Online Tool to Help Illinois Schools Support Student Mental Health Illinois Youth Suicide Prevention Project Jennifer L. Martin, M.S.W. ISBE Special Education Directors Conference August 6, 2015 We want a society where people can live to their full potential; however, the reality is that a variety of circumstances can lead a person to feel helpless, even attempt to take one s life. This training is made available by the Illinois Department of Public Health through funding from grant number 1U79SM060429 01 awarded by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS. Recognize training is one component of a comprehensive school suicide prevention program Overview of the courses available and how to access them Resources Q&A 1
THE REALITY OF YOUTH SUICIDE Youth ages 10 to 24 Suicide Suicide is the third leading cause of death Approximately 125 young lives lost each year in Illinois Illinois Data Based on IVDRS data MENTAL HEALTH CIRCUMSTANCES 1/3 Current Depressed Mood 1/3 History of Mental Health Treatment 40% Current Mental Health Problem Youth ages 10 to 24 Illinois Data Based on IVDRS data(cont.) PRECIPITATING CIRCUMSTANCES 24% Experienced crisis within last 2 weeks 4% Financial problems 28% Problem with current or former intimate partner 15% Relationship problem (family, friend, other)18.9 percent of students reported seriously considering suicide SUBSTANCE ABUSE 1/3 Positive blood alcohol test 6% Alcohol dependence problem 10% Substance abuse problem 2
Youth ages 10 to 24 Illinois Data (cont.) Suicide Ideation Suicide attempt Bases on a 2013 Illinois survey Approximately 3,000 youth of youth in grades 9 12 in receive medical care for selfinflicted injuries at the 12 months preceding the Emergency Departments in survey Illinois 18.9 percent of students In an average classroom of 30 reported seriously considering high school students, two suicide students will have attempted 16.9 percent reported creating suicide in past 12 months a plan 12.4 percent reporting trying to take their own life 5.6 percent received medical care following the attempt At Risk Population LGB Youth In 2009, Illinois YRBS data found when lesbian, gay and bisexual youth are compared to their non gay peers they are more than three times more likely to report considering suicide in the past 12 months and to have made a suicide plan in the past 12 months. Additionally, they were almost five times more likely to have attempted suicide in the past 12 months. RISK FACTORS 3
Risk Factors Several factors can put a young person at risk for suicide. However, having these risk factors does not always mean that suicide will occur. The most significant ones are: Prior suicide attempt(s) Substance abuse Mood disorders Access to lethal means Other risk factors include the following circumstances and problems: Recent death of a friend, especially if by suicide Recent death of or separation from a family member Engaging in self harm Problems in school (academic and/or discipline) Relationship problems or breakups Bullying or other forms of violence Discrimination based on sexual orientation or gender nonconformity Family problems or abuse, current or in the past Legal issues Serious illness or injury Other stressful events WARNING SIGNS 4
The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change. If you or someone you know exhibits any of these signs, seek help as soon as possible by calling the Lifeline at 1 800 273 TALK (8255). Talking about wanting to die or to kill themselves. Looking for a way to kill themselves, such as searching online or buying a gun Talking about feeling hopeless or having no reason to live. Talking about feeling trapped or in unbearable pain. Talking about being a burden to others. Increasing the use of alcohol or drugs. Acting anxious or agitated; behaving recklessly. Sleeping too little or too much. Withdrawing or isolating themselves. Showing rage or talking about seeking revenge. Displaying extreme mood swings. Youth Suicide Warning Signs (Expert consensus meeting hosted by AAS/NCPYS and SAMHSA) Suicide may be imminent Particularly if behavior is new or increased and related to anticipated or actual painful event, loss or change Talking about or making plans for suicide Expressing hopelessness about the future Displaying severe emotional distress, sadness, or pain Showing worrisome behavioral clues or marked changes in behavior, specifically: Significant withdrawal from social connections/situations Increased agitation or irritability Anger or hostility that seems out of character or out of context Changes in sleep (increased or decreased) Information shared by Dr. Gutierrez at the 2014 IL Suicide Prevention conference based on the collaboration between American Association of Suicidology/National Center for the Prevention of Youth Suicide and the U.S. Substance Abuse and Mental Health Services Administration 5
PROTECTIVE FACTORS Protective factors are not just the opposite or lack of risk factors. Rather, they are conditions that promote strength and resilience and ensure that vulnerable individuals are supported and connected with others during difficult times, thereby making suicidal behaviors less likely. Effective clinical care for mental, physical and substance use disorders Easy access to a variety of clinical interventions and support for helpseeking Restricted access to highly lethal means of suicide Strong connections to family and community support Support through ongoing medical and mental health care relationships Skills in problem solving, conflict resolution and nonviolent handling of disputes Cultural and religious beliefs that discourage suicide and support self preservation However, positive resistance to suicide is not permanent, so programs that support and maintain protection against suicide should be ongoing. Connectedness as a Protective Factor The degree to which a person or group is socially close, interrelated, or shares resources with other persons or groups. Connectedness occurs within and between multiple levels of the social ecology that is between individuals, families, schools and other organizations, neighborhoods, cultural groups, and society as a whole Connectedness between individuals Connectedness of individuals and their families to community organizations Connectedness among community organizations and social institutions However, positive resistance to suicide is not permanent, so programs that support and maintain protection against suicide should be ongoing. 6
Suicide is a public health problem. Complex problem associated with multiple factors: Individual (biological, psychological) Environmental (physical, interpersonal, community, societal) Requires a community wide effort, across disciplines SCHOOL S ROLE Why Address Suicide? Four reasons why schools should address suicide 1. Maintaining a safe school environment is part of a school s overall mission. 2. Student s mental health can affect their academic performance. 3. A student suicide can significantly impact other students and the entire school community. 4. Schools have been sued for negligence (e.g., failure to notify parents, get assistance, adequately supervise) 7
Comprehensive School Suicide Prevention Program School wide programs that promote connectedness and emotional well-being Policies and procedures for helping students at risk and in crisis Protocols for responding to suicide death Postvention Staff education and training Parent/guardian education and outreach Student programs Curricula for all students Skill-building for students at risk Peer leader programs Screening for at-risk students School Code School code requirement School guidance counselors, teachers, school social workers and other school personnel who work with students in grades 7th through 12th are required to receive training to identify the warning signs of mental illness and suicidal behavior in adolescents and teens and shall be taught appropriate intervention and referral techniques. (P.A. 098 0471) Participating in or presenting at in service training programs on suicide prevention is among the list of possible professional development activities for teacher re licensure. Role of Educators Educators are on the front lines with students every day. May notice worrisome behavior and appearance. Have existing relationships with students. Educators not mental health experts, but can take small steps to a big difference. 8
Benefits of Gatekeeper Training A key strategy for prevention/early intervention and part of the national strategy for suicide prevention and. Reduces the anxiety teachers and staff may experience about responding to an at-risk student in their class. Reduces stigma associated with mental illness. Reduces the number of undetected students in schools and moves them into treatment as early as possible. Enhances safety for individual student, classroom, school and community A gatekeeper is any individual (i.e., not a mental health professional) trained to identify individuals at risk of psychological distress and connect them to treatment or supporting services as appropriate. ILLINOIS YOUTH SUICIDE PREVENTION PROJECT Illinois Youth Suicide Prevention Project 3 year grant funded program SAMHSA 1U79SM060429 01 Targets youth ages 10 24 Purposes of IYSPP include Advancing the state suicide prevention strategic plan Enhancing Primary Prevention Increasing Linkage to Services Increasing Protective Factors/Decrease Risk Factors for students Promote National Suicide Prevention Lifeline Core Activities include Kognito Gatekeeper Training in Secondary/Post Secondary Systems Expand the It Only Takes One website (suicide prevention campaign) Promote the National Suicide Prevention Lifeline Professional Development Stakeholder Meetings 9
Secondary Schools COURSE WALKTHROUGH Kognito At Risk Suite for Educators What Makes Kognito Training Special. Fun, engaging, effective Designed especially for education community Hands on practice Private role play with intelligent avatars Individualized, real time feedback ISBE CE credit Easy to implement district, or school wide, or in higher ed illinois.kognito.com @2012 Kognito Interactive. All Rights Reserved 10
At Risk for K 12 Educators Online 24/7; 50 60 minutes Virtual role play conversations with at risk emotionally active student avatars Created in collaboration with school and mental health experts and educators Deliberate practice and personalized feedback Listed: SPRC/AFSP Best Practice Registry Listed: National Registry of Evidence Based Programs and Practices (HS only) Effectiveness demonstrated in national empirical studies (HS only) Widespread adoption over 100,000 teachers in Texas, NY, Arizona, Ohio (HS only) Learning Objectives 1. Recognize warning signs that a student may be suffering from psychological stress. 2. Initiate a conversation with a student to build resiliency and help the student identify sources of support. 3. Upon discovering that a student experiences anxiety, depression, substance abuse, or bullying, refer the student to appropriate support. 4. Recognize signs that a student might be considering suicide, how to ask the student about possible suicidal thoughts and plans, and connect the student to the appropriate support immediately. 5. Avoid common pitfalls such as attempting to diagnose the problem or giving unwarranted advice during the conversation 6. Learn about how counseling can assist students Assume a Role Learners assume the role of Mr. Bauer, a middle school teacher, or Mr. Lyons, a high school teacher. Jackie Torres, a child psychologist, introduces the topic of gatekeeper training and provides the user with feedback throughout the training. 11
Middle School Student Avatars MARIAH New to the school Teased by popular girls Cyber bully victim Ran out of class upset JEN Popular but rude Angry outbursts Teased another student Conflict at home MICHAEL Losing a loved one Worrisome journal entry Sometimes withdrawn Thoughts of suicide High School Student Avatars Rene Highly motivated student Stressed about grades Evidence of self harm Excessive demands for teacher s time and attention Roberto Aggressive in class (bullied student) Rude, disrespectful behavior Outbursts of anger Missing class Joey Wrote about suicide Very shy, withdrawn Father died by suicide Deteriorating grades Bullied by others Examine Student Profiles (HS Only) Learners can click on a student for more information, such as : (1) academics (grades, participation, attendance) (2) any troubling behaviors Mr. Lyons has noticed (3) any information about the student that Mr. Lyons gathered from others in the community: teachers, students or family members 4) and the student s physical appearance. After exploring the profiles, the learner decides which student to talk with first. 12
Supporting LBGTQ Students Supporting LBGTQ Students Talk to Students Users engage in conversations with the three student avatars. Practice and learn to use openended questions, reflective listening and other motivational interviewing techniques to effectively: 1. Broach the topic of psychological distress 2. Motivate the student to seek help 3. Avoid common pitfalls such as attempting to diagnose the problem or giving unwarranted advice 13
Talk to Students The learner controls the conversation by choosing what topic to brings up and what specific things to say. Learners receive instant feedback through the student s verbal responses and body language Talk to Students as well as encouragement and constructive criticism on their decisions from Jackie. Critical errors lead to immediate corrective feedback as well as the opportunity to undo and correct their decision. Summary Feedback Upon concluding each conversation, learners receive narrated and animated feedback that highlights important lessons and key strategies for identifying, approaching and referring at risk students. Training is completed once they speak with three students. 14
Resources Once you ve completed the training, be sure to click on the links at the top for: Information about local services Downloading your certificate of completion Taking the online survey to give feedback about the course Downloading a summary of the course and some additional resources Additional Features illinois.kognito.com @2012 Kognito Interactive. All Rights Reserved. Demo Demo illinois.kognito.com @2012 Kognito Interactive. All Rights Reserved. 15
IDEAS FOR IMPLEMENTING AND PROMOTING THE COURSES Implementation Guides Assist with: Getting started (K 12) Secure support of stakeholders, create web presence, leverage media, follow up and host a kick off webinar Tips for announcing and promoting these courses on campus (K 12) Customizable presentation slides, emails, handouts and posters promoting the need for the training and the training itself. Potential Stakeholders (K 12) School superintendent, principal, assistant principal (and their unions and associations) School safety officials Teachers School counselors, school psychologists, school social workers Health and PE Local education and mental health agencies Local legislators PTA and other parent organizations Community mental health and suicide prevention coalitions/specialists Media 16
Promote the Program Links to resources Community Partners and School Leaders can access resources to promote the program to schools in their area by clicking on Tips & Resources for Schools Use the resources to reach out to school boards, school leaders, parents groups and others who can encourage the school to participate Promoting the Program Implementation 17
RESOURCES Best Practice Registry http://www.sprc.org/bpr/secti on i evidence based programs Best Practice Registry http://www.sprc.org/bpr/alllistings 18
Resources Download at http://www.sprc.org/sites/sprc.org/files/library/afterasuicidetoolkitforschools.pdf Resources National Suicide Prevention Lifeline Resources 19
Resources http://www.sprc.org/ Resources http://www.itonlytakesone.org/ Q&A SPEAKER CONTACT INFORMATION Jennifer L Martin Illinois Department of Public Health Jennifer.L.Martin@illinois.gov Phone (217) 558 4081 20