Suicide Awareness:  What You Need to Know, Where to Go for Help
This article contains these topics:

• Suicide in Adolescents
• Common Suicide Contributing Factors
• Warning Signs of Suicide
• What to Do If You Are Concerned About a Loved One
• Crisis Lines & Resources
• Suicide Crisis Tips (CIT)

Suicide in Adolescents
Predicting and preventing suicide is an error-prone, frustrating task - even more challenging when the person is an adolescent.  After a suicide, it is tempting to "second guess" the reasons why or use hindsight for signs "you should have seen."
Suicide is the result of a complex set of behaviors difficult to assess and prevent.  This article is neither comprehensive nor exhaustive about this risk.  An adolescent who completes suicide views taking his or her life as the only solution to a problem they have been unable to resolve.  Reasons and environmental contributions are often specific to that person and can defy explanation.

Common Suicide Contributing Factors
Mental illness - Depression (up to 80% suicide risk), anxiety, conduct disorders (up to 50% suicide risk), eating disorders, bipolar disorders

• Drug or alcohol use
• Victim of physical, sexual, and/or emotional abuse - the more severe the abuse, the greater the risk of suicidal behavior.
• Poor self-concept characterized by self doubt and pessimism about the future.
• Sexual preference - Some research shows gay or lesbian teens at higher risk
• Major relationship loss or conflict - Loss of or conflict in parental or romantic relationships may be a factor in up to 70% of suicides in teens.
• Stress.
• History of impulsive or aggressive behavior.
• Access to lethal means - firearms, pills, automobiles.

Please note that any one or a combination of several of these factors, or none of them, may be present in someone at risk of suicide.

Warning Signs of Suicide

• Symptoms of mental illness, particularly depression (withdrawing/isolating; irritability/anger; sadness; hopelessness/ helplessness; communication reflecting suicidal, death, escapist, or apathetic content; less interest in previously enjoyed activities)
• Sudden changes in behavior
• Reduction in self-care (poor hygiene, unkempt appearance – particularly a sudden change)
• Self-harming behaviors (cutting, burning, overeating, binging/ purging, not eating)
• Recent relationship loss or conflict
• Chronic relationship problems
• Victim of physical, sexual/emotional abuse
• Substance abuse
• Acute or chronic stressors with perceived or expected failure
• Recent suicides in the community

What to Do if You Are Concerned about a Loved One
Ask the person directly about thoughts of suicide.

• Talk about your concerns – be concrete and specific.
• Don’t judge responses or attempt to “correct” perceptions.
• Listen, listen, listen to what is being said.
• Be more inquisitive about everything: ask, ask, ask.
• Reduce or eliminate unsupervised time.
• Express your concerns to school staff, close family, friends, mentors, etc.
• Restrict or eliminate access to lethal means.
• SEEK PROFESSIONAL HELP - Contact police/hospital for immediate and urgent concerns.  Call Crisis Lines and/or Counseling and Mental Health Services (see list).

Crises Lines & Resources – 24/7 Service unless noted otherwise
ACI MAP AND CRISIS NUMBERS
Hope Line 800-SUICIDE (800-784-2433)
The National HopeLine Network brings the knowledge, skill, and resources of existing crisis centers under the safety net of a single, easy-to-remember, toll-free number to help make appropriate, critical services available to all.

Suicide Prevention Life Line 800-273-TALK (800-273-8255)www.suicidepreventionlifeline.org
The National Suicide Prevention Lifeline provides immediate assistance to individuals in suicidal crisis by connecting them to the nearest available suicide prevention and mental health service provider through a toll-free telephone number: 1-800-273-TALK (8255).  It is the only national suicide prevention and intervention telephone resource funded by the Federal Government.

Suicide Crisis Tips
Most St. Louis area police departments have Crisis Intervention Teams - teams of officers specially recruited and trained to respond to individuals experiencing a mental health crisis.  How can family/friends assist Crisis Intervention Team (CIT) police officers when a mental health crisis occurs?

• Find out if CIT is part of your police department.
• When calling for police assistance, ask for a CIT officer.
• Keep a current list of medications and doctors’ names and offer it to the CIT officer when he/she arrives.
• Meet the CIT officer outside if possible and fully explain the crisis and what you would like to happen.
• Make the CIT officer aware of anything you know that upsets the person in crisis.
• Keep all guns out of the home.
• When the CIT officer arrives, advise him/her if the person is armed or has access to weapons.  Remember, when weapons are involved, police concentrate on the possible threat of violence until it is neutralized.
• Understand that the CIT officer will probably ask you to wait in an area away from the person in a crisis.  Let the officer do his/her job and only offer assistance if asked.
• Be prepared to go to the hospital – but remember all CIT calls do not necessarily mean a trip to the hospital.
• Get to know your police department.  Introduce your family member or friend to the police when they are not in crisis.  Call your police department and have CIT officer stop by your house when he/she has time or go to the police station when a CIT officer will be there.
• Let your family member know the police are there to help.
• Educate yourself about your family member’s or friend’s mental illness by requesting information from NAMI St. Louis’ HELPline: 314-966-4670 or visit the website:  www.namistl.org

If you have any questions about the CIT program, feel free to call:

   Tips for Making a 911 CALL for Assistance in a Mental Health Crisis

• Speak slowly and clearly.
• Be clear as to reason for your call and the specific emergency.
• Provide address of emergency and directions to location.
• Provide the name of the person in crisis.
• Request a CIT officer respond if police assistance is needed.
• Include information known about others who may be in the house, access to weapons, or aggressive animals present.
• Answer any questions the dispatcher asks.
• Do not hang up until you are clear about who will be responding and what you are to do until they arrive.

Tips for When 911 Help Arrives

• Have the porch light on and/or the door open.
• Identify one person designated as spokesperson.
• Have others in the home gathered into a safe location away from the crisis.
• Greet the officer/emergency personnel at the door.
• Provide the name of the person in crisis, the mental health diagnosis, and the names of known medications and/or illicit drugs he/she may have taken.
• Follow the directions of the officer/emergency personnel, including removing yourself and others from the premises if that is requested.
• Realize that a mental health crisis is a HIGH STRESS situation for everyone.
• Stay out of the way.
• Be patient and try to remain calm.

We thank the St. Louis County Police Department for their help in compiling these tips.