Best Practices Suicide

on College Campuses

Meghan CampbellConstance Carmona

Gissel RiveraRachel Seavey

Courtney Struble

Statistics• More than 1,000 students on campus commit

suicide each year

• Suicide is the second leading cause of death among college students

• 8 – 15% of students attempt suicide in the United States

• 5% of students report making a suicide attempt annually

• Only 23% of students who died by suicide were seen by their college counseling centers

• Gender Paradox

Suicide Cases in 2012

April 2012• Boston University Graduate Student• Suffolk University Senior • Harvard University Senior

May 2012• Boston College Sophomore

June 2012• Amherst College Freshman

December 2012• American International College

Freshman

Landmark Legislation• Garrett Lee Smith Act

Notable Prevention Efforts• JED

• Campus Suicide Prevention Program

Recent Recommendations• Recommendations for reporting on suicide

• Return of “in loco parentis”

Issues with Past Practices

• Self Reporting• Social Stigma

• Gap Between Perception and Reality

Risk Factors & Warning Signs

• Psychiatric Disorders• Past History of Attempted Suicide• Genetic Predisposition• Neurotransmitters• Impulsivity• Suicide Crisis• Precipitating Event• Intense Affective State• Changes in Behavior

Observable Signs of Serious Depression:• Unrelenting Low Mood• Pessimism• Hopelessness• Desperation• Anxiety• Inner Tension• Withdrawal• Sleep Problems• Increased Alcohol and/or Drug Use• Recent Impulsiveness• Threatening suicide• Expressing a Strong Will to Die• Making a Plan• Unexpected Rage or Anger

• Increased risk of depression, PTSD, & drop out rates

• Negative PR• Suicide Ideation• Suicide Contagion

Dangers of a Poor Campus Response

Suicide IdeationIdeation is a broad term ranging from thoughts of suicide to unsuccessful attempts.

1 in 12 students has made a suicide plan, and approximately 24,000 suicide attempts occur annually among U.S. college students

Signs of ideation : Arnold Lazarus’s BASIC ID model

• Behaviors• Affect• Sensation• Imagery• Cognitions• Interpersonal Relationships• Drugs or Biology

Suicide Contagion

“Suicidal behavior by additional people that is influenced by a previous attempt or completion.”

On average 1 suicide affects 6 lives*However, this number drastically increases when a suicide occurs on a campus.

Suicide Contagion Example: St. Clair High School in Missouri

As of November 15, 2012 there had been 3 student suicides in 7 weeks.

Best Practices for a Campus: Preventing Contagion

• Implement a Death Response Team (DRT)

• Notify “suicide victims” (those individuals directly connected to the deceased)

• Address student body/community as a whole, dispel myths & rumors.

• Discuss suicide as a byproduct of mental illness and depression.

The 2007 Award winning campaign created by the University of California, Irvine and A Better World Advertising.

Avoiding Contagion• Implement an already existing DTR.

• Minimize public memorials and vigils to avoid ideation.

• Abstain from publishing media articles that expose unnecessary information about the student like suicide notes, pictures, or pre-mortem Facebook statuses.

• Reassign roommates or floor mates if needed.

Avoiding Contagion cont.

• Refrain from using the deceased student’s room as a memorial site.

• Respond with education initiatives vs. romanticism.

• Offer grief counseling and mental health services.

• *Must still publicly recognize the event vs. ignoring it.

Providing Resources• Accessibility• Addresses the whole student

population (i.e., LGBT and Veterans)

• Screenings and services to detect student pre-suicide attempt

• Innovative ways to reach the high risk students

Example:ETSU PEAKSBU Secrets

Boston University: Revealing Secrets Can Help Students

Importance of Mental Health Services• Poor mental health can have negative effects on a student’s ability to

perform well academically (ACHA, 2011)• College students are the largest uninsured group (ACHA, 2011)• Most insurances provide little to no benefits for mental health and

substance abuse (ACHA, 2011)• Reduce the number of students suffering from depression or other mental

crises• Connect the institution to “troubled” students• Relay services and initiatives steered towards helping students at risk

Conclusion

References• ACHA. (2011). Accredited student health services - aaahc and the joint

commission. American College Health Association, Retrieved fromwww.acha.org/Topics/docs/Accredited_Student_Health_Services.pdf

• Levine, H. (2008). Suicide and its impact on campus. New Directions for Student Services, (121), 63-76.

• Nicoletti, J., Spencer-Thomas, S., Bollinger, C. (2010). Violence Goes to College: The Authoritative Guide to Prevention and Intervention 2nd Edition. Springfield, Illinois: Charles C Thomas Publisher,

LTD.

• Warren, L.(2012)Three Students at St Clair High School in Missouri Have killed Themselves in Seven Weeks. USA Prepares: November 15, 2012. Retrieved from: http://www.usaprepares.com/health/three-students-at-st-clair-high-school-in-missouri-have-killed-themselves-in-seven-weeks

• Hirsh, J.K. & Barton A.L. (2011). Positive social support, Negative social exchanges, and suicidal behavior in college students. Journal of American College Health 59(5), 393 – 398.

• Cukrowicz, K.C., Schlegel, E.F., Smith, P.N., Jacobs, M.P., Van Orden, K.A., Paukert, A.L., Pettit, J.W. & Joiner,

T.E. (2011). Suicide ideation among college students evidencing subclinical depression. Journal of American College Health 59(7), 575-581.