Understanding suicide prevention

In 2003, a Spokane-area 13-year-old leaped off a busy freeway overpass to her death. Later that year, another Spokane student planned to commit suicide by being shot by police after bringing a gun to school. In 2011, a former University of Idaho assistant professor shot a student and then proceeded to shoot himself. In January 2013, a student committed suicide in a UI residence complex.

Suicide is difficult to talk about — a long-time taboo topic — but it can touch anyone’s life at any moment. In 2008, there were a total of 37,000 deaths by suicide in the U.S.,  an average of one person every 15 minutes.

Suicide education 

Daily activities, environment and habits are all strong influences on a student’s emotional and psychological behavior, UI Health Education Coordinator Shannon Haselhuhn said. To improve students’ mental and physical health, she hopes to also improve the environment in which students are living and learning every day. To do this, Haselhuhn said the university has established an educational program to enhance “bystander intervention” — the beneficial involvement and effect students can have when it comes to campus-wide health issues.

In September of last year, the UI Campus Safety Committee initiated a campus-wide UI Safety Week. With it, professionals brought various breeds of programming to educate students about self-defense, LGBTQA health and safety, alcohol awareness and information on healthy relationships.

“When we looked at Campus Safety Week and what a lot of other campuses were doing, we (wanted to) put less of a focus on safety itself, and more on ‘let’s create an environment in which people are really looking out for each other,'” Haselhuhn said.

Encouraging students to look out for each other quickly became one of the main messages of the Campus Safety Week. The university also prompted “I Got Your Back,” a
program to encourage bystander intervention.

Students listen to each other — peer-to-peer communication is really effective,” Haselhuhn said. “Peers are on the front lines — whether it’s at a party or in the dorms, just being around somebody every day … (peers) see behavior first-hand.”

Haselhuhn hopes this programming will empower students to look out for each other, and in turn encourage students to speak up for other students when they notice a change in behavior or the exhibition of dangerous, risky or
violent behavior.

“Bystander intervention is a real best-practice on college campuses,” Haselhuhn said. “‘I Got Your Back’ turned into that campaign and the message behind some of the bystander intervention trainings we had (within) the campus UI Safety Week.”

The importance of bystander intervention on college campuses began with a safety program introduced by the National Collegiate Athletics Association and the University of Arizona C.A.T.S Life Skills Program called “Step Up!” Haselhuhn said students have the power to play a unique role in the health and safety of their peers, and the “I Got Your Back” programming emphasizes that.

Sharon Fritz, UI psychologist and professor, leads a training program for university faculty and staff members to advocate intervention from an administrator’s point of view. Haselhuhn said the program, called “Mental Health First Aid,” is offered multiple times a year and gives faculty and staff members tips on how to pick up signs
from students.

“It’s training people to be first responders, to notice when something isn’t quite right and to help somebody get to the help they need,” Haselhuhn said. “That training is super effective.”

Haselhuhn said the Mental Health First Aid classes show professors and university administrators how to tune into signs students may be exhibiting. From apparent depression, anxiety or eating disorders, professors can become
the necessary vehicles students need to get to the resources available with the help of the Mental First
Aid class.

According to the Idaho Council for Suicide Prevention, Idaho is 51st in the nation in spending on mental health,
spending only $33 dollars per capita.

“There are a lot of pressures here, coming in (to university life), and that can be really scary and it can affect the decisions you make, and they can really affect your life,” Haselhuhn said.

From drastic changes in a daily routine or living environment, stressors can come from homework, expectations from classes
or even perceived pressure to fit in with a particular group of friends.

“It’s important for incoming students to have the necessary important information to be successful here,
and some of that is lifestyle components (and) adjusting to college life,” Haselhuhn said. “The idea is that we’re taking care of
each other.”

Peering into university protocol

Psychologist, professor and Director of the UI Counseling & Testing Center Joan Pulakos said circumstances of suicide are tough issues that often require intense communication, even when speaking up may
be difficult.

“What we want to do is just understand what’s going on, how the individual is feeling, where there are areas of concern,” Pulakos said. “The first step is to simply get to know somebody, to kind of get a broad picture of who they are and what’s going on. In that sense it’s similar to when anybody comes in for counseling, it’s about finding out some of those issues.”

Pulakos has been working in the UI CTC since 1983 and has had the opportunity to observe the changing landscape of students at the university. She said highlighting stressors found in the daily routine is an important part of dealing with suicidal thoughts.

“We’ll talk about … particular stressors going on right now, particular things that are contributing to (the suicidal feelings), if it’s been a long-standing issue, or is it sort of recent in terms of issues or … thoughts they’ve been having,” Pulakos said.

“Many folks have suicidal thoughts in their life (and) a large percentage of students will have those thoughts in their lives,” Pulakos said. “They vary in terms of severity — sometimes it’s just a passing thought, not necessarily considered ‘severe’… while others think about it more, so it’s a progression of how serious it is and how much people have actually thought about it.”

Pulakos was involved in the early stages of introducing the university’s current protocol.

UI has a particular protocol when dealing with suicide.

The protocol, called the Suicide Behavior Response Plan, is set in place after a student has exhibited “some level of suicidal behavior,” Pulakos said.

If a student comes into the Counseling Center and reports having suicidal thoughts, then the program wouldn’t be kicked in because whatever comes into the Counseling Center is confidential. But, according to the university, “faculty and staff have a right and responsibility to confront disruptive behavior.”  Confronting that behavior can include breaking codes of confidentiality when necessary, as defined by the legal qualifications of the CTC.

“Because of the CTC’s confidentiality legalities, the reports are funneled through the Dean of Students,” Pulakos said.

This process gives the university more flexibility to adequately treat students. But when a student could present a violent threat to either themselves or the campus community, the appropriate action must be taken.

As part of the university’s protocol when dealing with any suicidal ideation, the CTC and Dean of Students work to promote the use of Suicide Behavior Reports as a way to document and study suicidal behavior in the campus community.

Reports come from various places — some students will call in with concern for a friend, some professors will come in with concerns for a student, from residence life or from Greek life. These behavior reports are sent to the Suicide Behavior Assessment Team to evaluate whether the behavior discussed crosses the established “threshold” for suicidal behavior.

From suicidal ideation and expression of future suicidal attempt to increasingly dangerous behavior and suicidal threats, Pulakos said the suicidal feelings may fluctuate in terms of frequency and where they exist within the threshold’s spectrum of behaviors.

“Our role is doing the counseling and working closely with folks, and it’s very important that people feel safe and they feel it’s an opportunity to talk about whatever they need because we can’t share information with professors or with parents,” Pulakos said.

While suicide is currently the second-leading cause of death between the ages of 15 and 34 in Idaho, especially for teenage males, the Suicide Prevention Action Network of Idaho works to lower the state’s suicide rate through advocacy, education, collaboration and the spread of best-practice solutions to handle suicide-related situations.

According to SPAN, Idaho was the first state in the country to initiate an affiliate of the National Suicide Prevention Action Network in 2002, otherwise known as SPAN USA.

Psychiatric and mental health professionals from the Adolescent Suicide Task Force and the cluster of Idaho Suicide Prevention Services wished to establish a formal organization to gather data and document the state’s suicide patterns, in hopes to seek clarity on the convoluted subject.

According to SPAN’s most recent data, gathered in October 2012, Latah County had a rate of 12 suicides per every 100,000 over a five-year period from 2007 to 2011.

Idaho is consistently among the states with the highest suicide rates. SPAN said Idaho’s 2010 suicide rate ranked 6th–highest in the country — 49 percent higher than the national average. On a university scale, Pulakos said the suicide rate on national campuses didn’t have that large of a margin.

“The goal of this plan is if something happens … in the university community, is to help facilitate students to get access to the assessment we want them to have,” Pulakos said.

Suicide in the media

University of London psychologist Alex Mesoudi urged reporters to “keep the word ‘suicide’ out of the headline, don’t release details or romanticize the death, limit the number of stories (on the topic), and bury whatever stories you run in the middle of the paper or the broadcast.” But, these guidelines, as also supported by the World Health Organization, can seem outdated in today’s media landscape.

With primary duty to the public, yet the imperative sensitivity to surroundings of the suicide as well, how is a reporter supposed to navigate through the muddled waters of social and professional responsibility?

“Given certain circumstances, those things shift,” said Steve Smith, UI clinical assistant professor and instructor of the UI mass media ethics courses.

Considering the ever-evolving face of media, the reporter’s responsibility to cover suicide comes with many complicated ethical issues.

He said navigating through the ethics of reporting suicide is difficult.

“I imagine it to be much like riding a unicycle between cars on the freeway — so many directions and considerations, and even more ways one can crash and burn,” he said.

While it would be easier to instill a company policy to never report on suicide, he said, journalists must continually carry on with their public duty but with increased sensitivity and appropriateness in mind.

Smith said mainstream media isn’t generally concerned with covering suicide in hopes to give peace and privacy to those affected.

“Under most circumstances, it’s not viewed as being of significance to the public — reporting a suicide doesn’t point to large social problems, and it generally doesn’t signify a large social problem as a whole — it’s a private matter,” Smith said.

But while there are no hard and fast rules as to how to cover journalism, Smith said there are many guidelines that, in spite of their importance in a journalist’s gamut, contradict themselves. Mainstream media will honor their code of privacy unless the suicide intersects with a local or national public issue.

In January, when a student in the Wallace Residence Center shot himself, many issues came to the surface. Not only was the campus community mourning the loss of a student, but the issue of gun violence on campus was also on point. Suicide by firearm as well, for that matter; 63 percent of Idaho suicides involved a firearm — 13 percent more than the national average.

“There’s still, on one hand, the issue of privacy for the victim and the victim’s family and friends,” Smiths said. “But, the nature of the incident and the importance of the issue shift the responsibility of the journalist or reporter from the family and privacy to the responsibility of the public, and that’s a hard issue for some people to get past.”

How much privacy to give is an overwhelming issue for some news publications. Some publications continue to give privacy in efforts to protect those affected from prying eyes while also trying to protect the public and cover suicide minimally. Others, Smith said, cover suicide brazenly in efforts to bring attention to public mental health issues.

“There are people within the medical and psychiatric community who say you should report them all because: a) it removes the stigma and b) it shines a light on this problem,” Smith said.

The stigma associated with suicide, Smith said, is one that is changing and evolving right along with the landscape of media.

“At that point, our responsibility (as journalists) is no longer with either the family or the victim — bless their hearts, we mourn with them — but our job at that point isn’t to make the community feel better,” Smith said. “It’s to inform the community in a way that helps people understand what happened, why it happened, and questions need to be answered and resolved.”

Chloe Rambo can be reached at [email protected] 

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