Supporting Youth Wellness: A Discussion on Suicide ... · Supporting Youth Wellness: A Discussion...

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Supporting Youth Wellness: A Discussion on Suicide Prevention and Intervention April 3, 2012 Jennifer Ramage, MSW RSW School Social Worker, Lorne Park S.S.

Transcript of Supporting Youth Wellness: A Discussion on Suicide ... · Supporting Youth Wellness: A Discussion...

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Supporting Youth Wellness: A Discussion on Suicide Prevention

and Intervention

April 3, 2012

Jennifer Ramage, MSW RSW

School Social Worker, Lorne Park S.S.

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Supporting Youth Wellness: A Discussion on Suicide Prevention and Intervention

The teen brain and common behaviours in teens

Building resiliency in teens

The continuum of mental health

Identifying teens at risk

How to have a conversation asking about suicidal feelings

Supports available at school and in the community

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Adolescence

• Is a time of excitement, exhilaration and adventure.

• Is a time of birth, preparation, independence, and evolvement; it is exciting and stressful. (Erickson 1968)

• Lots of positives in teens lives, good news........

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The Teen Brain

New discoveries in brain research over the past 10 yrs have shown that the brain grows and changes continually in young people. These new insights are assisting to better understand teenage behaviour.

Research is showing that important brain regions undergo refinement throughout adolescence and at least into a person's early 20's and maybe into their 30's.

This research is helping to understand why teen brains are superior in some ways and yet are immature in one key area – the frontal lobe.

The frontal lobe is responsible for thinking, planning, reasoning and interpreting social signals. Harvard Magazine “The

Teen Brain” Sept/Oct 2008 - Jennifer Kolari “You're Ruining My Life” Surviving the Teenage Years With Connected Parenting

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The Teen Brain

Because there is so much going on in the brain, teens can frequently become overwhelmed and their brains can go into fight or flight mode, activating the amygdala which is responsible for “gut reactions.” This sends adrenaline pumping through the brain and can result in teens becoming overly emotional, impulsive and reckless with the inability to engage in higher level reasoning.

This is something as parents we have to keep in mind.

Other common behaviours we may see include: door slamming, being oppositional, major mood swings, boundary pushing, argumentative, difficulty reasoning with, being sullen, non-communicative, insolent, rebellious, powerful emotions, being insulting, hurtful, rejecting-Jennifer Kolari “Surviving The Teenage Years With Connected Parenting.”

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Connected Parenting

This background info in understanding what is going on in the teens brain helps us to see what parenting approaches can be most helpful.

So what we understand is that teens can tend to react emotionally without thinking about whether their reactions are appropriate to the situation.

Because frontal lobes are not fully developed we know that trying to reason is not going to be helpful.

We also know that teens need us to model appropriate behaviour and to provide guidance and compassion to help them develop this ability.

Jennifer Kolari – Connected Parenting

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Connected Parenting Jennifer Kolari in her book “You're Ruining My Life”

contends that this is why connecting on the emotional level is key to communicating effectively with teens.

By appealing directly to the emotional centre of your teenager's brain you're sending the message that you empathize with what he/she is feeling. This allows them to calm down so that you are able to communicate about an issue. You are using your own reasoning abilities to help them become better at regulating their emotions.

At this time of pushes and pulls, loving you and hating you, your teen still wants and needs to know that he/she's attached to you and that you're the place of safety they can always return to.

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Connected Parenting

Kolari presents her CALM technique to assist your teen to understand that in amongst their process of separating from you, that despite many of the unpleasant and sometimes unacceptable behaviours they exhibit; that you're still there for them – that the attachment is still there.

Need to look at the things your teen is doing well.

Need to be aware that our own feelings, worries, anger, exhaustion or guilt often get in the way.

Need to emphasize, mirror your teen’s feelings so that they feel heard and understood.

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CALM Technique

Premise – Need to set everything else aside, including your own feelings and concentrate and show unrelenting understanding of the what the other person is feeling.

1. CALM: Connect, Affect, Listen, Mirror

2. Present the Problem

3. Find a Solution

Jennifer Kolari: Surviving the Teenage Years with Connected Parenting.

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Common Teen Behaviours

It's important to acknowledge that in amongst all of these difficult behaviours and emotions that teens can struggle with there are many positives happening during the teen years including watching your teen become an adult with their own unique independent thoughts, beliefs, interests, hobbies and personality.

Nurturing this is very important to enable your teen to build resiliency.

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Parenting/Building Resiliencies

Our role as parents is trying to build resiliencies in our children that will assist them to cope in difficult and stressful times in life.

Resiliency is the term given to a person's ability to cope with a challenging event or situation and is an important protection against problems such as: depression, anxiety, drug & alcohol use, problematic eating behaviours, poor achievement, increased risk taking behaviour, criminal involvement..

-CAMH - Growing Up Resilient

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Parenting/Building Resiliencies

Many young people face adversity and change and it's important that they are able to cope with life's challenges effectively.

By being resilient young people can grow and develop new skills as a result of dealing with these challenges.

Young people may face the following difficulites: moving away from family and friends, transitioning from primary to secondary to post-secondary education, increased responsibilities, parental divorce, loss of family member or close contact, physical illness, relationship breakup...

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Parenting – What Can We Do?

We can create opportunities for our children to develop hobbies, interests, social networks, obtain regular exercise, ensure proper sleep and eating, develop a sense of spirituality...

As a parent you are working to provide your children and adolescents with every opportunity to succeed and reach their full potential.

While all persons are different and have unique needs we want to convey to our children that: we are more alike than different, we are all of value no matter what, we all need to be treated with respect and dignity, we all have strengths and limitations and we need one another -(Hincks

Dellcrest)

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Parenting – What Can We Do?

The daily activities of parents and families, as well as parent's positive relationships with their children and adolescents, promote the mental health of their adolescents.

Parent's roles and relationships impact adolescent's feelings of self-worth, dignity, identity and belonging.

Parents are in a position to strengthen these elements of mental health.

Parents are also in the position to observe mood or behavioural changes which could indicate a problem. We also must trust our gut instincts. (Hincks-Dellcrest)

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Parenting – What Can We Do?

Positive home environment, we need to model:

Support, caring relationships, respectful interactions, acceptance of differences, opportunities for success, involvement, contribution and recognition

Clear expectations and predictable routines

Modelling of optimism, positive behaviour, understanding and acceptance of feelings, regulation of emotion and conflict resolution

Fostering interest and pleasure in life

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Mental Health for All Children and Youth

The term “child and adolescent mental health” refers to the social, emotional and behavioural well-being of children and adolescents and is an integral part of healthy development.

Just as with physical health, no one goes through life without some mental health problems.

The Continuum of Mental Health ranges from developmentally normal, through problems that may be addressed in everyday life, to problems that require expert assessment and intensive clinical interventions. This fluctuates throughout life. (CAMH)

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Mental Health for All Children and Youth

Many problems are a normal part of life and we can learn and grow from them.

For adolescents, adult awareness, sensitivity and guidance are important to help them learn and grow from such problems. (Hincks Dellcrest Parent Resource)

For some adolescents, the problems are serious enough that supports and guidance from the main adults in their lives is not sufficient and specialized assistance is needed to prevent more serious mental health problems down the road.

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Mental Health for All Children and Adolescents

Need to look at age and stage of development, temperament, social context and unique needs of the adolescent, a particular behaviour or difficulty the adolescent is having to determine if there is a concern and how serious.

Need to look at the frequency, intensity, if the behaviour is interfering in the adolescents functioning in the home or community and need to trust yourself.

Also need to determine adolescent's risk factors and their resilience. (Hincks Dellcrest Parent Resource)

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Mental Health Disorders in Children and Youth

It's estimated that 1 in 5 Ontario children under age of 19 experiences a mental, emotional or behaviour disorder that is severe enough to seriously affect their daily functioning at home, school or in the community.

Common mental health disorders affecting children and youth: anxiety disorders, AD/HD, ASD, behaviour disorders (ODD, CD), mood disorders (depression, bipolar disorder), eating disorders, schizophrenia, substance abuse, tourette syndrome..

Early diagnosis and treatment lead to better outcomes later in life. (Children's Mental Health Ontario)

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Mental Health Concerns in Children and Youth

Many children and youth will exhibit some of the following at various times during normal childhood development:

Getting significantly lower marks in school, avoiding friends and family, having frequent outbursts of anger and rage, losing his or her appetite, having difficulty sleeping, rebelling against authority, drinking a lot/and or using drugs, not doing the things he/she used to enjoy, damaging others property, worrying, mood swings, lacking energy/motivation, hitting or bullying other children, attempting to injure her or himself, obsessed by weight, not concerned with appearance.

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Mental Health Concerns in Youth

These characteristics and behaviour’s may be signs of an underlying mental health disorder if they are:

Intense

Persist over long periods of time

Are inappropriate for the child's age

Interfere with the child's life

-Hincks Dellcrest Parent Resource

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Mental Health Concerns in Youth

Children and Youth with the most serious mental health disorders (ie. Severe psychosis or schizophrenia) may exhibit:

Distorted thinking

Excessive anxiety

Odd body movements

Abnormal mood swings

Acting overly suspicious of others

Seeing or hearing things that others don't see or hear

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Suicidal Behaviour

Recent stats show that over the last 10 yrs the rate of suicide among young people is declining (Canadian

Medical Association Journal).

Suicide is the second most common cause of death in teenagers, after accidents.

Boys kill themselves 3 times as often as girls mainly b/c they choose more lethal methods – shooting, hanging, jumping whereas girls prefer overdosing on pills.

Girls attempt suicide 3 times as often as boys.

(Hincks Dellcrest Parent Resource)

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Suicide Myths

Myths

Talking about suicide may give someone the idea.

Teens that talk about suicide are just seeking attention.

People who talk about suicide won't really do it.

Anyone who tries to kill him/herself must be crazy

People who commit suicide are people who were unwilling to seek help.

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Suicidal Behaviour

While not all suicides are preventable, in 70-90% of cases there is a pre-existing diagnosable psychiatric disorder, and if treated appropriately, the risk could be reduced significantly.

The most substantial risk factors for youth suicide are mental health disorders, family history of suicide and previous suicide attempts.

Suggested prevention strategies are often school-based, with others being community-based or involving health care professionals, early identification and effective treatment of mental health disorders in youth. (Canadian Medical Association Journal)

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Suicidal BehaviourRisk Factors:

Suicide has been shown to have a partly inherited or genetic component

Having a co-existing medical disorder or disability is a factor, especially if it interferes with socialization

Past history of mental illness (depression, anxiety, psychosis) and past history of drug/alcohol abuse makes a person vulnerable to suicide

Having a learning disability may decrease self-esteem to the point of having thoughts of suicide

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Suicidal Behaviour

Risk Factors Continued:

High conflict divorce and parental/marital discord

An early history of loss ie. Death of parent

Physical, sexual or emotional abuse and neglect by parents

If a parental reaction to a previous suicide attempt was one of anger

If the teen feels “different” for any reason ie. Being gay, trans-gendered, too fat, too thin, too smart, too slow, at risk of being isolated, excluded or bullied.

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Suicidal Behaviour

Risk Factors Continued:

In boys bullying tends to be direct ie. Child will be physically beaten up or taunted.

With girls the bullying is often “by exclusion” not being invited to parties, or not being part of a clique and more subtle.

Recent use of social media to spread rumours has been particularly destructive and was behind a number of teens who took their lives after being “outed” for being gay.

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Suicidal Behaviour

Risk Factors Continued:

Teens are more prone to influence of “contagion” ie. high profile media reports of death by suicide.

Losing a friend or close relative to suicide.

The strongest predictor of suicidal behaviour is past attempts so any child who has tried once, needs to be carefully monitored.

Readily accessible firearms, impulsiveness and taking unnecessary risks, lack of connection to family and friends (no one to talk to).

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Suicide: Potential Warning Signs

Warning Signs:

Hopelessness, anger, acting reckless or engaging in risky activities, feeling like there is no way out, increased use of drugs and alcohol, withdrawing from family and friends, anxiety, dramatic mood changes and feelings like the person has no sense of purpose and no reason for living.

Some estimate that 80% of those thinking about suicide want others to be aware of their emotional pain and stop them from dying. (Youth Suicide Prevention

Program)

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Suicide: Potential Warning Signs

Warning Signs:

A warning sign does not automatically mean a person is going to attempt suicide, but it should be taken seriously.

Prior suicide attempts, talking about suicide and making a plan, writing about suicide, giving away prized possessions, preoccupation with death, signs of depression, hopelessness and anxiety, increased drug and alcohol use, recent dating relationship break up, conflict with parents, news reports of other suicides by young people, recent death or suicide of a friend or family member.

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How to Help

Pay attention to the risks and warning signs as well as your own gut instinct about your child

Show that you care: listen carefully to what they have to say, ask about their feelings and talk about yours. ie. “I'm worried about you, and how you are feeling” “you mean a lot to me and I want to help” “I'm here if you need someone to talk to”

Ask the Question: Don't hesitate to raise the subject. Be direct, caring and non-confrontational ie. “Are you thinking about suicide?” “Do you really want to die?” “Do you want your problems to go away?” “Do you have a plan?”

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How to Help

Get Help: Never keep talk of suicide a secret, even if your teen asks you to. You can be of most help by taking your child to a professional while you continue to offer support yourself. “I know where we can get some help” “Let's call the crisis line now” “I care about you and want you to be safe and am going to take you to the doctor/hospital now”

Share the load: You can never determine if a drawing, song, poem, or even an attempt is “serious” or not. Your family doctor should be a starting point and refer you to further help if required. If you are strongly concerned or your child has made an attempt, you should go to the nearest emergency department.

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How to help

Stay calm and non-judgemental

Emphasize the possibility of options to help the situation or their ability to cope with a situation

Gently challenge hopelessness – after all suicide is a permanent solution to what is often a temporary or at least changeable situation.

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School Supports

Formal Supports

Teacher

Guidance Counsellors

Student Success Teacher

School Social Worker

Informal Supports

Many clubs, team sports, activities offered such as running club, yoga, pilates, KARMA, Gay Straight Alliance…

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Web Resources

Mental Health/Information on Suicide Resources

www.kidshelphoneline.ca

www.inurhead.ca Youth Mental Health Website for Peel Youth and Their Families

www.suicideprevention.ca

www.thejackproject.org

www.camh.net

www.hincksdellcrest.org

www.yspp.org

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Community Resources

Family Doctor

Hospital Emergency Department

Peel 24 hr Youth Crisis Response (can come to the home) 416-410-8615

Kids Help Phone Line 24 hrs 1-800-668-6868

Counselling:

Centralized Intake Line for Mental Health Services for Children and Youth - 905-451-4655

Rapport Youth and Family Services 905-455-4100

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Community Resources

Bereavement:

Bereaved Families of Peel – 905-848-4337

www.bereavedfamilies.ca

The Lighthouse – Oakville – 905-337-2333

www.grievingchildrenlighthouse.org

www.centreforloss.com (Dr. Wolfelt)

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Community Resources

Addictions/Substance Uses:

Withdrawal Management Centre (Detox) 905-456-3500

Credit Valley Hospital, Alcohol & Drug Treatment 905-813-4402

Youth Substance Abuse Program (YSAP)905-276-9322

Center for Addiction and Mental Health (CAMH) 416-535-8501