# Helping Give Away Psychological Science/Suicide Prevention in Schools

HGAPS is finding new ways to make psychological science conferences more accessible!
Here are examples from APA 2022 and the JCCAP Future Directions Forum. Coming soon... ABCT! ~ More at HGAPS.org ~
This page brings together resources for preventing suicides in schools. For more generation information regarding suicidal ideation, visit our other page. For information regarding non-suicidal self injury, visit our NSSI page. These pages were curated by Helping Give Away Psychological Science, a non-profit focused on dissemination and connecting people to resources from which they could greatly benefit.

## Hotlines
#### School Safety Hotline 1-877-729-7867

* Anonymously report weapon violations, bomb threats, drug misuse, bullying, etc.

#### Crisis Text Line

* Text 741741; Text HOME to connect to a crisis counselor
* https://www.crisistextline.org

#### National Drug Addiction Hotline 1-844-289-0879

* https://www.abovetheinfluence.com
* text ABOVE to 741741 for 24/7 anonymous free crisis counseling via Crisis Text Line

#### National Domestic Violence Hotline 1-800-799-7233

* text 1-800-787-3224

#### National Teen Dating Abuse Hotline 1-866-331-9474

* text "loveis" to 22522
* online chat: https://www.loveisrespect.org

#### Finding a Safe Place

* text "safe" and your current location to 4HELP (44357)
* reply "2chat" to talk with a trained counselor
* https://www.nationalsafeplace.org/txt-4-help

## Risk Factors
### Bullying
#### General Resources

https://www.stopbullying.gov
https://www.bullybust.org/students
Stomp Out Bullying HelpChat Live
* https://www.stompoutbullying.org/get-help/helpchat-line

#### 6 Ways to Be An Ally (English and Spanish)

* Support targets, whether you know them or not
* Don't participate
* Tell aggressors to stop
* Inform a trusted adult
* Get to know people instead of judging them
* Be an ally online

#### YRBS Findings on Students' experience with Bullying

* 14.9% of students nationwide have been electronically bullied (texts or any form of social media) in the last 12 months
* 19% of students nationwide have been bullied on school property in the last 12 months

### Gender and Sexuality (Gender and Sexuality (LGBTQIA+)
#### General Resources

Crisis Hotline for LGBTQIA+ Youth via the Trevor Project 1-866-488-7386
Trevor Project
* https://www.thetrevorproject.org/get-help-now
CDC Page on Resources for LGBTQIA+ youth
* https://www.cdc.gov/lgbthealth/youth-resources.htm
Resources via GLAAD for LGBTQIA+ community
* https://www.glaad.org/resourcelist

#### YRBS Findings on LGBTQIA+ Students

* 14.6% of students nationwide did not identify as heterosexual
* 20.5% of non-heterosexual students nationwide reported having been threatened or injured with a weapon on school property
* 49.1% of non-heterosexual students nationwide reported having been electronically bullied
* 57.3% of non-heterosexual students nationwide reported having been bullied on school property
* 38.9% of non-heterosexual students nationwide reported having experienced sexual violence in the last 12 months
* 63.6% of non-heterosexual students nationwide reported having made a suicide plan in the last 12 months

### Substance Abuse
#### General Resources

National Drug Addiction Hotline 1-844-289-0879
https://www.abovetheinfluence.com
* text ABOVE to 741741 for 24/7 anonymous free crisis counseling via Crisis Text Line

#### How does drug use affect high school grades?

* Lower grades
* Higher rate of absenteeism from school
* Heavy marijuana use in teen years and continued into adulthood
* Higher rates of school drop out

#### YRBS Findings on Students' experience with Substance Misuse

* 5.5% of students nationwide who drove a car had driven a car when they had been drinking alcohol
* 13% of students nationwide who drove a car had driven a car when they had been using marijuana
* 9.5% of students nationwide had first tried cigarette smoking before age 13
* 9.7% of students nationwide who currently smoke cigarettes reported smoking more than 10 cigarettes per day
* 42.2% of students nationwide reported having used an electronic vapor product
* 15.5% of students nationwide had their first drink of alcohol before age 13
* 13.5% of students nationwide reported having had 4 or more drinks of alcohol in a row (females) or 5 or more drinks of alcohol in a row (males) at least one day in the last month
* 36.5% of students nationwide have used marijuana one or more times

### Athletic Pressures
#### How to help a teen athlete deal with Sports Pressure

* Encourage a balanced life
* Change the mindset to "embrace the pressure and thrive"
* Relaxation techniques
* Recognize an injury
* Don't allow sports to become your identity
* Watch for substance misuse

#### YRBS Findings on Students' Health

* 54.3% of students nationwide reported having played on at least one sports team in the last 12 months
* 47.1% of students nationwide reported trying to lose weight
* 31.5% of students nationwide identified as being slightly or very overweight
* 15.1% of students nationwide had a concussion one or more times in the last 12 months

### Trauma
#### General Resources

National Child Abuse/Neglect Hotline 1-800-422-4453
Experiences with bullying, wanting to run away, homelessness, feeling unsafe
* https://www.1800runaway.org
Immigrants' Rights
* ACLU's "know your rights" outlined
* https://www.aclu.org/know-your-rights/immigrants-rights
National Domestic Violence Hotline 1-800-799-7233
* text 1-800-787-3224
Rape, Abuse, and Incest National Network (RAINN) Sexual Assault Telephone Hotline 1-800-656-4673
National Teen Dating Abuse Hotline 1-866-331-9474
* text "loveis" to 22522
* online chat: https://www.loveisrespect.org
Finding a Safe Place
* text "safe" and your current location to 4HELP (44357)
* reply "2chat" to talk with a trained counselor
* https://www.nationalsafeplace.org/txt-4-help

#### YRBS Findings on Students' experience with traumatic events

* 6.7% of students nationwide reported having not gone to school on at least one day due to feeling unsafe at school, or on their way to school
* 7.4% of students nationwide reported having been forced to have sexual intercourse when they did not want to
* 8% of students nationwide who reported having dated someone reported having been physically hurt on purpose by partner

## Identifying Suicidal Behavior
### Questions to ask a friend you are worried about

A good first step is often to ask your friend questions that might help you to identify if they are in danger of acting on suicidal feelings. It might feel scary to ask them these types of questions, but giving them the space to talk about their feelings may actually reduce the risk of them acting on them. Some good questions to start with include:
* Are you thinking about dying?
* Are you thinking about hurting yourself?
* Are you thinking about suicide?
* Have you ever thought about suicide before?
* Have you ever tried to hurt yourself before?
* Have you thought about how or when you would do it?
* Do you have access to any weapons or things you could use to harm yourself?

### Identifying Warning Signs
#### Warning Signs that are Easy to Identify

The following signs can be observed by someone who is suicidal. While there isn’t a concrete pattern of what is typically demonstrated by those who feel suicidal, these are common to look out for
* Expressing wanting to die or talking about dying in general
* Expressing dark thoughts with no hope such as feeling empty, defeated, or having no way out of problems
* Expressing intense feelings of guilt and shame
* Expressing that others around them would be better off without them or mentioning having no will to live
* Experiencing social withdrawal and isolation
* Giving away personal or sentimental items
* Saying goodbye to close friends and family

#### Less Obvious Warning Signs

While there are signs that are more observable in those who are suicidal, there are cases where others along with the individual themself may not realize how deeply hopeless they feel. It’s important to make note of the following signs since it could indicate that someone is feeling suicidal.
* Unusual changes in behavior: While this is a common sign in those who feel suicidal, this isn’t easily observable or distinguishable from normal behavior.
* Changes in normal sleeping patterns: Individuals who feel suicidal may struggle with their sleeping pattern, and it can look differently between individuals. Some may sleep more, less, struggle from fatigue as a result, and can experience more effort getting out of bad. This is a symptom that is important to track and check-in on even if the individual doesn’t appear to be suicidal.
* Accessing harmful means: An individual gathering lethal means can be harmful since they can keep this hidden from others. It is important to be aware if they have access to lethal means because it increases the risk of suicide.
* Emotional distance: Those who feel suicidal may become disconnected from activities or people that they valued or found joy in. They can act indifferent, and this is an important sign to check-in on since it can be a warning sign for depression as well.
* Physical pain: Physiological symptoms that others should note is that they can experience headaches or general body pains. This isn’t an easy sign to detect, but it should be tended to especially when there’s no easy explanation for the symptoms.

### What to do if your friend is suicidal

* Offer immediate support
** It’s important to validate your friend’s feelings and experiences. You can use phrases such as “I’m sorry you’re going through this” and “I know that you are in pain” to let them know that you hear them and want to help.
** Let them know how much you care about them by telling them things like “You mean so much to me” and “I can’t imagine life without you”. Remember to stay calm and non-aggressive, and continue validating their feelings (avoid phrases such as “I know you don’t really want to do” and “Your life isn’t really that bad!” and “This will all blow over”).
* Know when to act
** If your friend has expressed that they are thinking about suicide, it is time to to seek help.
*** Encourage your friend to see a therapist/school counselor
*** If your friend refuses to seek professional help, but you believe they are a danger to themself, tell an adult you trust and ask them for help - even if your friend tells you not to.
** If they express that they are actively suicidal, do not wait. If your friend has a therapist or psychiatrist, you can call them. You can also call a suicide hotline (link) or a trusted adult.
For more information, visit: https://www.nami.org/Blogs/NAMI-Blog/September-2020/My-Friend-Is-Suicidal-What-Should-I-Do

## Prevention
### Benefits of Early Interventions in Schools

* Lower risk of relapse
* Reduced risk of suicide
* Reduced vocational/developmental disruption
* Reduced family stress
* Improved recovery
* Reduced need for hospitalization

### Destigmatizing mental health
#### Steps to cope with stigma

* Get treatment
* Don't let stigma create self-doubt and shame
* Don't isolate yourself
* Don't equate yourself with your illness
* Join a support group
* Get help at school
* Speak out against stigma

### Self-Esteem
#### What is Self-Esteem?

* Self-esteem is the confidence in one’s worth or abilities
* Those who have low self-esteem generally have a negative opinion of themselves, their abilities, and their overall identity
* Low self-esteem can look like:
** Frequent self-criticism
** Ignoring your positive qualities
** Negative emotions (e.g. depression, anxiety, guilt, shame, etc.)
** Relationship problems
** The feeling of being “undeserving” of recreation and leisure
** Problems maintaining self-care

#### Improving Self-Esteem

* Improving self-esteem can seem like a difficult process and involves challenging and reconstructing deep-seated opinions of yourself. With time and practice, this process can become easier.
** Challenge Biased Expectations

### Self-Harm

Crisis Text Line
* Text 741741; Text HOME to connect to a crisis counselor
* https://www.crisistextline.org

#### Resources from the National Alliance on Mental Illness

* What is self-harm?
* Why do people self-harm?
* Treatment and coping
* What to do when someone else self-harms
* https://www.nami.org/learn-more/mental-health-conditions/related-conditions/self-harm

### Suicidality
#### Educating Parents

* Common reasons teens consider suicide
* Learn to recognize the warning signs
* How to help if you notice warning signs
* https://www.stanfordchildrens.org/en/topic/default?id=teen-suicide-learning-to-recognize-the-warning-signs-1-1696

#### Counseling on Access to Lethal Means (CALM)

* Reduce access to lethal means (firearms, medication, sharp objects, lighters, etc) to prevent suicidal behavior
* 48% of those who attempted suicide reported having first started thinking about making that attempt within 10 minutes before the attempt.
* 83-90% of firearm suicide attempts are lethal
* Firearms represent 51% of the fatal suicide attempts in the US

##### Lethal Means Counseling

* assess suicide risk
* explain risk to patient and parent/support person
* collaborate on a plan to reduce access to lethal means
* agree on roles and timetable and document the plan
* follow up within 24 hours and at next appointment

##### Safety Plan

* identify warning signs
* coping strategies to distract from negative thoughts
* people one can reach out to for help
* professionals / agencies one can contact in a crisis
* how to make the environment safe/limit access to lethal means

### Counseling Services In and Outside of School

* contact your school counselor and/or school social worker for psychological services
* speak with your teachers about mental health resources within the school
* speak with your parents about seeking community-based mental health services (individual and/or group therapy)

### Youth Risk Behavior Surveillance (YRBS) 2017 Findings on High School Students' Suicidal Behavior

* 17.2% of students nationwide had seriously considered attempting suicide in last 12 months
* Prevalence of having seriously considered attempting suicide was higher among females (22.1%) than males (11.9%)
* 13.6% of students nationwide had made a suicide plan in last 12 months
* 7.4% of students nationwide had attempted suicide at least once in last 12 months