YSPI Schools Programme - Student Booklet
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The Four Steps to<br />
Help <strong>Programme</strong><br />
<strong>Schools</strong><br />
&<br />
Colleges Edition<br />
MENTAL HEALTH AWARENESS<br />
AND SUICIDE PREVENTION<br />
Presentaon Notes
YOUTH SUICIDE PREVENTION IRELAND<br />
All informaon in this leaflet is provided as an informaon resource about suicide prevenon and research acvies<br />
only. It is not the intenon of Youth Suicide Prevenon Ireland Publicaons Limited to provide specific treatment or<br />
care advice.<br />
Youth Suicide Prevenon Ireland Publicaons Limited does not provide cerficaon or accreditaon for any counselling<br />
organisaon, individual praconers or treatment or care models that users may find out about through our<br />
informaon or publicaons or other materials provided by or through us.<br />
Youth Suicide Prevenon Ireland Publicaons Limited does not endorse or recommend any of the service providers,<br />
agencies or organisaons listed on any leaflet or publicaon provided by us or any other organisaon.<br />
In no event shall liability exist to any user (or any third party who obtains access to the informaon) under any law for<br />
any loss or damage (including but not limited to direct, indirect, economic and consequenal damage) in respect of any<br />
maer whatsoever related to any informaon in any website or leaflet or publicaon nor for the use of the informaon<br />
nor for acons taken or not taken as a result of informaon contained in this or any other websites leaflets or<br />
publicaons (including, without limitaon, loss or damage caused by negligence).<br />
The material contained in this leaflet is provided for general informaon purposes only and does not constute care,<br />
treatment or other professional advice. Due to the general nature of the informaon provided in the leaflet, should you<br />
require specific help, you should seek the assistance of an appropriately trained professional person. While every care<br />
has been taken in the preparaon of the informaon contained in this leaflet, due to the nature of the informaon and<br />
the processes of publicaon, the informaon may not be complete, correct or up to date.<br />
Informaon contained in this leaflet which has been provided by recognised third pares is provided in good faith and<br />
no liability shall exist for any errors or omissions contained.<br />
© Copyright Youth Suicide Prevenon Ireland Publicaons Limited 2018. All Rights Reserved. E&OE.<br />
Youth Suicide Prevenon Ireland<br />
Registered Charity 20070670<br />
Head Office<br />
1st Floor, 59 High Street, Killarney, Co Kerry V93 N977<br />
1800 828 030 admin@yspi.ie<br />
Main Website<br />
www.yspi.ie<br />
Facebook<br />
C youth.suicide.prevenon.ireland<br />
Campaign Websites<br />
<strong>Schools</strong>.yspi.ie<br />
parents.yspi.ie<br />
<strong>Student</strong>s.yspi.ie<br />
Supported by Folens Publishers<br />
PAGE 2
FOUR STEPS TO HELP PROGRAMME<br />
SUICIDE WARNING SIGNS<br />
If someone is seriously depressed and thinking of aempng suicide there are<br />
oen warning signs that family and friends can pick up on. Nocing and acng<br />
upon these warning signs could save a life. Most people who are considering<br />
suicide are willing to talk about their problems if someone shows they care. Don’t<br />
be afraid of discussing the subject with someone you think may be suicidal. Talking<br />
about suicide won’t ‘plant the idea’ in someone’s head. This is a myth. If you are<br />
wrong, you’re at least showing a friend you care. If you are right, you could save<br />
their life.<br />
Somemes stress or a traumac event like bereavement can trigger suicidal<br />
thoughts in a vulnerable person. For this reason it’s important to ask a friend who<br />
is going through a tough me how they are coping and if they need some support.<br />
Having someone to talk with can make all the difference.<br />
Warning signs can include but are not limited to:<br />
Withdrawing from family and friends.<br />
Having difficulty concentrang and thinking clearly.<br />
Sleeping too much or too lile.<br />
Feeling red most of the me.<br />
Gaining or losing a significant amount of weight.<br />
Talking about feeling hopeless or guilty.<br />
Talking about suicide or death.<br />
Self-destrucve behaviour like drinking too much or abusing drugs.<br />
Losing interest in favourite things or acvies.<br />
Giving away prized possessions.<br />
Mood swings.<br />
IMPORTANT<br />
If a friend menons suicide, take it seriously. If they have expressed an immediate<br />
plan, or have access to prescripon medicaon or other potenally deadly means,<br />
do not leave them alone. Get help immediately.<br />
PAGE 3
YOUTH SUICIDE PREVENTION IRELAND<br />
About the Four Steps to Help <strong>Programme</strong><br />
The Four Steps to Help <strong>Programme</strong> for <strong>Schools</strong> has been developed and approved by our<br />
Advisory Panel which includes a consultant child and adolescent psychiatrist and has been<br />
deemed to be age appropriate for ages 16+.<br />
These school visits are fully funded by the <strong>YSPI</strong> School Visits <strong>Programme</strong> as part of our<br />
outreach work and there is no cost to the school or organisaon to book and host a talk.<br />
The talks we present are based on our own “Four Steps to Help <strong>Programme</strong>” which is<br />
designed to increase awareness of suicide prevenon and to provide informaon on the<br />
support and resources available to anyone who is concerned about suicide or is concerned<br />
about a friend or family member.<br />
The Four Steps to Help <strong>Programme</strong> for <strong>Schools</strong> focuses on providing simple, factual guidance<br />
for suicide awareness and prevenon.<br />
The programme emphasises:<br />
<br />
<br />
the importance of awareness of sudden changes in behaviour in friends, family or<br />
acquaintances;<br />
Understanding how to recognise the suicide warning signs, as well as signs of other<br />
PAGE 4
FOUR STEPS TO HELP PROGRAMME<br />
<br />
<br />
<br />
mental health issues;<br />
promoon of ‘acve listening’, giving simple listening skills and exercises which can be<br />
used in everyday situaons;<br />
emphasis on making appropriate family members or other adults aware of concerns so<br />
that acon can be taken;<br />
Praccal informaon on dealing with a crisis situaon and how to respond.<br />
We all need to know and understand<br />
that there is always someone that we<br />
can turn to in our life and talk about<br />
the issues facing us without fear of<br />
rejecon if we are prepared to take<br />
the first step.<br />
What is much more challenging is<br />
being prepared to take that first step<br />
for someone else; to face possible<br />
rejecon or ridicule by being<br />
prepared to use the Four Step<br />
<strong>Programme</strong> to potenally save a life.<br />
But there are so many other problems, surely suicide and mental health<br />
aren’t a priority anymore?<br />
And yet all these crises can increase the chances of mental health issues developing AND<br />
increase the risk of suicide<br />
PAGE 5
YOUTH SUICIDE PREVENTION IRELAND<br />
Ireland has the fourth highest teen suicide rate in the EU/OECD<br />
Well-being of Young People 2017 - UNICEF<br />
Youth Suicide Prevenon Ireland has been working for over 11 years to provide free educaon<br />
and training services to schools and colleges around Ireland. According to the World Health<br />
Organisaon's 2016 report suicide is the 2nd highest cause of death amongst young people<br />
across the World. Sadly Ireland is not spared from this problem which affects almost every<br />
community in the country.<br />
In the European Union during 2015, according to Eurostat, there were approximately 56,000<br />
reported deaths by suicide making it one of the leading causes of death. Males accounted for<br />
43,000 of those deaths or 76%.<br />
According to research by UNICEF published in 2017 Ireland has the fourth highest teen suicide<br />
rate in the EU/OECD region. The organisaon's latest report card on well-being of young people<br />
found that Ireland's suicide rate amongst adolescents aged 15 to 19 was 10.3 per 100,000<br />
populaon and ranks well above the naonal country average of 6.1 per 100,000.<br />
<strong>Schools</strong> and teachers are so important to the development of personality, social skills and selfworth<br />
in a young person. The WHO states that among the six most important ways of reducing<br />
suicide rates is through School-based Intervenons.<br />
PAGE 6
FOUR STEPS TO HELP PROGRAMME<br />
PAGE 7
YOUTH SUICIDE PREVENTION IRELAND<br />
The Four Steps to Help <strong>Programme</strong> is a simple introducon to suicide prevenon and mental<br />
health awareness informaon. The talks focus on four steps:<br />
Step 1: Watching<br />
This step focusses on raising awareness of the suicide warning signs and encouraging<br />
parcipants to watch out for sudden behaviour changes in their friends and family members.<br />
Step 2: Showing<br />
This step focusses on showing friends and family members that they can discuss any concerns<br />
with their friend or sibling, and they can turn to parents and trusted adults for support and<br />
advice. This step introduces the Acve Listening skillset and provides techniques and<br />
examples.<br />
Step 3: Asking<br />
This step focusses on simple techniques for asking someone how they are feeling and<br />
encouraging them to talk about their concerns. This step builds on the techniques<br />
introduced in step 2<br />
Step 4: Helping<br />
This step provides guidance on how to help someone you are concerned about and focusses<br />
on geng assistance from a trusted adult or directly from a medical professional. This step<br />
also introduces a crisis scenario and provides informaon on how to deal with the need to get<br />
immediate assistance. This step links to the <strong>YSPI</strong> FreeText Crisis Informaon service detailed<br />
on the back page of this leaflet.<br />
PAGE 8
FOUR STEPS TO HELP PROGRAMME<br />
PAGE 9
YOUTH SUICIDE PREVENTION IRELAND<br />
PRE-SUICIDAL INDICATORS<br />
Talking about suicide Any talk about suicide, dying, or self-harm, such as "I<br />
wish I hadn't been born," "If I see you again..." and "I'd<br />
be beer off dead."<br />
Seeking out lethal means<br />
Preoccupaon with death<br />
No hope for the future<br />
Self-loathing, self-hatred<br />
Geng affairs in order<br />
Saying goodbye<br />
Withdrawing from others<br />
Self-destrucve behaviour<br />
Sudden sense of calm<br />
Seeking access to guns, pills, knives, or other objects<br />
that could be used in a suicide aempt.<br />
Unusual focus on death, dying, or violence. Wring<br />
poems or stories about death.<br />
Feelings of helplessness, hopelessness, and being<br />
trapped ("There's no way out"). Belief that things will<br />
never get beer or change.<br />
Feelings of worthlessness, guilt, shame, and self-hatred.<br />
Feeling like a burden ("Everyone would be beer off<br />
without me").<br />
Making out a will. Giving away prized possessions.<br />
Making arrangements for family members.<br />
Unusual or unexpected visits or calls to family and<br />
friends. Saying goodbye to people as if they won't be<br />
seen again.<br />
Withdrawing from friends and family. Increasing social<br />
isolaon. Desire to be le alone.<br />
Increased alcohol or drug use, reckless driving, unsafe<br />
sex. Taking unnecessary risks as if they have a "death<br />
wish."<br />
A sudden sense of calm and happiness aer being<br />
extremely depressed can mean that the person has<br />
made a decision to die by suicide.<br />
PAGE 10
FOUR STEPS TO HELP PROGRAMME<br />
SPECIFIC RISK FACTORS IN TEENAGERS<br />
Teenage suicide is a serious and growing problem. The teenage years can be emoonally<br />
turbulent and stressful. Teenagers face pressures to succeed and fit in. They may struggle<br />
with self-esteem issues, self-doubt, and feelings of alienaon. For some, this leads to<br />
suicide. Depression is also a major risk factor for teen suicide.<br />
Other risk factors for teenage suicide include:<br />
<br />
<br />
<br />
<br />
<br />
<br />
Childhood abuse<br />
Recent traumac event<br />
Lack of a support network<br />
Availability of means of suicide<br />
Hosle social or school environment<br />
Exposure to other teen suicides<br />
SPECIFIC SUICIDE WARNING SIGNS IN TEENAGERS<br />
Addional warning signs that a teen may be considering suicide:<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
Change in eang and sleeping habits<br />
Withdrawal from friends, family, and regular acvies<br />
Violent or rebellious behaviour, running away<br />
Drug or alcohol abuse<br />
Unusual neglect of personal appearance<br />
Persistent boredom, difficulty concentrang, or a decline in the quality of schoolwork<br />
Frequent complaints about physical symptoms, oen related to emoons, such as<br />
stomach-aches, headaches, fague, etc.<br />
Not tolerang praise or rewards<br />
DANGEROUS CALM<br />
Somemes when someone is under tremendous stress they can make very bad decisions,<br />
including the decision to end their own life. In some people making this decision takes away<br />
their pain and anxiety so their behaviours quickly return to normal. BUT their decision is sll<br />
made and that decision can stay dormant for weeks or months!<br />
SO if you are concerned about someone and they seem to recover very quickly, and perhaps<br />
suddenly become very happy and enthusiasc, remember the dangerous calm. Let<br />
someone know you are sll concerned and tell your friends so you can all be vigilant and<br />
supporve.<br />
PAGE 11
YOUTH SUICIDE PREVENTION IRELAND<br />
PAGE 12
FOUR STEPS TO HELP PROGRAMME<br />
TRUE OR FALSE?<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
TRUE OR FALSE<br />
1. People who talk about suicide seldom mean it and can, in fact, be<br />
regarded as low risk to aempt suicide.<br />
2. The fact that someone has aempted suicide once greatly reduces<br />
the risk of a second aempt.<br />
3. Women aempt suicide more oen than men.<br />
4. Suicide now ranks among the leading causes of youth death in the<br />
European Union.<br />
5. Most suicides occur "out of the blue" without any warning signs.<br />
6. Asking someone if they are thinking about suicide will put the idea in<br />
their head.<br />
7. Teenagers rarely aempt suicide, although they may frequently think<br />
about it.<br />
8. Suicide aempts mean a person has ambivalent feelings toward life<br />
and death.<br />
9. Improvement following a suicidal crisis means that the suicidal risk is<br />
over.<br />
10. Suicide is inherited or runs in the family.<br />
11. All suicidal individuals are mentally ill and suicide always is the act of<br />
a psychoc person.<br />
12. The incidence of suicide among the poor and deprived is<br />
substanally higher than among the advantaged.<br />
13. At least half of all people who complete suicide leave notes<br />
explaining their acon.<br />
14. The elderly have the highest rate of suicide for any age group.<br />
Answers are on page 23<br />
PAGE 13
YOUTH SUICIDE PREVENTION IRELAND<br />
SOME MYTHS ABOUT SUICIDE<br />
If I talk to people about their suicidal feelings, it will put the idea into their<br />
heads.<br />
If a person talks about wanng to die that is a sure sign that no suicide<br />
aempt will be made.<br />
If you think about suicide or suicide aempts, you will eventually die by<br />
suicide.<br />
People who think about suicide, aempt suicide or kill themselves are always<br />
mentally ill.<br />
When a person talks about suicide, it's just for aenon and the best thing to<br />
do is to ignore the words.<br />
FALSE !!<br />
FALSE !!<br />
FALSE !!<br />
FALSE !!<br />
FALSE !!<br />
Suicide occurs without warning so there is no way to prevent it. FALSE !!<br />
We can relax once the suicidal person is geng professional help. FALSE !!<br />
The depression has lied and the person seems to be much beer and<br />
happier. This is an indicaon that the person is out of danger.<br />
FALSE !!<br />
People who talk about suicide don't kill themselves. FALSE !!<br />
When teenagers talk about suicide, change the subject and try to get their<br />
minds off of it.<br />
FALSE !!<br />
PAGE 14
FOUR STEPS TO HELP PROGRAMME<br />
PAGE 15
YOUTH SUICIDE PREVENTION IRELAND<br />
WHAT IS “ACTIVE LISTENING”?<br />
"Acve Listening" is simply the offering of friendship by one ordinary human being to<br />
another at a me of crisis or loneliness. An Acve Listener has no professional status or<br />
authority, but is simply a fellow human being who cares. The purpose of Acve Listening is to<br />
listen, accept, care and empathise.<br />
LISTEN<br />
Allowing the person with a problem to express and to talk without being judged.<br />
ACCEPT<br />
Allowing the person to stay in neutral and accept feelings as they are.<br />
CARE<br />
Allowing one human being to reach out to another human being with respect.<br />
EMPATHISE<br />
Allowing the listener to hear where the speaker is coming from and allows us to be sensive<br />
to another's feelings or ideas even when we don’t agree.<br />
The purpose of Acve Listening is not to give advice, instruct, solve problems, or judge. It is<br />
to respect the worth and value of another human being through Listening, Accepng, Caring,<br />
and Empathising.<br />
A GUIDE TO “ACTIVE LISTENING”<br />
It's hard to know what to do when someone you care about is feeling depressed or upset.<br />
You can use the following list as a guide to good Acve Listening:<br />
DO:<br />
Befriend<br />
Consider the possibility of suicide<br />
Focus on the pain<br />
Ask if suicide is on their minds<br />
Get involved<br />
Allow the expression of feeling<br />
LISTEN<br />
Make life an opon<br />
Be non-judgmental<br />
Get help from responsible persons<br />
Stay with the person at risk<br />
Keep details of the story confidenal<br />
PAGE 16
FOUR STEPS TO HELP PROGRAMME<br />
DON'T:<br />
× Lecture or moralise or give advice<br />
× Think it is a passing phase<br />
× Brush off feelings with inane remarks<br />
× Be afraid that you will insl the idea<br />
× Do nothing<br />
× Trample on feelings<br />
× TALK TOO MUCH<br />
× Dare them to follow through with suicide<br />
× React verbally or physically with shock<br />
× Go it alone<br />
× Leave the person alone<br />
× Promise not to tell anyone<br />
WHAT MAKES A GOOD “ACTIVE LISTENER”?<br />
A good Acve Listener is someone who:<br />
Does<br />
listen more than talk<br />
direct the conversaon to the painful<br />
feelings<br />
have compassion for sufferer<br />
risk being foolish<br />
aempt to be available at all mes<br />
remain willing to share another person's<br />
pain<br />
respect confidences<br />
listen<br />
accept<br />
empathise<br />
Does not<br />
× offer opinion or judgments<br />
× belile or minimise concerns<br />
× discuss one's own problems<br />
× give advice<br />
× express shock or surprise<br />
× patronise or probe<br />
× offer platudes and clichés<br />
× make promises that cannot be kept<br />
× interpret, lecture or diagnose<br />
× Say "I know just how you feel."<br />
× fail to pay aenon or care<br />
Remember, a good friend will always tell a trusted adult about someone who is<br />
struggling with a serious problem, is deeply depressed or considering suicide.<br />
PAGE 17
YOUTH SUICIDE PREVENTION IRELAND<br />
PAGE 18
FOUR STEPS TO HELP PROGRAMME<br />
ASKING ABOUT SUICIDE<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
DO be yourself. Let the person know you care, that he/she is not alone. The right words<br />
are oen unimportant. If you are concerned, your voice and manner will show it.<br />
DO Listen. Let the suicidal person unload despair, venlate anger. No maer how<br />
negave the conversaon seems, the fact that it exists is a posive sign.<br />
DO be sympathec, non-judgmental, paent, calm, accepng. Your friend or family<br />
member is doing the right thing by talking about his/her feelings.<br />
DO offer hope. Reassure the person that help is available and that the suicidal feelings<br />
are temporary. Let the person know that his or her life is important to you.<br />
If the person says things like, “I’m so depressed, I can’t go on,” ask the queson: “Are<br />
you having thoughts of suicide?” You are not pung ideas in their head; you are<br />
showing that you are concerned, that you take them seriously, and that it’s OK for them<br />
to share their pain with you.<br />
DON’T argue with the suicidal person. Avoid saying things like: "You have so much to live<br />
for," "Your suicide will hurt your family," or “Look on the bright side.”<br />
DON’T act shocked, lecture on the value of life, or say that suicide is wrong.<br />
DON’T promise confidenality. Refuse to be sworn to secrecy. A life is at stake and you<br />
may need to speak to a mental health professional in order to keep the suicidal person<br />
safe. If you promise to keep your discussions secret, you may have to break your word.<br />
DON’T offer ways to fix their problems, or give advice, or make them feel like they have<br />
to jusfy their suicidal feelings. It is not about how bad the problem is, but how badly it’s<br />
hurng your friend or loved one.<br />
DON’T blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness<br />
or lack thereof, is not your responsibility.<br />
PAGE 19
YOUTH SUICIDE PREVENTION IRELAND<br />
PAGE 20
FOUR STEPS TO HELP PROGRAMME<br />
PAGE 21
YOUTH SUICIDE PREVENTION IRELAND<br />
What are they thinking? - A Parents’ Guide<br />
This book gives a broad introducon to youth mental health awareness and suicide<br />
prevenon and the state of youth mental health in Ireland today for parents and those<br />
concerned about the welfare of young people in this fast paced, ever-changing world of 21st<br />
Century Ireland.<br />
Order online & we'll deliver to your door. We provide this book to you free of charge but we<br />
do ask for a small voluntary donaon to cover the cost of postage. Your book will be<br />
dispatched to you within 10 working days via An Post. All orders are dispatched in plain<br />
envelopes with no charity informaon visible.<br />
Order at parents.yspi.ie<br />
PAGE 22
FOUR STEPS TO HELP PROGRAMME<br />
www.saythesword.eu<br />
True Or False Answers<br />
1 False 2 False 3 True 4 True 5 False 6 False 7 False 8 True 9 False 10 False 11 False 12 False<br />
13 False 14 True<br />
PAGE 23
FreeText Crisis Assistance is a service of Youth Suicide Prevenon Ireland in associaon with NeonSMS. This<br />
service is provided free of charge and without cost to the user. All informaon provided is in the public domain.<br />
E&OE.<br />
You can also visit ineedhelp.ie at anyme 24/7 for informaon on naonal and local helplines,<br />
naonal and local support groups and safe places near you.