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Webinar Materials: Suicide Risk Assessment
Key Points Made by the Presenter
Suicide as a Complex Issue was emphasized!
•Dr. Kutcher explained:
- contrary to myth, most teenagers pass through the adolescent years without severe and prolonged difficulties
- About 15 - 20 percent of teens will experience a mental disorder or substantial mental health problem during adolescence
- Mental illnesses are the most prevalent medical disorders that onset in adolescence (about 70% of all mental disorders onset prior to age 25) and make up almost 1/3 of the global burden of disease in this age group
- Suicide in young people is closely linked to mental disorders (particularly depression) but is also influenced by other factors (such as: availability of lethal means; socio-cultural phenomenon; etc.)
He warned that the same factors may not be at play in all locations and suggested that professionals MUST be careful with "explanations" for causes of suicide. Dr. Kutcher debunked some common reasons that may be given for death from suicide as not necessarily causal factors (i.e. adolescents being under tremendous stress, or not having enough life experiences, or because of trouble at home; change in family dynamics, change of schools, social struggles, the natural separation from parents, dating, etc. )
Risk Factors: Stan explained that risk factors are co-relates and most are not “causal”. Risk factors have different strengths of effect (effect size; odds ratio) – not all risk factors are similarly impactful. Risk factors may not exert their effect independently (for example may only operate in the context of another risk factor).
Moderate to strong “risk factors”:
Prior suicide attempt (~ 35% completers – especially males)
FH suicide/suicide attempts (5x mother, 2x father)
Juvenile Justice System vs. regular education system
Evidence for Effectiveness of Youth Suicide Prevention
•Early diagnosis and effective treatment of mental disorders (particularly depression) – in primary health care and mental health care.
•Restriction of lethal means (bridge barriers, gun control, pesticide control).
•Early identification of youth suffering from mental disorders and youth who are suicidal (“gatekeeper” training programs applied in institutional and organizational settings).
Suicide Prevention: Some Possible Individual and Public Health Strategies to Consider in your Location
•Increasing the diagnosis of and access to effective treatment for those people who have mental illnesses – requires enhancement of clinical service capacity and early identification capability – individual approach
•Restriction of common lethal means (such as firearm control; safe storage of poisons and gasoline; etc.) – public health approach
•Media training (not to sensationalize reports about suicide) – public health approach
•Birds of a feather flock together – not well tested but may be useful approach to deal with the issue of cluster, contagion or “copy-cat” suicides – also addressing mental health need in others – individual approach
•Gatekeeper PLUS models – for example: teachers, guidance counselors training may be helpful in identifying youth at higher risk and improving knowledge and competencies in mental health – individual and public health approach
Identification of “high risk” student
•Is the student’s emotion, cognition or behavior distressing to others?
• Does the student exhibit a lack of social convention that he/she seems unaware of?
• Are the student’s emotions, cognitions or behaviors substantively different that those of her/his socio-cultural peers?
•Are the student’s peers or parents concerned about the student’s functioning (include social exclusion)?
•Has there been a significant change in the student’s emotions, cognition, behavior or functioning?
•Has a “friend” shown substantial problems (including suicide attempt)
Tool for Assessment of Suicide Risk (TASR – A)
Dr. Kutcher recommended that professionals be aware of the information that is located on the Teenmentalhealth website. This site is dedicated to helping improve the mental health of youth by the effective translation and transfer of scientific knowledge.
In a previous Webinar on youth and mental health he also recommended: www.cmha.ca/highschoolcurriculum
This page also contains background information on teen suicide.
Mental Health Round Table (2005)
Canada holds the unhappy distinction of having the worst adolescent suicide rate among the world's leading industrial powers. Every year, 300 kids between the ages of 10 and 19 kill themselves.
Offord Review of Prevention Programs
This review looked at school-based, community-based, and health-care-based suicide
prevention programs and evaluated their effectiveness to prevent suicide in teenagers.
When Something's Wrong
For a number of years, CPRF's Education Committee had offered school programs for parents, teachers and students wanting to learn more about mental health issues and about related behaviours they did not understand. It was through this work that the committee learned of the need for concrete reference guides on mental disorders that contained strategies for coping, as well as additional resources for teachers, parents and others working with young people. To answer this need, the committee recruited a group of parents, educators, social workers, school psychologists, in-take coordinators, school administrators and psychiatrists for a project called When Something's Wrong.
The handbook, When Something's Wrong: Strategies for Teachers was made possible by many corporate, academic and community partners. It was launched in May 2001 at CPRF's first Open Mind conference, attended by over 300 people, and featured speakers who are experts in the issues outlined in the handbook (e.g, anxiety disorders, depression, eating disorders and schizophrenia).
BC Coroners Report on Teen Suicide (Vancouver Sun)
More than two-thirds of youths who kill themselves had exhibited previous suicidal behaviour, and most had reached out to someone for help before their deaths, says a new report issued Tuesday through the BC Coroners Service.
Suicide Prevention Web Site (Australia)
The Living Is For Everyone (LIFE) website is a world-class suicide and self-harm prevention resource. Dedicated to providing the best available evidence and resources to guide activities aimed at reducing the rate at which people take their lives in Australia, the LIFE website is designed for people across the community who are involved in suicide and self-harm prevention activities.
Canadian Association for Suicide PreventionCASP works towards reducing the suicide rate and minimizing the harmful consequences of suicide by advocating, supporting and educating
Centre for Suicide Prevention
The Centre for Suicide Preventionhas three main branches - The Suicide Information & Education Collection (SIEC) is a special library and resource centre providing information on suicide and suicidal behaviour. The Suicide Prevention Training Programs (SPTP) branchprovides caregiver training in suicide intervention, awareness, bereavement, crisis management and related topics. Suicide Prevention Research Projects (SPRP) advocates for, and supports research on suicide and suicidal behaviour.
Acting On What We Know: Preventing Youth Suicide in First Nations
In 2001, the National Chief of the Assembly of First Nations, Matthew **** Come, and former Minister of Health, Allan Rock, appointed a panel of eight Aboriginal and non-Aboriginal researchers and health practitioners to make recommendations regarding the prevention of suicide among First Nations youth. The members of the Suicide Prevention Advisory Group were selected by the First Nations and Inuit Health Branch (FNIHB) of Health Canada and the Assembly of First Nations for their knowledge and experience in the areas of suicide prevention, health promotion and First Nations community development. The profiles of Advisory Group members are outlined in Appendix A.National Chief **** Come and Minister Rock commissioned the Advisory Group to develop specific, viable strategies for short- and long- term action to address this issue, based on reviews of previous studies, current literature and assessment of service delivery gaps.See the Chapters on:
- Guidelines for Effective Suicide Prevention
- List of Suicide Prevention/Mental Health Promotion Programs Reviewed
- Identity, Resilience & Culture
- School-based Strategies
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