1. Child Life Support
through
Suicidal Situations
“Keeping More Than
Dreams Alive”
Staff Training
Seminar
Douglas T. Chan, M.S.,
LPC-Supervisor,
C.A.R.T.

2. Youth Suicide
“The Silent
Epidemic”

3. The Purpose
To confront the “Silent Epidemic”
of youth suicide by equipping Child
Life Specialists, young people, and
their parents with information,
tools, and resources to help identify
and assist at-risk individuals.

4. Attorneys General
Attorneys General
in many states have
committed to taking
a stand against the
“Silent Epidemic.”March 2004 – NAAG
Passed Resolution urging
AG’s to become involved
in youth suicide
prevention.
Texas Attorney General
Greg Abbott

5. What Can You Expect Today?
Not meant to make you an expert on
youth suicide or a crisis counselor.
We will… help bring an awareness of
the problem of youth suicide
and suggest ways of identifying and
helping “at-risk” youth.

6. First Step
Awareness

7. Dr. David Satcher, US
Surgeon General, declared
Suicide a “A National Health
Problem” ..especially within
the youth and elderly.
In 1999…

8. How Many
young people do
we lose Each
Year to Suicide?
In the United States

9. We will lose in
Excess of 5,000
Young People.
It is estimated that…

10. Each Week in our Nation….
We lose approximately
100+ young people to
this “Silent Epidemic”
of youth Suicide!

11. Reported that in the year 2010 over
THREE million youth, ages 12-17,
were at-risk of suicide.
And, of that THREE million, over
ONE million actually attempted
suicide.
In July 2012, NHSDA Report /
SAMHSA and U.S. Dept. Of Health

12. In a typical week, there are
more than 19,000 suicide
attempts nationally!
Almost two attempts each
minute - 2700+ per day
That Means…

13. Girls attempt suicide
over three times more
than boys.
Why?
Fact

14. Fact
However, boys complete
suicide over three times
more than girls.
The reason for the
difference…

15. Choice of means:
Girls usually choose drugs,
which can provide a “window
of opportunity” for
intervention.
Boys usually choose firearms,
which are more lethal.

16. Girls are turning to more
lethal means at an alarming
rate. If this continues, the
number of completed
suicides will rise at an
even higher pace.
A recent trend…

17. Firearms are used in almost
70% of completed
suicides…. Since 1980, 90%
of the increase in suicide
attempts has been through
the use of firearms.
Fact

18. Suicide is the THIRD
leading cause of
death for youth ages
15-24
Fact

19. Suicide is now the
SECOND leading
cause of death for
college-age youth.
Fact

20. In Ages 10-14, We have seen
an alarming 128% increase in
Suicides since 1980- making it
the 4th
leading cause of death
for that age group.
Fact

21. In the last 40 years…
youth suicide
rates have more
than tripled.

22. More teenagers and young adults
die from suicide than from
cancer, heart disease, AIDS, birth
defects, stroke, pneumonia and
influenza, and chronic lung
disease, COMBINED
Did you know?

23. Youth Risk Behavioral Survey
2012 - CDC
This survey covers a broad range of
questions concerning behavioral
actions and thoughts from our youth.
It is presented in public schools to
grades 9-12 – some districts choose
to include grades 7-8.

24. Question #1
“Have you felt sad or hopeless
almost every day in a row for two
weeks or greater so that it affected
your usual activities in the past
twelve months?”
Nationally 28.5%
Over 1 out of every 4 Students

25. Question #2
“Have you seriously considered
suicide in the past twelve
months?”
Nationally 16.9%
1 out of every 6 students

26. Question #3
“Have you made a plan on
how to commit suicide in the
past twelve months?”
Nationally 13%
1 out of every 8 students

27. Question #4
“Have you attempted suicide
one or more times in the past
twelve months?”
Nationally 8.4%
Almost 1 out of every 12 students

28. What About
Our State?
Texas

29. Question #1
“Have you felt sad or hopeless almost
every day in a row for two weeks or
greater so that it affected your usual
activities in the past twelve months?”
Texas – 31.4%
Almost 1 out of 3 battled the start of
depression

30. Question #2
“ Have you seriously considered suicide
in the past twelve months?”
Texas – 15.9%
Almost 1 out of 6 seriously considered
suicide.

31. Question #3
“Have you made a plan on
how to commit suicide in the
past twelve months?”
Texas – 12.2 %
1 out of 8 made a plan to commit
suicide

32. Question #4
“ Have you attempted suicide one or
more times in the past twelve
months?”
Texas – 9.4 %
1 out of 11 attempted suicide

33. • Beginning Depression – 605,256
• Seriously Consider Suicide – 306,483
• Will Make a Plan – 235,163
• Will Make an Attempt – 181,914 or
an average of 496 young people each
day!
What does that mean in real
lives for Texas ??
Utilizing 2005 Student Population

34. Key to Prevention:
Education

35. Four out of five
completed suicides gave
“clear warning” signs
before the attempt!
According to the National Mental
Health Association

36. That means…
In 80% of suicide
attempts…..we have
an “opportunity” to
recognize the warning
signs and intervene!

37. Do not normalize
It is important to remember and share
that not everyone is attempting suicide.
(1 out of 12 did, 11 did not attempt etc.)
However, we must not understate
suicide’s impact on our youth, families
and communities.
One is too many!

38. Youth
Educators Parents
Triangle of Prevention
Programs and Seminars
An effective
program of
prevention
must include
the three main
areas of
influence in a
young
person’s life.

39. What Can Be Done:
Increase awareness
Dispel Myths
Educate
Learn warning signs and
elevated risk factors

40. Increasing Your
Awareness
Increasing Awareness through;
 Listening to the patient’s words and meanings.
 Paying attention the patient’s actions and lack of
actions
 Listen to the family and friends.
 Pay attention to what the patient desires to do and
what he/she is not wanting to do.
 Don’t Be afraid to ask questions.

41. Dispelling Myths
Talking to a person about his/her suicidal
feelings may cause him/her to attempt
suicide.
Someone who talks about suicide often is
not a risk.
Suicide is impulsive and there is nothing
we can do to prevent it.

42. Signs of Concern
A general listing by The U. S.
Surgeon General’s Office, these
are sometimes referred to as
Warning Signs

43. It is important to note that these
represent a few general signs of
concern and are not to be considered
a comprehensive list that always
indicates suicidal intentions.
When in doubt, always seek
professional help!
Important

44. Remember that many times signs of
concern can be considered part of normal
growth unless…
They persist over a long period of
time,
There are several signs evident at
once or
The behavior is “out-of-character”
for the individual as you know
him/her.

45. Five Signs of Concern:
 Suicide Threats
 Previous Suicide Attempts
 Depression
 Out of Character Behavior
 Final Arrangements

46. Suicide Threats
“I would be better off dead!”
“You won’t have me around much longer
to bother you!”
“I wish I was dead”
“I am going to kill myself”…(this is
straight forward, but it happens)
Can you think of other examples….

47. Previous Suicide Attempts
Four out of five completed suicides
are not the first attempt by the victim.
Take even so-called “half-hearted”
attempts seriously…these are serious
calls for help!
Never keep an attempt secret from
parents / school officials (counselors).

48. Depression
In a study conducted by the U.S. Surgeon
General’s office in 2010, it was reported that
one out of seven teenagers in our nation
could be considered “clinically depressed”.
Depression in young people often times
exhibits itself through “out-of-character
behavior”.

49. Out-of-Character Behavior may
include:
 Abrupt changes in
attendance…
 Dwindling academic
performance
 Sudden failure to
complete assignments
 Lack of interest and
withdrawal
 Sudden changes in
appearance
 Changed relationships
with classmates
 Increased irritability
or aggressiveness
 Preoccupation with
death and suicide
 Despairing attitude
 Abrupt changes in
eating and sleeping
habits

50. Final Arrangements
Giving away “prized possessions”
Examples: favorite piece of jewelry or
clothing, driver’s license, collection, etc.
“Making rounds” (visiting friends to set
things right and say good-bye)
Sharing of funeral plans (primarily by
girls to a best friend).

51. Can you think of any other
“Signs of Concern” that
could signal that a student
might be having problems?
Additional Signals

52. If you have any doubt of a
young person’s intentions or
any concern about their
behavior, get professional
help for them immediately!
Basic Rule to Remember

53. Although there is really no
suicidal type of young person, the
statistics on youth suicide do
suggest that there are certain
behaviors or characteristics that
can alert you to an elevated risk
of possible suicidal ideation.
Elevated Risks

54. Elevated Risk Factors:
Perfectionists
Low self esteem
Depressed Teens
Students first
real trouble
Abused,
molested or
neglected youth
Loners
Gay/ Lesbian
youth
Learning-Disabled
Changes in school
status
Abusers of Drugs /
Alcohol

55. The Don’ts
• Don’t Panic.
• Don’t ignore the situation and hopes that it goes away.
• Don’t blame the patient for the choices that he/she has made.
• Don’t look for quick fix solutions to make the patient feel
better.
• Don’t criticize or blame the patient for the way that they are
and have been feeling.
• Don’t trivialize, normalize or dismiss the issues that the
patient may be going through.
• Don’t be patronizing, assuming, or judgmental.
• Don’t take it personally. (Q-TIP)

56. The Don’ts(con’t)
• Don’t leave the patient alone if they are claiming a
suicidal risk.
• Don’t make promises that you can not keep (i.e..
Keeping their suicidal feelings a secret).
• Don’t Argue with the suicidal person. Avoid
saying things like: "You have so much to live
for," "Your suicide will hurt your family," or
“Look on the bright side.”
• Don’t lecture on the value of life, or say that
suicide is wrong

57. The Don’ts (con’t)
• Don’t offer ways to fix their problems, or
give advice, or make them feel like they have
to justify their suicidal feelings. It is not about
how bad the problem is, but how badly it’s
hurting your friend or loved one
• Don’t blame yourself. You can’t “fix”
someone’s depression. Your loved one’s
happiness, or lack thereof, is not your
responsibility.

58. The Do’s
• Do be there for the patient.
• Do ask if the patient is thinking about suicide.
• Do check out their safety. (Think safety with the
items that you may use with the patients.)
• Do ask if the patient has a plan and the means to
complete the plan.
• Do ask for a promise.
• Do Stay involved and hand off any
communication.
• Do take care of yourself.

59. The Do’s (con’t)
• Do look, listen and learn from what the patient is
doing and saying.
• Do ask the patient to consider talking with their
family about the situation.
• Do consider talking with the family and friends
about the ongoing situation.
• Do consider working with the MD about a psych
consult.
• Do work with your team for the best outcome.

60. References
• American Academy of Pediatrics - http://www.aap.org/
• American Foundation for Suicide Prevention - http://www.afsp.org/
• American Psychiatric Association - http://www.psych.org/
• American Psychological Association - http://apa.org/
• Center for Disease Control and Prevention - http://www.cdc.gov/
• Jason Foundation - http://jasonfoundation.com/
• National Survey on Drug Use and Health - http://www.whitehouse.gov/ondcp/national-survey-on-drug-use-and-health
• Office of the Attorney General Texas - https://www.oag.state.tx.us/
• Office of the Surgeon General - http://www.surgeongeneral.gov/
• SAMHSA - http://www.samhsa.gov/
• Suicide Awareness Voices of Education - http://www.save.org/
• Suicide Prevention Resource Center - http://www.sprc.org/states/texas
• Texas Counseling Association - http://www.txca.org/
• Texas Department of State Health Services - http://www.dshs.state.tx.us/mhsa/suicide/Suicide-Prevention.aspx
• Texas Suicide and Crisis Hotline - http://www.suicidehotlines.com/texas.html
• Texas Suicide Prevention - http://www.texassuicideprevention.org/
• U.S. Department of Health and Human Services - http://www.hhs.gov/
• Youth Risk Behavior Surveillance System (YRBSS) - http://www.cdc.gov/HealthyYouth/yrbs/index.htm

61. Thank You
Douglas T. Chan, M.S., LPC-Supervisor, C.A.R.T.
(281) 826 – 1699
douglas.chan.lpc-s@comcast.net
KBCC
2323 Timber Shadows Drive, Suite B
Kingwood, Texas 77339
KPH
2001 Ladbrook Drive
Kingwood, Texas 77339