JLMC Forum on Teen Suicide Prevention Sparks an Important Conversation
The subject of youth suicide is a very emotional and difficult one to broach publicly. Noting the recent spike in the Monmouth County youth suicide rate (currently the highest in New Jersey-tied with Bergen County with 23 out of 234 in 2011), The JLMC decided to address the often “hushed” issue during Suicide Prevention Month in a special community forum held on Friday, September 25.
A group of panelists, including Ms. Liss, and other participants shared experiences, best practices and resources with their audience to better understand the signs and symptoms of suicide, and ways to respond including school intervention.
Stacy Doumas, MD, a Psychiatrist at Jersey Shore University Me dical Center, presented the statistics and facts on youth suicide defined as ages 15 to 24; with the suicide rate increasing as teens age. New Jersey still happens to have one of the lowest youth suicide rates in comparison to the rest of the United States, attributable to the state’s low percentage of gun ownership, a consequence of New Jersey’s strong gun control laws.
The majority of youth suicides are young males who have experienced a crisis within the past two weeks to 24 hours of their attempt. These may include: a family fight, relationship breakup, shame over some incident, or difficulty in transitions such as from high school to college. Twenty percent of those who have committed suicide suffered substance abuse problems, 15% were involved in legal proceedings, and 7% knew someone who committed suicide.
General risk factors include: family history of suicide; a previous self-harm event; exposure to others who have made attempts or committed suicide, expression of suicidal thoughts, access to lethal medicine, lack of social support, psychotic disorder, substance abuse, depression, and family discord.
Dr. Doumas stated that once the risks are identified, protections to prevent suicide include making sure the young person is safe in providing appropriate supervision and eliminating access to dangers such as deadly medications. Then treatment must be sought to address the underlying psychological issues.
She added that treatment includes psychotherapy and perhaps prescription of the appropriate anti-depression medications. Noting the controversy over anti-depressive medications that some accounts purport to actually contribute to suicide, she stated, “Depression is very treatable with anti-depression medication; and for the vast majority of severely depressed youth, the benefit of the medication far outweighs the risks.”
She added that she feels her industry can do a better job in the critical transitioning of patient care through the medical establishment.
“We don’t want to lose patients in the cracks when they move between a hospital setting back to a therapist’s care,” she stated.
An important part of suicide prevention includes screening for depression and developing strong suicide awareness programs most often in the school environment.
In 2005, the New Jersey legislature passed Senate bill no. 2622, a suicide prevention law, in response to the growing number of teenage suicides. The law requires that schools create and present student suicide awareness programs for students and provide suicide prevention training for teachers, who are often a major line of defense in observing warning signs of suicide. The RBR School Based Youth Service Program, The Source, in conjunction with the Health Education classes began implementing a Signs of Suicide (SOS) program in 2004 in response to a student who died by suicide. Stacy Liss, the Clinical Supervisor of the Source, reports that the SOS program is presented every year in the Health Education Classes, by a Source Clinician and the Student Assistance counselor. The SOS program has identified many students at risk for suicide and mental health concerns. The SOURCE, one of only 80 school-based mental health programs in the state, employs licensed Clinicians, who are able to screen students at risk and recommend the appropriate level of care to address the students’ needs. The focus is on prevention, intervention, and in the unfortunate case of a death by suicide, Postvention. Ms. Liss is also a co-leader of the RBR Crisis Team, comprised of Source Clinicians, Guidance, CST, Administrators and teachers, who have developed Policy, Procedures and Protocols to respond to sudden deaths such as suicide. The Crisis Team is trained to respond to a student suicide by a planned Postvention, with the goal of identifying additional students who may be at risk and therefore reduce the likelihood of a “copycat” suicide or contagion.
Through the Source, RBR has worked with students at risk providing individual, group and family counseling, crisis intervention and with referrals to outside therapists and agencies when necessary. The value of having mental-health professionals in house gives students immediate access to these services in the school environment. When school is not is session, and between the most vulnerable hours of midnight to early morning, Ms. Liss encourages at-risk students to reach out to 2nd Floor, the Suicide prevention hotline. She encourages her students to enter the hotline number in their phones. Parents are also provided with 24 hour help through Children’s Mobile Response and Stabilization Services.
“It is heartbreaking, but despite a school and communities best efforts sometimes a suicide occurs,” Ms. Liss commented, “then, the most important step is reducing contagion and providing postvention protocols to prevent copy-cat situations.”
She continued that while students are grieving and want to honor the memory of a student they cared about, a fine line must be navigated as not to glorify the student in a way that could inspire imitation of the act.
She praised the message that the musician Courtney Love sent to the fans of her famous husband Kurt Cobain following his suicide. “She spoke directly to the fans who gathered at their home the day of his suicide and told them it wasn’t okay and that suicide is not the answer!”
The Source at RBRHS maintains a comprehensive referral list for community mental health agencies and therapists. One of the therapists RBR refers its students to, Alicia Zink, who also participated in the JLMC panel. Her practice predominantly encompasses teenagers and families from Monmouth County towns.
She stated, “The biggest risk factor I see in young people is low self-esteem and low confidence, which causes depression. It is influenced by friend groups and pressure from school. Social media has aggravated the situation, making teens feel they are not good enough. That, however, is the hallmark of adolescents, they don’t know who they are while they are trying to differentiate from their parents and don’t have their footing yet; all their friends are struggling with this as well.”
She added that the whole purpose of the JLMC event was a coming together to partner and provide information on care and resources so the teens can get the help they need. Many of the organizations that provide help to possible suicide victims and their parents participated in the conversation. Some included:
· 2nd Floor Youth Helpline: 1-888-222-2228
· Society for the Prevention of Teen Suicide at www.sptsusa.org
· Support Groups for teenagers and parents can be located at National Alliance on Mental Illness at NAMI.org.