Approaches to Suicide Prevention on Higher Education Campuses

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Approaches to Suicide Prevention on Higher Education Campuses Larraine Bernstein, MS University of Maryland

Approaches to Suicide Prevention on Higher Education Campuses Larraine Bernstein, MS University of Maryland Baltimore MARYLAND SPIN Suicide Prevention and Early Intervention Network

Today’s Presenters • John (Jay) Coughlin, III, Psy. D, Director, Counseling and Career Services

Today’s Presenters • John (Jay) Coughlin, III, Psy. D, Director, Counseling and Career Services Academic/Student Support and Career Services, The Rouse Company Foundation Student Services Hall, Howard Community College • Ralph Piper, Ph. D, Assistant Director and Senior Clinical Supervisor, Morgan State University • Charon Burda, DNP, PMHNP-BC, CARN-AP, Assistant Professor, Specialty Director, and Psychiatric Mental Health Nurse Practitioner, University of Maryland School of Nursing

SAMHSA funded grant for 2014 -2019 Goal of MD-SPIN: Reduce premature loss of lives

SAMHSA funded grant for 2014 -2019 Goal of MD-SPIN: Reduce premature loss of lives from suicide by increasing the number of at-risk youth who are identified, referred and receive quality behavioral health services. MD-SPIN Key Components q q q Public Awareness and Materials Dissemination Technical Assistance and Training Center Screening, training, and follow-up protocols in emergency departments and the inpatient units to which they refer Online gatekeeper training by Kognito’s Training Games and Simulations for Health Evaluation

 • Interventions Implemented Kognito Gatekeeper Trainings Emergency Department Screening and Assessment • Online,

• Interventions Implemented Kognito Gatekeeper Trainings Emergency Department Screening and Assessment • Online, avatar-based training program • Practice having conversation with student/friend who may be experiencing psychological distress and/or having suicidal thoughts • Standardized, evidence-based screening (ASQ – Ask Suicide Questions) • Training and brief Interventions • Follow-up of high-risk youth

The Need for Suicide Prevention • Nationally, suicide is second leading cause of death

The Need for Suicide Prevention • Nationally, suicide is second leading cause of death for 15 -34 year-olds. 1 • In Maryland, 321 young adults 18 -24 died by suicide from 2009 -2014. • Teachers, faculty, and staff are in a position to recognize signs of psychological distress and support transition-aged youth. 2 References: 1. Centers for Disease Control and Prevention (2015). Suicide: Facts at a glance. Retrieved from https: //www. cdc. gov/violenceprevention/pdf/suicide-datasheet-a. pdf 2. Koller, J. , Osterlind, S. , Paris, K. , & Weston, K. (2004). Differences between novice and expert teachers' undergraduate preparation and ratings of importance in the area of children's mental health. International Journal of Mental Health Promotion, 6(2), 40 -46.

Suicide Deaths of 18 -24 year-olds in Maryland Number of Suicide Deaths 70 60

Suicide Deaths of 18 -24 year-olds in Maryland Number of Suicide Deaths 70 60 50 50 49 48 2009 2010 2011 62 60 2013 2014 52 40 30 20 10 0 2012

A Ba nn Allg lti e A an m ru y o n Ba

A Ba nn Allg lti e A an m ru y o n Ba re C del lti ou m n or ty e C Ca ity l Ca vert ro lin Ca e rro ll Ce C ci Do har l rc les he Fr ste ed r er Ga ick rr Ha ett rfo Ho rd w ar d M o K Pr nt en in go t ce m Qu Ge ery ee org n e's A St nne. M 's So ary m 's er se W Ta t as lb hi ot n W gto ic n W omi or co ce st er Number of Suicide Deaths of 18 -24 year-olds by Maryland County 2009 -2014 50 45 10 5 0 44 35 30 7 42 40 37 33 28 25 20 15 15 9 0 16 17 5 1 14 10 10 9 10 2 5 1 2 2 3

Risk Factors • Gender: females are more likely to consider and attempt suicide, but

Risk Factors • Gender: females are more likely to consider and attempt suicide, but males more likely to complete suicide 1 • Transition-aged youth (ages 16 -24) are at high-risk for emotional and behavioral disorders, with the average of onset for many mental health disorders falling within this age range 2 • Ethnicity: The suicide rate among American Indian/Alaska Native adults aged 15 -34 is 1. 5 times higher than the national average 3 • SES: No consistent statistically significant differences documented to date 1 1. 2. 3. References: Gould, M. S. , Greenberg, T. , Velting, D. , Shaffer, D. (2012). Youth Suicide Risk and Preventive Inventions: A Review of the Past 10 Years. Journal of American Academy of Child Adolescent Psychiatry, 42(4), doi: 10. 1097/10. 01. CHI. 00000046821. 95464. CF Arnett, J. J. (2006). Emerging adulthood: Understanding the new way of coming of age. In J. J. Arnett & J. L. Tanner (Eds. ), Emerging adults in America: Coming of age in the twenty-first century (pp. 3 -20). Washington, D. C. : American Psychological Association. Centers for Disease Control and Prevention (2015). Suicide: Facts at a glance. Retrieved from https: //www. cdc. gov/violenceprevention/pdf/suicide-datasheet-a. pdf

Protective Factors • Family acceptance and support 1 • Connections to friends and others

Protective Factors • Family acceptance and support 1 • Connections to friends and others who care about them • Community support • Sense of safety • Access to effective care • Restricted access to lethal means • Coping skills References 1. Suicide Prevention Resource Center. (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Retrieved from http: //www. sprc. org/sites/default/files/migrate/library/SPRC_LGBT_Youth. pdf

GATEKEEPER TRAINING A gatekeeper is any individual (i. e. , not a mental health

GATEKEEPER TRAINING A gatekeeper is any individual (i. e. , not a mental health professional) trained to identify individuals at risk of psychological distress and connect them to treatment or supporting services as appropriate. • A key strategy for prevention and early intervention as part of the national strategy for recognizing psychological distress, including suicide prevention • Reduces the anxiety faculty and staff may experience about responding to an at-risk student in their class and stigma associated with mental illness • Reduces the number of undetected students in schools and moves them into treatment as early as possible • Enhances safety for students, classrooms, schools, dorms and communities

Suite of Trainings for Faculty & Staff Veterans on Campus LGBTQ on Campus for

Suite of Trainings for Faculty & Staff Veterans on Campus LGBTQ on Campus for Faculty & Staff At-Risk for Faculty & Staff Features: • Online, 24/7 accessibility • Materials for on-campus promotion • Includes simulated conversations with • Veterans on Campus is a collaboration emotionally responsive student avatars • Built-in program assessment and tracking • Utilized by 650+ institutions, listed in SPRC Best Practices Registry, and evaluated in a nation study between Student Veterans of America(SVA) and Kognito Interactive • LGBTQ On Campus is a joint initiative of The Trevor Project, Campus Pride, and Kognito Interactive © 2015 Kognito. All Rights Reserved.

Suite of Trainings for Students Veterans on Campus LGBTQ on Campus for Students At-Risk

Suite of Trainings for Students Veterans on Campus LGBTQ on Campus for Students At-Risk for Students Features: • Online, 24/7 accessibility • Veterans on Campus is a collaboration • Includes simulated conversations with emotionally responsive student avatars • Built-in program assessment and tracking • Materials for on-campus promotion • Utilized by 650+ institutions, listed in SPRC Best Practices Registry, and evaluated in a national study between Student Veterans of America (SVA) and Kognito Interactive • LGBTQ on Campus is a joint initiative of The Trevor Project, Campus Pride and Kognito Interactive • At-Risk for Students listed in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP) © 2015 Kognito. All Rights Reserved.

At-Risk Training from Kognito for Higher Education • At-Risk for Higher Education - At-Risk

At-Risk Training from Kognito for Higher Education • At-Risk for Higher Education - At-Risk for Faculty and Staff - Veterans on Campus - LGBTQ on Campus - At-Risk for Students - Veterans on Campus - LGBTQ on Campus

Learning Objectives In these courses, faculty, staff and students will learn: 1. How to

Learning Objectives In these courses, faculty, staff and students will learn: 1. How to recognize the common warning signs of emotional or psychological distress and PTSD 2. Ways to approach students/peers with greater skill and confidence and effectively refer them to campus mental health services, administrative support, and student groups on campus 3. How to effectively manage a conversation, both in and out of the classroom for faculty/staff, or on and off campus for peers, around topics that may be sensitive to veteran and LGBTQ students 4. Their local and college-specific resources © 2015 Kognito. All Rights Reserved.

REFERENCES Arnett, J. J. (2006). Emerging adulthood: Understanding the new way of coming of

REFERENCES Arnett, J. J. (2006). Emerging adulthood: Understanding the new way of coming of age. In J. J. Arnett & J. L. Tanner (Eds. ), Emerging adults in America: Coming of age in the twenty-first century (pp. 3 -20). Washington, D. C. : American Psychological Association. Centers for Disease Control and Prevention (2015). Suicide: Facts at a glance. Retrieved from https: //www. cdc. gov/violenceprevention/pdf/suicide-datasheet-a. pdf Gould, M. S. , Greenberg, T. , Velting, D. , Shaffer, D. (2012). Youth Suicide Risk and Preventive Inventions: A Review of the Past 10 Years. Journal of American Academy of Child Adolescent Psychiatry, 42(4), doi: 10. 1097/10. 01. CHI. 00000046821. 95464. CF Gould, MS. , Kramer, R. A. (2001). Youth suicide prevention. Suicide Life Threatening Behavior, 31(suppl), 6 -31. Suicide Prevention Resource Center. (2017). Lesbian, gay, bisexual, and/or transgender people. Retrieved from http: //www. sprc. org/populations/lgbt Suicide Prevention Resource Center. (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Retrieved from http: //www. sprc. org/sites/default/files/migrate/library/SPRC_LGBT_Youth. pdf

QUESTIONS Larraine Bernstein, Outreach and Training Program Manager lbernste@som. umaryland. edu (410) 706 -6687

QUESTIONS Larraine Bernstein, Outreach and Training Program Manager lbernste@som. umaryland. edu (410) 706 -6687

Maryland’s Twenty-Ninth Annual Suicide Prevention Conference October 4, 2017 Approaches to Suicide Prevention on

Maryland’s Twenty-Ninth Annual Suicide Prevention Conference October 4, 2017 Approaches to Suicide Prevention on Higher Education Campuses Jay Coughlin, Psy. D. Director, Counseling and Career Services Howard Community College

ASSIST Team Reports. Faculty/Staff Mental Health Screening Days Walk-In Crisis Hours Referrals from Family/Friends/Public

ASSIST Team Reports. Faculty/Staff Mental Health Screening Days Walk-In Crisis Hours Referrals from Family/Friends/Public Kognito. Safety Training for Faculty/Staff

ASSIST Team Reports. Faculty/Staff Faculty and staff can use the ASSIST icon on their

ASSIST Team Reports. Faculty/Staff Faculty and staff can use the ASSIST icon on their computers at work to file a report regarding a student of concern. Dr. Joy Stephens and Dr. Jay Coughlin serve on the core ASSIST team and will frequently follow up on reports regarding students who are a danger to themselves or others.

Mental Health Screening Days Throughout the academic year, mental health screening events are offered

Mental Health Screening Days Throughout the academic year, mental health screening events are offered on campus. The largest event, the Depression Screening, occurs in October, allows students to identify resources early in their HCC experience.

Walk-In Crisis Hours Four hours of each day are reserved for walk-in crisis appointments.

Walk-In Crisis Hours Four hours of each day are reserved for walk-in crisis appointments. During this time, a counselor will be available to see a student in need. CRISIS HOURS SCHEDULE Summer/Fall 2017 Mon Time Counselor 9 am-10 am 10 am-11 am Terry X 4007 11 am-12 pm Jay X 4032 12 pm-1 pm 1 pm-2 pm 2 pm-3 pm Eileen X 3044 3 pm-4 pm Dave X 4260 4 pm-5 pm Tue Counselor Kassy X 4428 Dave X 4260 Joy X 4288 Wed Counselor Joy X 4288 Jay X 4032 Terry X 4007 Thu Counselor Jay X 4032 Paul X 4855 Joy X 4288 Jay X 4032 Fri Counselor Paul X 4855 Joy X 4288 Dave X 4260

Referrals from Friends/Family/Public Safety CCS often receives calls, emails or meets face-toface with family

Referrals from Friends/Family/Public Safety CCS often receives calls, emails or meets face-toface with family or friends to get information. CCS can either guide family and friends in helping the student seek services or clinicians can call the student directly. CCS have a great relation with Public Safety. Each officer is trained in QPR each year. Officers are highly skilled in working with students who struggle with mental illness and will walk them over to our office.

Kognito Training This is an online training program that help people identify, talk to

Kognito Training This is an online training program that help people identify, talk to and refer students of concern. Since this program was implemented 2 years ago, Kognito has had a significant impact increasing the number of students in crisis seeking counseling or being referred. Kognito Program Number of Individuals Trained (as of 10/2/17) Faculty/Staff: At-Risk Students 306 Faculty/Staff: LGBTQ on Campus 262 Faculty/Staff: Veterans on Campus 263

Crisis Appointments 160 140 120 [VALUE] 117 105 140 142 FY 16 FY 17

Crisis Appointments 160 140 120 [VALUE] 117 105 140 142 FY 16 FY 17 113 100 80 Kognito Starts 60 40 20 0 FY 12 FY 13 FY 14 FY 15

Referral Source 120 104 103 100 84 80 80 96 89 87 93 84

Referral Source 120 104 103 100 84 80 80 96 89 87 93 84 80 60 0 Kognito Starts 20 Kognito Starts 40 Instructor Staff (Non Faculty) FY 13 FY 14 FY 15 FY 16 FY 17

Current Thoughts of Suicide, Yes 70 60 59 40 30 39 41 38 20

Current Thoughts of Suicide, Yes 70 60 59 40 30 39 41 38 20 10 61 Kognito Starts 50 0 FY 13 FY 14 FY 15 FY 16 FY 17

If Yes, Scale from 1 to 5 42 45 40 35 30 29 29

If Yes, Scale from 1 to 5 42 45 40 35 30 29 29 28 28 25 21 17 20 15 10 24 19 19 15 12 12 13 6 5 5 0 1 level 2 level 3 level FY 13 FY 14 FY 15 4 5 1 4 level FY 16 FY 17 5 3 2 0 5 level 0 2

Collaborative Assessment and Management of Suicidality (CAMS) Forms Counseling Center Assessment of Psychological Symptoms

Collaborative Assessment and Management of Suicidality (CAMS) Forms Counseling Center Assessment of Psychological Symptoms (CCAPS) Form Weekly Consultation Meetings Flag Feature on Titanium “There is Hope” Phone App

Collaborative Assessment and Management of Suicidality (CAMS) Forms If a student endorses suicidal thoughts

Collaborative Assessment and Management of Suicidality (CAMS) Forms If a student endorses suicidal thoughts on our intake paperwork, the form helps us make a thorough clinical assessment that includes a treatment plan and consultation with other clinicians.

Kognito Starts 7 r-1 Ap 16 6 17 Fe b- ec - D ct

Kognito Starts 7 r-1 Ap 16 6 17 Fe b- ec - D ct -1 O -1 6 Au g 6 6 n 1 Ju 16 15 5 r-1 Ap Fe b- ec - D -1 ct O -1 5 Au g 5 5 n 1 Ju 15 14 4 r-1 Ap Fe b- ec - D -1 ct O 4 -1 4 Au g n 1 Ju 8 6 4 2 0

Counseling Center Assessment of Psychological Symptoms (CCAPS) Form Before each personal counseling appointment, the

Counseling Center Assessment of Psychological Symptoms (CCAPS) Form Before each personal counseling appointment, the student completes this form which tracks progress made in several areas (e. g. hostility, eating concerns, depression anxiety, etc. ).

Weekly Consultation Meetings Clinical staff meet weekly to discuss: • that weeks walk-in crisis

Weekly Consultation Meetings Clinical staff meet weekly to discuss: • that weeks walk-in crisis appts • any ongoing CAMS clients • difficult/challenging cases Bring in speaker to discuss specific topic

Flag Feature on Titanium This feature is used by clinicians to identify students of

Flag Feature on Titanium This feature is used by clinicians to identify students of concern who have repeatedly used mental health/counseling services. Flags we use: • Client of Concern • CAMS • Release on File • Client not a student • Frequent No-Shows • Hospitalization

“There is Hope” Phone App This app allows students with suicidal ideation to take

“There is Hope” Phone App This app allows students with suicidal ideation to take the self -assessment if their thoughts get stronger. A high score helps them easily access the Grassroots Crisis Hotline.

Jay Coughlin Howard Community College Columbia, MD Email: jcoughlin@howardcc. edu Phone: 443 -518 -4032

Jay Coughlin Howard Community College Columbia, MD Email: jcoughlin@howardcc. edu Phone: 443 -518 -4032