Online Tool to Help Illinois Schools Support Student Mental Health

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Online Tool to Help Illinois Schools Support Student Mental Health

Illinois Youth Suicide Prevention Project

Jennifer L. Martin, M.S.W.

ISBE Special Education Directors’ Conference August 6, 2015

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Today’s Presentation

We want a society where people can live to their full potential; however, the reality is that a variety of circumstances can lead a person to feel helpless,

even attempt to take one’s life.

This training is made available by the Illinois Department of Public Health through funding from grant number 1U79SM060429-01 awarded by the Substance Abuse and Mental Health Services Administration

(SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.

Today’s Presentation

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Today’s Presentation

• Recognize training is one component of a comprehensive school suicide prevention program

• Overview of the courses available and how to access them

• Resources

• Q&A

Today’s Presentation

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THE REALITY OF YOUTH SUICIDE

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The reality of youth suicide

Illinois Data

Youth – ages 10 to 24

• Suicide

– Suicide is the third leading cause of death

– Approximately 125 young lives lost each year in

Illinois

• Based on IVDRS data

– MENTAL HEALTH CIRCUMSTANCES

• 1/3 – Current Depressed Mood

• 1/3 – History of Mental Health Treatment

• 40% - Current Mental Health Problem

The reality of youth suicide

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The reality of youth suicide

Illinois Data

• Based on IVDRS data(cont.)

– PRECIPITATING CIRCUMSTANCES

• 24% - Experienced crisis within last 2 weeks

• 4% - Financial problems

• 28% - Problem with current or former intimate partner

• 15% - Relationship problem (family, friend, other)18.9 percent of students reported seriously considering suicide

– SUBSTANCE ABUSE

• 1/3 – Positive blood alcohol test

• 6% - Alcohol dependence problem

• 10% - Substance abuse problem

The reality of youth suicide

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The reality of youth suicide

Illinois Data (cont.)

• Suicide attempt

– Approximately 3,000 youth receive medical care for self- inflicted injuries at

Emergency Departments in Illinois

– In an average classroom of 30 high school students, two students will have attempted suicide in past 12 months

• Suicide Ideation

– Bases on a 2013 Illinois survey of youth in grades 9-12 – “in the 12 months preceding the survey”

• 18.9 percent of students

reported seriously considering suicide

• 16.9 percent reported creating a plan

• 12.4 percent reporting trying to take their own life

• 5.6 percent received medical care following the attempt

The reality of youth suicide

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The reality of youth suicide

At-Risk Population – LGB Youth

• In 2009, Illinois YRBS data found when lesbian, gay and bisexual youth are compared to their non-gay peers they are more than three times more likely to report considering suicide in the past 12 months and to have made a suicide plan in the past 12 months.

Additionally, they were almost five times more likely to have attempted suicide in the past 12 months.

The reality of youth suicide

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RISK FACTORS

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Several factors can put a young person at risk for suicide.

However, having these risk factors does not always mean that suicide will occur.

The most significant ones are:

• Prior suicide attempt(s)

• Substance abuse

• Mood disorders

• Access to lethal means

Risk Factors

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Risk Factors

• Recent death of a friend, especially if by suicide

• Recent death of or separation from a family member

• Engaging in self-harm

• Problems in school (academic and/or discipline)

• Relationship problems or breakups

• Bullying or other forms of violence

• Discrimination based on sexual orientation or gender nonconformity

• Family problems or abuse, current or in the past

• Legal issues

• Serious illness or injury

• Other stressful events

Other risk factors include the following circumstances and problems:

Risk Factors

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WARNING SIGNS

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Warning signs

The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change. If you or someone you know exhibits any of these signs, seek help as soon as possible by calling the Lifeline at 1-800-273-TALK (8255).

• Talking about wanting to die or to kill themselves.

• Looking for a way to kill themselves, 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.

Warning Signs

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Warning signs

• Increasing the use of alcohol or drugs.

• Acting anxious or agitated; behaving recklessly.

• Sleeping too little or too much.

• Withdrawing or isolating themselves.

• Showing rage or talking about seeking revenge.

• Displaying extreme mood swings.

Warning Signs (cont.)

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Youth Suicide Warning Signs

(Expert consensus meeting hosted by AAS/NCPYS and SAMHSA) Suicide may be imminent

•Particularly if behavior is new or increased and related to anticipated or actual painful event, loss or change

•Talking about or making plans for suicide

•Expressing hopelessness about the future

•Displaying severe emotional distress, sadness, or pain

•Showing worrisome behavioral clues or marked changes in behavior, specifically:

•Significant withdrawal from social connections/situations

•Increased agitation or irritability

•Anger or hostility that seems out of character or out of context

•Changes in sleep (increased or decreased)

Warning Signs for Youth

Information shared by Dr. Gutierrez at the 2014 IL Suicide Prevention conference based on the collaboration between American Association of Suicidology/National Center for the Prevention of Youth Suicide and the U.S.

Substance Abuse and Mental Health Services Administration

Warning Signs for Youth

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PROTECTIVE FACTORS

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Protective factors are not just the opposite or lack of risk factors. Rather, they are conditions that promote strength and resilience and ensure that vulnerable individuals are supported and connected with others during difficult times,

thereby making suicidal behaviors less likely.

• Effective clinical care for mental, physical and substance use disorders

• Easy access to a variety of clinical interventions and support for helpseeking

• Restricted access to highly lethal means of suicide

• Strong connections to family and community support

• Support through ongoing medical and mental health care relationships

• Skills in problem solving, conflict resolution and nonviolent handling of disputes

• Cultural and religious beliefs that discourage suicide and support self preservation

However, positive resistance to suicide is not permanent, so programs that support and maintain protection against suicide should be ongoing.

Protective Factors

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The degree to which a person or group is socially close, interrelated, or shares resources with other persons or groups. Connectedness occurs within and between multiple levels of the social ecology that is between individuals, families, schools and other organizations, neighborhoods, cultural groups, and society as a whole

• Connectedness between individuals

• Connectedness of individuals and their families to community organizations

• Connectedness among community organizations and social institutions

However, positive resistance to suicide is not permanent, so

programs that support and maintain protection against suicide should be ongoing.

Connectedness as a Protective Factor

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Suicide is a public health problem.



Complex problem associated with multiple factors:



Individual (biological, psychological)

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Environmental (physical, interpersonal, community, societal)

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Requires a community-wide effort, across

disciplines

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SCHOOL’S ROLE

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Four reasons why schools should address suicide

1. Maintaining a safe school environment is part of a school’s overall mission.

2. Student’s mental health can affect their academic performance.

3. A student suicide can significantly impact other students and the entire school community.

4. Schools have been sued for negligence (e.g., failure to notify parents, get assistance, adequately supervise)

Why Address Suicide?

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• School wide programs that promote connectedness and emotional well-being

• Policies and procedures for helping students at risk and in crisis

• Protocols for responding to suicide death

• Postvention

• Staff education and training

• Parent/guardian education and outreach

• Student programs

• Curricula for all students

• Skill-building for students at risk

• Peer leader programs

• Screening for at-risk students

Comprehensive School Suicide Prevention Program

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School Code Requirement

• School code requirement

• School guidance counselors, teachers, school social workers and other school personnel who work with students in grades 7th through 12th are required to receive training to identify the warning signs of mental illness and suicidal behavior in adolescents and teens and shall be taught appropriate intervention and

referral techniques. (P.A. 098-0471)

• Participating in or presenting at in-service training programs on suicide prevention is among the list of

possible professional development activities for teacher re-licensure.

School Code

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• Educators are on the front lines with students every day.

• May notice worrisome behavior and appearance.

• Have existing relationships with students.

• Educators not mental health experts, but can take small steps to a big difference.

Role of Educators

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• A key strategy for prevention/early intervention and part of the national strategy for suicide prevention and.

• Reduces the anxiety teachers and staff may experience about responding to an at-risk student in their class.

• Reduces stigma associated with mental illness.

• Reduces the number of undetected students in schools and moves them into treatment as early as possible.

• Enhances safety for individual student, classroom, school and community

A “gatekeeper” is any individual (i.e., not a mental health professional) trained to identify individuals at risk of psychological distress and connect them to treatment or supporting services as appropriate.

Benefits of “Gatekeeper” Training

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ILLINOIS YOUTH SUICIDE

PREVENTION PROJECT

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Illinois Youth Suicide Prevention Project

• 3-year grant-funded program – SAMHSA 1U79SM060429-01

• Targets youth ages 10-24

• Purposes of IYSPP include

• Advancing the state suicide prevention strategic plan

• Enhancing Primary Prevention

• Increasing Linkage to Services

• Increasing Protective Factors/Decrease Risk Factors for students

• Promote National Suicide Prevention Lifeline

• Core Activities include

• Kognito Gatekeeper Training in Secondary/Post-Secondary Systems

• Expand the “It Only Takes One” website (suicide prevention campaign)

• Promote the National Suicide Prevention Lifeline

• Professional Development

• Stakeholder Meetings

Illinois Youth Suicide Prevention Project

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COURSE WALKTHROUGH

Secondary Schools

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Kognito At-Risk Suite for Educators

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What Makes Kognito Trainings Special?

• Fun, engaging, effective

• Designed especially for education community

• Hands on practice

• Private role play with intelligent avatars

• Individualized, real-time feedback

• ISBE CE credit

• Easy to implement district, or school-wide, or in higher ed

illinois.kognito.com

What Makes Kognito Training Special.

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• Online 24/7; 50 – 60 minutes

• Virtual role-play conversations with at-risk

“emotionally active” student avatars

• Created in collaboration with school and mental health experts and educators

• Deliberate practice and personalized feedback

• Listed: SPRC/AFSP Best Practice Registry

• Listed: National Registry of Evidence- Based Programs and Practices (HS only)

• Effectiveness demonstrated in national empirical studies (HS only)

• Widespread adoption – over 100,000 teachers in Texas, NY, Arizona, Ohio (HS only)

At-Risk for K-12 Educators

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1. Recognize warning signs that a student may be suffering from psychological stress.

2. Initiate a conversation with a student to build resiliency and help the student identify sources of support.

3. Upon discovering that a student experiences anxiety, depression, substance abuse, or bullying, refer the student to appropriate support.

4. Recognize signs that a student might be considering suicide, how to ask the student about possible suicidal thoughts and plans, and connect the student to the appropriate support immediately.

5. Avoid common pitfalls such as attempting to diagnose the problem or giving unwarranted advice during the conversation

6. Learn about how counseling can assist students

Learning Objectives

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Learners assume the role of Mr. Bauer, a middle school teacher, or Mr. Lyons, a high school teacher. Jackie Torres, a child psychologist, introduces the topic of gatekeeper training and provides the user with feedback throughout the training.

Assume a Role

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MICHAEL Losing a loved one Worrisome journal entry

Sometimes withdrawn Thoughts of suicide JEN

Popular but rude Angry outbursts Teased another student

Conflict at home MARIAH

New to the school Teased by popular girls

Cyber-bully victim Ran out of class upset

Middle School Student Avatars

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Joey

Wrote about suicide Very shy, withdrawn Father died by suicide

Deteriorating grades Bullied by others Roberto

Aggressive in class (bullied student)

Rude, disrespectful behavior Outbursts of anger

Missing class Rene

Highly motivated student Stressed about grades

Evidence of self-harm Excessive demands for

teacher’s time and attention

High School Student Avatars

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Learners can click on a student for more information, such as :

(1) academics (grades, participation, attendance) (2) any troubling behaviors Mr.

Lyons has noticed (3) any information about the student that Mr. Lyons gathered from others in the community: teachers, students or family members 4) and the student’s physical appearance.

After exploring the profiles, the learner decides which student to talk with first.

Examine Student Profiles (HS Only)

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Supporting LBGTQ Students

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Supporting LBGTQ Students

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Users engage in conversations with the three student avatars.

Practice and learn to use open- ended questions, reflective

listening and other motivational interviewing techniques to

effectively:

1. Broach the topic of psychological distress

2. Motivate the student to seek help

3. Avoid common pitfalls such as attempting to diagnose the

problem or giving unwarranted advice

Talk to Students

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Talk to Students

The learner controls the conversation by choosing what topic to brings up and what specific things to say. Learners receive instant feedback through the student’s verbal responses and body language …

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Talk to Students

… as well as encouragement and constructive criticism on their decisions from Jackie. Critical errors lead to immediate corrective feedback as well as the opportunity to undo and correct their decision.

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Upon concluding each conversation, learners receive narrated and animated feedback that highlights important lessons and key strategies for identifying, approaching and referring at-risk students. Training is completed once they speak with three students.

Summary Feedback

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Once you’ve completed the training, be sure to click on the links at the top for:

• Information about local services

• Downloading your certificate of completion

• Taking the online survey to give feedback about the course

• Downloading a summary of the course and some additional resources

Resources

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Additional Features

illinois.kognito.com

Additional Features

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Demo

illinois.kognito.com

Demo

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IDEAS FOR IMPLEMENTING AND

PROMOTING THE COURSES

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• Getting started

– (K-12) Secure support of stakeholders, create web presence, leverage media, follow up and host a kick-off webinar

• Tips for announcing and promoting these courses on campus

– (K-12) Customizable presentation slides, emails, handouts and posters promoting the need for the training and the training itself.

Implementation Guides Assist with:

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Potential Stakeholders (K-12)

• School superintendent, principal, assistant principal (and their unions and associations)

• School safety officials

• Teachers

• School counselors, school psychologists, school social workers

• Health and PE

• Local education and mental health agencies

• Local legislators

• PTA and other parent organizations

• Community mental health and suicide prevention coalitions/specialists

• Media

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• Community Partners and School Leaders can access resources to promote the program to schools in their area by clicking on “Tips & Resources for Schools”

• Use the resources to reach out to school boards, school leaders, parents groups and others who can encourage the school to participate

Links to resources

Promote the Program

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Promoting the Program

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Implementation

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RESOURCES

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Best Practices Registry

http://www.sprc.org/bpr/secti on-i-evidence-based-programs

Best Practice Registry

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http://www.sprc.org/bpr/all- listings

Best Practice Registry

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Resources

Download at http://www.sprc.org/sites/sprc.org/files/library/AfteraSuicideToolkitforSchools.pdf

Resources

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Resources

National Suicide Prevention Lifeline

Resources

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Resources

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Resources

http://www.sprc.org/

Resources

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Resources

http://www.itonlytakesone.org/

Resources

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Jennifer L Martin

Illinois Department of Public Health Jennifer.L.Martin@illinois.gov  

Phone (217) 558-4081