Suicide prevention

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RED para la

PREVENCION de

SUI IDIO NACIONAL 1-888-628-9454

www.suicidepreventionlifeline.org

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1st leading cause of death for ages 10-14

Nebraska Youth Suicide Prevention

2nd leading cause of death for ages 15-24

2nd leading cause of death for ages 25-34

This insert was developed in part under a grant number 5U79SM061741 from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS) via the Nebraska Department of Health and Human Services, Division of Behavioral Health and Region 4 Behavioral Health System. The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.

Warning Signs of Suicide

• Talking about wanting to die or to kill oneself

• Looking for a way to kill oneself, 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 feeling isolated

• Showing rage or talking about seeking revenge • Displaying extreme mood swings

• Losing interest in things, or losing the ability to experience pleasure

When Someone is Suicidal

There are actions you can take to help someone when warning signs of suicide are detected.

Introducing the topic of suicide will not put the idea into their head, instead, the person will probably feel relief that they can finally share and talk about it. Saying things out loud may help the person actually hear it for the first time and bring a new perspective to the situation.

ASK THE QUESTION • “I have the feeling you are thinking about suicide but are having trouble bringing it up.”

• “Are you thinking about suicide?”

• “Sometimes people in certain situations feel suicidal. Have you been thinking about killing yourself?”

LISTEN • LISTEN AND LOOK FOR WARNING SIGNS / RISK FACTORS • Ask what is causing the distress

ASK ABOUT REASONS FOR LIVING AND PLANS FOR SUICIDE • Find out what is important to the person and why they may choose to live • “Do you have a plan to kill yourself?”

Ask How, Where, When, and if they have the means in place (Do they have a gun/ pills/ rope or whatever they plan to use?)

TAKE ACTION • Remove means like guns & pills • Offer your support in obtaining help from a professional • Don’t leave the person alone once you have determined he or she is at risk • Remind the person that seeking help for depression isn’t a sign of weakness and that chances for recovery are excellent All thoughts of suicide must be taken seriously.

NO EXCEPTIONS! There is help for anyone who is contemplating suicide - Call the National Suicide Prevention LIFELINE at 1-800-273-8255.

Training in QPR and/or Youth Mental Health First Aid can teach you to spot the signs and symptoms of someone who may be suicidal and how to ask those tough questions. Call Ann at 402-316-1779 if you are interested in either of these trainings.

At-Risk Populations for Suicide

The following populations are known to have an increased risk for suicidal behaviors (HHS, 2012): • American Indians/Alaska Natives • Individuals bereaved by suicide

• Individuals in justice and child welfare settings

• Individuals who engage in non- suicidal selfinjury • Individuals who have attempted suicide • Individuals with medical conditions

• Individuals with mental and/or substance use disorders • LGBT individuals • Members of the armed forces and veterans • Men in midlife • Older men

Gender Disparities

• Males take their own lives at nearly four times the rate of females and represent 77.9% of all suicides.

• Females are more likely than males to have suicidal thoughts.

• Suicide is the seventh leading cause of death for males and the fourteenth leading cause for females.

• Firearms are the most commonly used method of suicide among males (56.9%).

• Poisoning is the most common method of suicide for females (34.8%).

Sources: Center for Disease Control and Substance Abuse and Mental Health Services Administration

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You can help prevent suicide by taking the following actions:

Remove or Lock all firearms

Store firearms out of the home especially if you think someone in your home is impulsive or suicidal.

• Some police departments or sheriff’s offices will hold firearms temporarily. Call and explain your concern. (Don’t take guns to the police department unless they tell you to.)

• Otherwise, store them with a trusted friend or relative.

If storing them elsewhere isn’t an option, store all firearms unloaded and locked, and lock the ammunition in a separate location or remove it.

• Make sure the person you are concerned about doesn’t have access to the keys/combinations until the situation has improved.

• Remember, family members (especially teens) often know each other’s hiding places.

Firearms that must be carried as part of a job should be stored at work if possible.

“Suicide-proof” your Medicine Cabinet

For medicines your family needs...

• Keep only non-lethal quantities on hand. (Your doctor or pharmacist can provide guidance.)

• Lock up the rest.

For medicines your family doesn’t need or have expired...

• See if your town has a drug take-back program or a permanent drug disposal unit.

• If not, empty the medicines into a sealable plastic bag, crush them or dissolve with water, add yucky stuff like coffee grounds or kitty litter, seal the bag and toss into the trash.

• Do not flush or pour down the drain unless the label says to.

Permanent Drug Disposal Units within Region 4 Norfolk Police Department 202 N. 7th Street, Norfolk, NE

Columbus Police Department 2419 14th Street, Columbus, NE

West Point Police Department 444 S. Main Street, West Point, NE

Knox County Sheriff’s Office 206 Main Street, Center, NE

Antelope County Law Enforcement Center 1102 L. Street, Neligh, NE

Rock County Courthouse 400 State St., Bassett, NE

Boone County Sheriff’s Office 217 N. 5th Street, Albion, NE

Cherry County Sheriff’s Office 365 N. Main, Valentine, NE O’Neill Police Department 317 S. 4th Street, O’Neill, NE

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Promoting Wellness, Recovery and Resilience Region 4’s Roles & Responsibilities: • Network Development • Fiscal Management and Accountability • Advocacy • Program Management • Evaluation and Quality Management • Emergency System Coordination • Prevention Coordination • Consumer and Family Coordination • Youth System Coordination

Covering 22 Counties In Northeast & North Central Nebraska Regional Administrator

Ingrid Gansebom, 402-316-1782

Director of Network Services Melinda Lowe, 402-316-1783

Director of Emergency Services Steve Hecker, 402-316-1803

Professional Partners Director & Youth Systems Coordinator Deb Zimmerer, 402-316-1791

Prevention Coordinator Ann Koopman, 402-316-1779

Youth Suicide Prevention Outreach Coordinator Greg Priebe, 402-316-1797

LOSSteams help those grieving suicide

By MIKE BUHLER mbuhler@norfolkdailynews.com Dealing with the loss of a loved one or a friend after a suicide can be one of the hardest things imaginable. That is what makes the efforts of a LOSSteam (Local Outreach to Suicide Survivors Team) so important.

The mission of a LOSSteam is to reduce bereavement and distress after a suicide and to promote well-being. The team provides supportive services to those who have lost a loved one or a friend to suicide.

LOSSteams consist of trained individuals who themselves have felt the bereavement of losing someone they care for to suicide, giving them needed perspective in helping others who are dealing with the grief that they themselves have dealt with in the past.

“What we know is that peer to peer, survivor to survivor, it’s helpful when we walk into a scene where someone has recently lost a son, a daughter, a dad — whatever the relationship might be — and they hear those words, ‘Hi, I’m Don, I’m so sorry for your loss; I lost someone myself,’ ” Belau said. “When they hear that someone else ... has experienced that, it’s almost as if immediately those words fall upon the awareness that they’re not alone.”

Those who are left behind after a suicide battle feelings of isolation and many other conflicting emotions, Belau said.

“In a nutshell, it’s not therapy — it’s providing and guidance to people who are numb by the sudden loss of a loved one, or someone that they deeply care for, and help them get a sense that there is hope and that others have been through that experience,” Belau said. “They’re willing and able to spend some time right there at that moment as well as being connected with them in the future. ... It really is all about reaching out to the individuals who are suffering from that terrible shock, helping them heal and getting a sense of hope and direction as they move forward.”

LOSSteams are activated by local law enforcement officials after the victim is determined to have died by suicide. Law enforcement will contact the team’s coordinator and the LOSSteam typically responds within an hour or two.

Belau said connecting with law enforcement is important, as law enforcement plays an important part. Belau emphasized the importance of building partnerships with law enforcement, media, the mental health community and hospital settings — and he also acknowledges the importance of county attorneys and county coroners, who are the ones that declare the cause of death and lead to the activation of a LOSSteam.

“Law enforcement basically hands the scene off to us,” Belau said. “What we do is that we train and prepare law enforcement so that they can provide us that linkage with the family and the workplaces, wherever the case may be that the team is (needed.)”

Drs. David Miers and Don Belau brought the LOSSteam concept to Nebraska about 10 years ago after meeting Dr. Frank Campbell at a conference where he gave a brief presentation on the model for the program, which has since been replicated across the country and overseas.

“Dave and I were both so impressed by it that we literally said, ‘I think we can do this in Nebraska,’” Belau said, “so we came back and built a LOSSteam in Lincoln from the grassroots level. It has now been functioning for 9-10 years. We also have a team in Kearney (that has been there for) two years now and we have a team in Omaha based out of the Papillion area and it’s about a year and half (old).”

More LOSSteams are planned in the future, including one in Norfolk.

“What we’re hoping for is putting a LOSSteam in place in Norfolk, one in Columbus, and one in South Sioux City, up in that neck of the woods,” Belau said. “Ultimately, this is a project or a process that we’re building at such a level that it’ll be sustainable and not a flash in the pan kind of thing.”

Belau trained with clinicians here in Norfolk in August and he is pleased with what he has seen so far in Norfolk.

“I see key parts to this process of putting the LOSSteam in place,” Belau said. “It appears to me that there are a whole lot of folks at the table and working together, which I am really pleased to see in Northeast Nebraska.”

Want to learn more?

For more information about LOSSteams here in Nebraska, visit them online at nelossteam.nebraska.edu/ . Also, Dr. Campbell — who inspired the creation of the Nebraska LOSSteams — has a website of LOSSteam resources at www.lossteam.com/ .

Peer Suicide Support Group A support group meets the 2nd Tuesday of each month at First Baptist church, 404 W. Benjamin Ave., Norfolk, NE at 7 p.m. It is a peer support group with no counselors for anyone 18 and older who has lost someone to suicide.

Anyone who is struggling with depression and suicidal thoughts needs to seek out an individual counselor. This is NOT a support group for individuals contemplating suicide.

Please contact Donna Benson with any questions. 402-841-3834 donna68701@yahoo.com

Suicide Among College Students

• In 2000, the American College Health Association surveyed 16,000 college students from 28 college campuses. ✓ 9.5% of students had seriously contemplated suicide. ✓ 1.5% had made a suicide attempt. ✓ In the twelve month period prior to the survey, half of the sample reported feeling very sad, one third reported feeling hopeless and 22% reported feeling so depressed as to not be able to function. ✓ Of the 16,000 students surveyed, only 6.2% of males and 12.8% of females reported a diagnosis of depression. Therefore, there are a large number of students who are not receiving (adequate) treatment and/or who remain undiagnosed.

• Two groups of students might be at higher risk for suicide: ✓ Students with a pre-existing (before college) mental health condition, and ✓ Students who develop a mental health condition while in college • Reasons attributed to the appearance or increase of symptoms/disorders: ✓ New and unfamiliar environment; ✓ Academic and social pressures; ✓ Feelings of failure or decreased performance; ✓ Alienation; ✓ Family history of mental illness; ✓ Lack adequate coping skills; ✓ Difficulties adjusting to new demands and different work loads.

• Risk factors for suicide in college students include depression, sadness, hopelessness, and stress.

• As with the general population, depression plays a large role in suicide. “Ten percent of college students have been diagnosed with depression” (NMHA, 2001). “The vast majority of young adults aged 18 and older who are diagnosed with depression do not receive appropriate or even any treatment at all”.

Region 4 Behavioral Health System

Region 4 Behavioral Health System is a nationally accredited organization governed by a Regional Governing Board consisting of elected officials (Commissioners or Supervisors) from 22 counties in North Eastern and North Central Nebraska. These counties include: Antelope, Boone, Boyd, Brown, Burt, Cedar, Cherry, Colfax, Cuming, Dakota, Dixon, Holt, Keya Paha, Knox, Madison, Nance, Pierce, Platte, Rock, Stanton, Thurston, and Wayne. Region 4 contracts with community providers for many behavioral health services which are available to both youth and adults.

Through the Nebraska Youth Suicide Prevention Project, Region 4 is able to provide outreach to youth, parents, schools and other area stakeholders. Region 4 is also able to provide community and/or agency trainings in specific Evidence Based Practice models which may include: • LB293 requires all public school personnel in the State of Nebraska, www.education.ne.gov , to have one hour of education and awareness each year for suicide prevention. Making Educators Partners training was selected as the training during Year 2.

• QPR (Question, Persuade, Refer) Gatekeeper training – For anyone - teaches you the steps from how to ask if someone is considering suicide through referring them to the National Suicide Prevention Hotline @ 1 800-273-TALK (8255) • AMSR (Assessing and Managing Suicide Risk) and CAMS (Collaborative Assessment and Management of Suicidality) – both training for clinicians on suicide assessment through clinical planning • Youth Mental Health First Aid – For anyone who works with youth – teaches you how to look and listen for the warning signs of suicide and other behavioral health crisis and how to respond to those in a crisis.

Other trainings Region 4 provides include: • Mental Health First Aid – For anyone who works with adults – teaches us how to respond in a mental health emergency and offer support to someone who appears to be in emotional distress.

• Trauma Informed Care – For anyone – looks at trauma across the lifespan and the affect the trauma has on themselves and those around them.

If anyone is interested in holding and/or attending a QPR, Trauma Informed Care or either MHFA training, please contact Ann Koopman at 402-316-1779.