Stephanie Johnson November 24, 2003 Teaching Project: Suicide Prevention The group that I will be presenting to is high-school girls that have been identified as “at risk.” The group of about 10 girls ranges from 13-17 years of age. Their high school guidance counselor and school nurse has identified the girls as at risk based on academic, behavioral, and psychosocial problems. The group meets every other week to talk about issues and concerns that the girls may have and ideas the school nurse or guidance counselor sees necessary. The atmosphere in which they meet is a casual round table discussion group. The guidance counselors and school nurse are present to facilitate and guide the sessions. Along with facilitating they educate the girls on any misconceptions and information they have.
Upon deciding the topic of my presentation I decided to meet with the group of girls to get an idea of what their interest and what they have already been presented in previous sessions. From my own experience when you have a choice of what you want to learn more about, you are much more receptive in learning. In our session together all the girls had decided that due to the recent anniversary of a suicide of a fellow classmate they were interesting in learning more about suicide. After this session I spoke with the guidance counselor and school nurse on the topic and everyone was in agreement that this would be the most beneficial topic.
This group of girls has a variety of intellectual and emotional levels that were difficult to assess on a one-time meeting. I believe that this presentation will be beneficial and informative for the girls. Since the group of girls picked the topic they are more likely to be interested and involved in the presentation. In giving this presentation there are a few barriers that I perceive. The first is a personal barrier of being a little uncomfortable in presenting such a sensitive subject that I feel I lack some expertise or overwhelming amount of knowledge of this particular subject. I also believe that my age is a disadvantage, along with an advantage.
In speaking with the girls they may see me as not educated enough or too young to know. On the other hand they may thing that since I’m younger that I have a better understanding of their situation and perceptions on life. I am eager to meet with the girls and present. Nursing Diagnosis: Knowledge deficit characterized by a verbalization a deficiency in knowledge on suicide.
Teaching Project: Suicide Prevention Objectives Content Teaching Actions Evaluation 1. Clients will be able to identify facts about suicide by the end of the presentation. 1. In Virginia, suicide is: o 3 rd leading cause of death among 10-24 y / o , 2 nd among 25-34, and 4 th among 35-54 o There are estimated 25 suicide attempts for every death o More common in adolescent males then females o Substance/ alcohol abuse significantly increases the risk for suicide in ages 16 and older. o Nearly 3 of every 5 suicide in 1999 were committed with a firearm.
Presentation of facts through lecture. A short follow-up test will be administered to evaluate knowledge gain. 2. Clients will be able to identify contributing factors in youth suicide by the end of the presentation. o It is easier to get the tools for suicide (males- firearms, females- pills) o The pressures of modern life are greater. o Competition for good grades and college admission are stiff.
o More violence seen in media. o Parents may be less involved in their children’s life. Lecture and discussion A short follow-up test will be administered to evaluate knowledge gain. 3. Clients will be able to identify high-risk children by the end of the presentation. o Are preoccupied with death, and don’t understand its permanency.
o Believe a person goes to a better place after dying or can come alive after dying. o Are impulsive (act w / out realizing the consequences of their actions). o Have no sense of fear or danger. o Have perfectionist tendencies. o Truly feel that it would be better for everyone if they were dead. o Believe that if they could join a loved one who died, they would then be rid of their pain and be at peace.
o Speak of death in a positive way rather than negative; think that death might be pleasant. o Have parents or relatives who have attempted suicide (modeling behaviors / genetic factors involved here). o Are hopeless; feeling that things will never get better, that they will never feel better Lecture and discussion A short follow-up test will be administered to evaluate knowledge gain. 4. Clients will be able to identify warning signs of suicide by the end of the presentation. o Talking about suicide o Statements about hopelessness, helplessness, or worthlessness.
o Preoccupation with death o Suddenly happier, calmer. o Lost of in interest in things one cares about. o Visiting or calling people one cares about. o Setting affairs in order. o Giving things away.
Lecture and discussion A short follow-up test will be administered to evaluate knowledge gain. 5. Clients will be able to identify additional clues other then warning signs by the end of the presentation. Verbal Clues Saying things like: o I shouldn’t be here. o I’m going to run away. o I wish I were dead.
o I’m going to kill myself. o I wish I could disappear forever. o If a person did this or that… would he / she die? o The voices tell me to kill myself. o Maybe if I died, people would love me more.
o I want to see what it feels like to die. Behavioral Clues. o Talking or joking about suicide. o Giving away possessions. o Preoccupation with death / violence ; TV, movies, drawings, books, at play, music.
o Risky behavior; jumping from high places, running into traffic, self-cutting. o Having several accidents resulting in injury; “close calls” or “brushes with death.” o Obsession with guns and knives. o Previous suicidal thoughts or attempts Lecture and discussion A short follow-up test will be administered to evaluate knowledge gain. 6. Clients will be able to identify and understand symptoms of depression by the end of the presentation.
Depressive illnesses / anxiety may be disguised as, or presented as, eating disorders such as anorexia or bulimia, drug / alcohol abuse, sexual promiscuity, risk-taking behavior such as reckless driving, unprotected sex, carelessness when walking across busy streets, or on bridges or cliffs. There may be social isolation, running away, constant disobedience, getting into trouble with the law, physical or sexual assaults against others, obnoxious behavior, failure to care about appearance / hygiene , no sense of self or of values / morals , difficulty cultivating relationships, inability to establish / stick with occupational / educational goals. o Physical symptoms such as dizziness, headaches, stomachaches, neck aches, arms or legs hurt due to muscle tension, digestive disorders. (Ruling out other medical causes) o Persistent unhappiness, negativity, irritability.
o Uncontrollable anger or outbursts of rage. o Overly self-critical, unwarranted guilt, low self-esteem. Inability to concentrate, think straight, remember, or make decisions, possibly resulting in refusal to study in school or an inability (due to depression or attention deficit disorder) to do schoolwork. o Slowed or hesitant speech or body movements or restlessness (anxiety). o Loss of interest in once pleasurable activities. o Low energy, chronic fatigue, sluggishness.
o Change in appetite, noticeable weight loss or weight gain, or abnormal eating patterns. o Chronic worry, excessive fear. o Preoccupation with death themes in literature, music, drawings, speaking of death repeatedly, fascination with guns / knives . o Suicidal thoughts, plans, or attempts Lecture and discussion A short follow-up test will be administered to evaluate knowledge gain. 7.
Clients will be able to demonstrate knowledge on what to do if they see warning signs of suicide by the end of the presentation. If you see the warning signs of suicide… o Begin a dialogue by asking questions. Questions to ask: “Do you ever feel so badly that you think of suicide?”Do you have a plan?”Do you know when you would do it (today, next week)?”Do you have access to what you would use?” Asking these questions will allow you to determine if your friend is in immediate danger, and get help if needed.
A suicidal person should see a doctor or psychiatrist immediately. Calling 911 or going to a hospital emergency room are valid options. Always take thoughts of or plans for suicide seriously. o Never keep a plan for suicide a secret. Don’t worry about endangering a friendship if you truly feel a life is in danger.
It’s better to regret something you did, than something you didn’t do to help a friend. o Don’t try to minimize problems or shame a person into changing her mind. Your opinion of a person’s situation is irrelevant. Trying to convince a person it’s not that bad, or that she has everything to live for will only increase her feelings of guilt and hopelessness. Reassure her help is available, that depression is treatable, and that suicidal feelings are temporary. o If you feel the person isn’t in immediate danger, acknowledge the pain as legitimate and offer to work together to get help.
Make sure you follow through. This is one instance where you must be tenacious in your follow-up. Help find a doctor or a mental health professional, participate in making the first phone call, or go along to the first appointment. If you ” re in a position to help, don’t assume that your persistence is unwanted or intrusive. Risking your feelings to help save a life is a risk worth taking. Lecture and discussion A short follow-up test will be administered to evaluate knowledge gain.
8. Clients will acknowledge and understand misconceptions about suicide by the end of the presentation. 1. “People who talk about suicide won’t really do it.” Almost everyone who commits or attempts suicide has given some clue or warning.
Do not ignore suicide threats. Statements like “you ” ll be sorry when I’m dead,”I can’t see any way out,” — no matter how casually or jokingly said may indicate serious suicidal feelings. 2. “Anyone who tries to kill him / herself must be crazy.” Most suicidal people are not psychotic or insane. They must be upset, grief-stricken, depressed or despairing, but extreme distress and emotional pain are not necessarily signs of mental illness. 3.
“If a person is determined to kill him / herself , nothing is going to stop him / her .” Even the most severely depressed person has mixed feelings about death, wavering until the very last moment between wanting to live and wanting to die. Most suicidal people do not want death; they want the pain to stop. The impulse to end it all, however overpowering does not last forever. 4. “People who commit suicide are people who were unwilling to seek help.” Studies of suicide victims have shown that more then half had sought medical help within six month before their deaths. 5.
“Talking about suicide may give someone the idea.” You don’t give a suicidal person morbid ideas by talking about suicide. The opposite is true — bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do. Lecture and Discussion A short follow-up test will be administered to evaluate knowledge gain. 9. Clients will be aware of the resources available to them by the end of the presentation…
See handout Handout A short follow-up test will be administered to evaluate knowledge gain.