicide
risk
 Offerings
 SOS Curriculums/ASPEN Workshop for Students
 Evidence-Based Middle School and High School
programs
 Brief Introductory Training
 25 minute Video
 Guided Discussion
 Screening Instrument

 Jason Foundation Kits

 Orientation towards suicide prevention
 ASK CARE TELL cards for students
 ASPEN Offerings cont.
 ASPEN Presentation for your schools:
 Presentation- 35 minutes workshop for students
 Video Viewing- 13 minute movie regarding adolescent
suicide
 Depression Screening- with active parental consent
 ASAP-20 Follow-up for at-risk youth
 Postvention services:
 Response support to school systems
 Sudden Traumatic Loss Toolkit
 Trainings
 Awareness and QPR

 Adolescent Suicide
Assessment Protocol
(ASAP-20)

 PCP Toolkit Training

 Implementation of Suicide
Prevention Toolkit

 Applied Suicide Intervention

Support Training (ASIST)
 For More Information
 www.suicidology.org
 www.sprc.org
 www.afsp.org
 www.spanusa.org
 www.wvaspen.com
 www.wvsuicidecouncil.org
 www.jasonfoundation.org
 www.jedfoundation.org
 WV Contacts

Barri Faucett, MA Bob Musick

Project Director Executive Director
(304)-341-0511 ext 1691 WV Council for the Prevention
(304)-415-5787 of Suicide
barri.faucett@prestera.org (304) 296-1731
bmusick@valleyhealthcare.org