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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.

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