Suicide Awareness & Intervention Workshop

SUICIDE

Suicide Awareness & Intervention Workshop

SUICIDE

OVERVIEW Definitions and Statistics Myths and Facts About Suicide The Suicidal Process Precipitating and Risk Factors Warning Signs Suicide Intervention (ACE Model) Social Networks CF Policy Self Care Resources

Suicidal IdeationPersistent, repetitive, and preoccupying thoughts about suicide leading up to a suicide or suicide attempt.

Suicide AttemptA deliberate, life-threatening act against oneself with the intention of causing their own death.

SuicideA deliberate act against oneself that results in death.

DEFINITIONS

CF suicide rate (males) has been validated to 2008 and the four year average is 17.8/100 000.

Standardized suicide mortality rate to 2004 comparing the male CF to the general Canadian male population of the same age is approximately 80%

The CF suicide rate is 20% lower than the Canadian population.

CF Suicide Statistics

Common Myths &

Facts About Suicide

Common Myths & Facts About Suicide

“Suicide comeswithout warning!”

MYTH or FACT?MYTH

Common Myths & Facts About Suicide

“People consideringsuicide really want

to die.”

MYTH or FACT?MYTH

Common Myths & Facts About Suicide

“Suicide is an act of courage or cowardice.”

MYTH or FACT?MYTH

Common Myths & Facts About Suicide

“Once a person issuicidal, they will

neverchange their

mind.”

MYTH or FACT?MYTH

Common Myths & Facts About Suicide

“Someone who has attempted suicide doesn’t

really want to die; they’re just trying to get attention.”

MYTH or FACT?MYTH

Common Myths & Facts About Suicide

“Improvement following a

suicide attempt or intervention

signifies that the risk has passed."

MYTH or FACT?MYTH

Common Myths & Facts About Suicide

“Talking to someone about

their suicidal feelings will

cause them to attempt or complete suicide."

MYTH or FACT?MYTH

Common Myths & Facts About Suicide

"Most people who are suicidal

suffer from depression,

mental health or addiction

problems."

MYTH or FACT?FACT

Understand and increase awareness.

How Can You Help?

Divorce or relationship failure Grieving / loss of someone close Academic or professional failure Addictions / substance misuse Physical, emotional abuse/family violence Financial problems Legal problems

Precipitating Events

Trouble sleepingIrritabilityAnger, ImpatienceNervousness, anxietyMuscle tension HeadachesLow energyPoor concentrationNegative attitudeForgetfulnessProcrastinationOften late for workIncreased swearingDecreased productivity

Mental Health Continuum Model

Healthy Reacting Injured Ill

Noticeable fatigueAngry outbursts Panic attacksForgetting important thingsImpaired decision makingTaking risksInappropriate aggressionInsubordinationAbsenteeismIncreased accidental injuries

Severe memory lapses Cannot concentrateAvoiding or withdrawing Regular panic attacks Loss of controlCannot perform dutiesIndications of suicidal thoughts, intentionsLegal chargesSignificant change in behaviour

Calm & steadyConfident in self & othersGetting job doneIn control physically, mentally, emotionallyBehaving ethically and morallySense of humourFit, fed, restedRelaxing & recreatingSocially active

Risk Factors (Stats Can, Langlois,Morrison, 2002)VARY WITH AGE, GENDER

Depression or other mental health concerns Alcohol and/or other drug use Previous suicide attempts Family history of suicide behaviour Isolation or withdrawal Impulsivity Suicidal ideation

Warning Signs

Soon, I’ll get some peace.

Die now or later… what’s the difference?

I wrote my will.

I’m a loser…I’m useless.

You’ll be better off without me.

Thanks for everything you’ve done for me.

I  won’t be needing these things anymore.

           

Indirect Messages

I want to end it all.

I’m going to kill myself.

Life doesn’t mean anything to me anymore.

I’d be better off dead.

I just can’t take it anymore.

I’ll never be able to get out of this.

All of my problems will end soon.

Direct Messages

Trouble sleeping

Lack of appetite

General malaise

Extreme fatigue

Shortness of breath

Low or monotone

voice

Physical Signs

Changes in behaviour and/or

personality.

Isolation, withdrawal, sadness.

Abuse of alcohol, medications

or other drugs.

Reduced job performance or

academic results.

Difficulty making decisions,

lack of focus/concentration.

Neglect of personal appearance

or hygiene.

Psychological & Behavioural Signs

As someone outside the spiral, we see the support…As someone outside the spiral, we see the support…Someone who is suicidal, sees this…Someone who is suicidal, sees this…1. Person at risk seeks solutions…1. Person at risk seeks solutions…

2. Flash2. Flash

3. Ideation3. Ideation

4. Rumination4. Rumination

5. Crystallization5. Crystallization

THE SUICIDAL PROCESSTHE SUICIDAL PROCESS

Ask if the person is thinking about suicide: ask how, where and

when

The more detailed the plan, the faster you need to act.

Listen… let the person know that you care and understand.

Keep safe, disable plan (intervene).

Encourage the person to get help… link to resources

Go with them if they need support.

Follow up.

Get the information and support you need in order to be better

equipped to help.

What To Do / Intervention

ACEUS Army Center for Health Promotion and Preventative Medicine

Ask– Ask about suicidal thoughts.

• Know warning signs and if present, ask if person is thinking about killing themselves.

Care – Understand that person may be in pain.– Active listening may cause some relief.

• listen for what, where, and when• explore ambivalence

– Take action by removing any lethal means.

Escort– Take person to someone who can help.

• helping professionals (see references for complete list)• chain of command• identify support systems

Pass judgment.

Make false promises.

Challenge the person to do it.

Minimize their feelings.

Give advice or try to solve their problems.

Try to physically intervene

What NOT To Do

Confidentiality could risk the possibility of prevention or intervention.

The responsibility of maintaining confidentiality could be overwhelming for the person helping/assisting.

Confidentiality

INJURED

Anger / Conflict

Not Performing

Injuries

Insubordination

INJURED

Anger / Conflict

Not Performing

Injuries

Insubordination

ILL

Significant Changes

Not Functioning

Suicidal Thoughts

ILL

Significant Changes

Not Functioning

Suicidal Thoughts

REACTING

Absenteeism

Negative Attitude

Swearing

Impatience

REACTING

Absenteeism

Negative Attitude

Swearing

Impatience

HEALTHY

Performing Well

Constructive Input

Appropriate Behaviour

HEALTHY

Performing Well

Constructive Input

Appropriate Behaviour

What Can YOU do?

Get to know personnel.

Foster healthy environment.

Set example.

Watch for behaviour changes.

Advocate.

Get to know personnel.

Foster healthy environment.

Set example.

Watch for behaviour changes.

Advocate.

Minimize stressors.

Identify unhealthy situations.

Support.

Intervene – Consult – Identify Resources - Refer

Minimize stressors.

Identify unhealthy situations.

Support.

Intervene – Consult – Identify Resources - Refer

Involve resources.

Follow MELs.

Maintain contact & ensure support.

Deal with unacceptable behaviour.

Minimize rumours.

Involve resources.

Follow MELs.

Maintain contact & ensure support.

Deal with unacceptable behaviour.

Minimize rumours.

Maintain contact.

Ensure adequate resources / support.

Follow Medical Employment Limitations

Include member in Unit activities.

Maintain contact.

Ensure adequate resources / support.

Follow Medical Employment Limitations

Include member in Unit activities.

You can…

INJURED

Anger / Conflict

Not Performing

Injuries

Insubordination

INJURED

Anger / Conflict

Not Performing

Injuries

Insubordination

ILL

Significant Changes

Not Functioning

Suicidal Thoughts

ILL

Significant Changes

Not Functioning

Suicidal Thoughts

REACTING

Absenteeism

Negative Attitude

Swearing

Impatience

REACTING

Absenteeism

Negative Attitude

Swearing

Impatience

HEALTHY

Performing Well

Constructive Input

Appropriate Behaviour

HEALTHY

Performing Well

Constructive Input

Appropriate Behaviour

Key Role of Leaders

Foster healthy climate.

Reduce barriers to help-seeking.

Deal with performance issues promptly.

Identify and resolve problems early.

Demonstrate genuine concern.

Example of personal accountability.

Foster healthy climate.

Reduce barriers to help-seeking.

Deal with performance issues promptly.

Identify and resolve problems early.

Demonstrate genuine concern.

Example of personal accountability.

Involve members in social support.

Follow employment limitations.

Maintain respectful contact.

Seek consultation as needed.

Respect confidentiality.

Involve members in social support.

Follow employment limitations.

Maintain respectful contact.

Seek consultation as needed.

Respect confidentiality.

Social NetworkSocial Network

FAMILY

FRIEND

HELP

LINE

CARING

PERSON

TRAINIED IN SUICIDE AWARENESS

911 Padres Local Police Military Police Hospitals / Medical Clinics Mental Health Services Health Promotion Member Assistance Program (MAP) 1-800-268-7708 Employee Assistance Program (EAP) 1-800-387-4765 Family Resource Center (MFRC) Health Units

Resources

CF Policies

CFAO 19-44 Suicide Prevention http://admfincs.mil.ca/admfincs/subjects/cfao/019-

44_e.asp

DAOD 5017-0 Mental Health

http://admfincs.mil.ca/admfincs/subjects/DAOD/5017/0_e.asp

It is important to reduce the effects of an intervention experience.– self reflection and self monitoring of thoughts and

feelings after the event• writing/journaling, talking and sharing

– basic self care principles enough sleep/rest, good nutrition, and physical activity participate in activities you enjoy, have fun, humour spiritual renewal take a break from routine connect with nature

Self Care

CONCLUSION

Do not judge Listen, understand, aid. Be direct: ASK the question. If ‘yes’ then ask how / when / where? Consider safety… yours and theirs. Know your personal limits. Know and utilize available resources.

Suicide Awareness & Intervention Workshop

QUESTIONS or COMMENTS?

Suicide Awareness & Intervention Workshop

QUESTIONS or COMMENTS?

Your health - Our mission

Votre santé - Notre mission

HLIS Data

Social Wellness

Reasons for Seeking Help from a Mental Health Professional

Causes of MH Related Problems

Background: Suicide (HLIS 2008/9)

Relationship Satisfaction, Family Violence and Abuse

• 82% of survey respondents were currently in a relationship.

• Of those, 91% were either extremely, very, or somewhat satisfied with this relationship.

• 15% of CF personnel who responded had experienced at least one type of physical or sexual abuse in their current relationship.

• Males reported being on the receiving end of this abuse more commonly than females while males and females were equally reported to be perpetrators.

• A history of emotional or financial abuse was more common with 19% of CF personnel stating they were responsible and 25% stating their spouse was responsible.

Anger Management: HLIS 2008/9

• 78% of CF personnel rarely or never found themselves struggling with levels of anger that interfered with their ability to do their job or with personal relationships.

However, 18% reported that anger sometimes and 4% reported that anger often created this problem.