CDC Releases Survey Data Following Stark County Student Deaths

(Canton, Ohio) – The CDC is now releasing the survey results collected from more than 15,000 students, most in Stark County schools, during the 2017-2018 school year.

The survey was administered to students in 7th – 12th grades following the suicides of 12 students between August of 2017 and March of 2018. CDC officials note this is more than seven times the national rate and 11 times the rate in Stark County between 2011 and 2016.  Questions in the survey asked about connectedness, social media, mental health, life experiences, friendships, suicidal ideation, suicide attempts, and resiliency.

Key findings from the survey published in the 56-page report released on Monday, October 15th include:

  • 9 % of participating students feel lonely
  • Nearly 14% of participating Stark County students who have ever attempted suicide have access to a gun.
  • Risk of suicide is significantly higher among adolescents who use social media for two hours or more each day.
  • Only 1 in 2 students feel he or she is a ‘part of my school.’ And is ‘happy to be at my school.’
  • Nearly 1 in 4 students live with someone who is depressed, mentally ill or suicidal.
  • 3 in 10 students stated they have a mental health problem.
  • 1 in 5 students has thought of suicide, and 1 in 11 has attempted suicide at least once.

A collaborative public health initiative led by Stark County Health Department, along with the Ohio Department of Health, Stark County Mental Health & Addiction Recovery, Stark County Educational Service Center, worked with the CDC to produce the findings. “The report emphasizes the importance of continuing the unprecedented collaboration in developing and enhancing youth suicide prevention strategies,” says Kirk Norris, Health Commissioner for the Stark County Health Department. “These findings will be used to enhance our youth suicide prevention practices.”

John Aller, Executive Director of Stark County Mental Health & Addiction Recovery (StarkMHAR), notes he believes this information is a bridge between the young people facing these issues and the adults seeking solutions. “We know that getting the youth themselves involved in prevention activities increases our chances for success,” he says. “We want to help erase stigma by using what we now know to encourage frank conversations between young people and all the folks who are here to help them.”

The report focuses on several strategies within seven defined areas that may help engage schools, mental health providers, parents, and students:

  • Strengthen access and delivery of suicide care – Officials note mental illness is an important risk factor for suicide, but unfortunately, relatively few people in the U.S. with mental health disorders receive treatment. Nearly 16% of Stark County youth surveyed were not always able to get medical or psychological care when needed.
  • Create protective environments
    1. Officials suggest reducing access to lethal means among those at risk of suicide. 23% of Stark County youth have access to a gun; nearly twice the percentage of other U.S. adolescents (12.6%). Nearly 14% of Stark County students who have ever attempted suicide have access to a gun. Among those who attempt suicide, researches note those who use firearms are more likely to die than those who use other means. “Collaborating with gun owners, firearm dealers, shooting clubs, hunting organizations, and others to promote firearm safety is an important strategy for reducing suicide risk,” officials add.
    2. Additionally, they note the importance of policies and culture. “Less than half of Stark County youth feel safe at school. Nearly 60% of Stark County students reported they would feel “a bit more safe” or “much more safe” if a police officer or school resource officer was present at their school.
    3. Community-based strategies to reduce youth substance use. Nearly half of Stark County students surveyed noted they have used a substance at least once. The most common substances used by those who took the survey are alcohol, marijuana, and prescription pain medication. Substance use in adolescence, according to the report, increases risk of addiction, poor academic performance, involvement with the juvenile justice system, and suicide.
  • Promote “connectedness.”
    1. Community engagement activities. Compared with other youth in Ohio, Stark County youth are more involved in school and community activities. Despite this trend, nearly one in 10 adolescents in Stark County is not involved in any school or community activities. Given the important role of connectedness in preventing suicide, stakeholders may consider increasing outreach activities to students not actively involved in their school or community.
    2. Promotion of connectedness. Stark County youth feel less connected to their school, friends, and family than other adolescents in the U.S. Events and activities that build students’ and families’ sense of community may benefit Stark County youth in a number of ways, including buffering against risk of suicide.
    3. Parental engagement activities. Parental involvement in youth life through activities and interactions is important for prevention of suicide. Stark County youth report higher 45 percentages of parental involvement when compared with U.S. adolescents. These important relationships should be encouraged and strengthened where possible.
  • Teach coping and problem-solving skills –
    1. Social-emotional learning programs. Over 60% of Stark County youth have experienced at least one adverse childhood experience in their lifetime, higher than adolescents at the state and national level. Adverse childhood experiences can be prevented through interventions like strengthened economic supports for struggling families and parenting programs like the Incredible Years, Families Matter, and Strengthening Families 10-14 (Stone et al., 2017).
    2. Increase youth resiliency. The negative effects of adverse childhood experiences can be buffered through programs that increase children’s resiliency. Stakeholders in Stark County may consider implementing programs that increase problem-solving and coping skills, promote healthy relationships, and develop mindfulness to combat the effects of adverse childhood experiences.
  • Identify and support people at risk – The report suggests gatekeep training. Over 40% of participating students were aware of a friend’s, family member’s, or significant other’s suicidal ideation, suicide attempt or death by suicide. Over 60% of participating students would tell a friend if they were having suicidal ideation and over 50% of students would disclose suicidal ideation to a parent. Gatekeeper training is designed to train peers, teachers, coaches, clergy, emergency responders, primary and urgent care providers, and others in the community to identify people who may be at risk of suicide and to respond effectively, including facilitating treatment seeking and support services (Stone et al., 2017).
  • Lessen harms and prevent future risk –
    1. Sixteen percent of Stark County youth lost a friend, significant other, or family member to death by suicide in 2017–2018. Associates of decedents may be at increased risk of suicide. Persons substantially affected by suicide should be referred for further counseling or other services as needed. In suicide clusters, persons have attempted suicide or died by suicide even though they did not personally know victims who died by suicide earlier in the cluster.
    2. Responding to a death. Activities that glorify suicide victims or sensationalize suicide deaths have the potential to increase suicidal behaviors among youth exposed to these events. Nearly 40% of Stark County youth attended a vigil or moment of silence for a teenager who died by suicide. These events, while intended to demonstrate sincere compassion, can be potentially very dangerous. Communities may consider following suicide response guidelines for all announcements to students. Resources for safe suicide response are included in the Additional Resources section of this report.
    3. Safe reporting about suicide. Three-quarters of youth saw a news article about the teen suicides in Stark County in the past year. Sensationalism in news reporting is a real problem in the setting of a suicide cluster, as it potentiates the risk of suicide among readers who identify with the decedent. Engaging local and state media partners in suicide coalition planning and prevention efforts may be helpful to ensure adherence to safe suicide reporting guidelines.
    4. Safe messaging about suicide. Thirteen percent of Stark County youth posted on social media and nearly 70% of Stark County youth saw posts on social media about the recent suicides among adolescents. It is important for school & county stakeholders to monitor social media channels regularly and respond to any disclosures of suicidal thoughts or behaviors
  • Administer ongoing youth health and behavior surveys.

The full report can be found here:

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Resources available for parents and community members to utilize include:

Suicide Prevention
Evidence-Based Prevention – Search tool from Suicide Prevention Resource Center to help partners make decisions about the programs and practices that will be a part of a comprehensive approach to suicide prevention.
http://www.sprc.org/keys-success/evidence-based-prevention

Los Angeles County Youth Suicide Prevention Project
Website with separate sections for school administrators, school staff, parents, and students. Each section contains information sheets, videos, and other helpful resources. The website also has links to resources on a variety of at-risk populations and special issues in suicide prevention.
http://preventsuicide.lacoe.edu

Preventing Suicide: A Toolkit for High Schools
Toolkit helps high schools, school districts, and their partners design and implement strategies to prevent suicide and promote behavioral health among their students. It describes the steps necessary to implement all the components of a comprehensive school-based suicide prevention program and contains numerous tools to help carry out the steps.
http://store.samhsa.gov/product/Preventing-Suicide-A-Toolkit-for-High-Schools/SMA12-
4669?WT

The Trevor Project
The Trevor Project is a national organization with a focus on crisis and suicide prevention among lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. It provides a toll-free crisis phone line, an online social networking community for LGBTQ youth and their friends and allies, educational programs for schools, and advocacy initiatives.
http://www.thetrevorproject.org

Crisis Planning
Practical Information on Crisis Planning
Guide for schools and communities to navigate crisis planning. Provides an overview of critical concepts and components of crisis planning with examples of promising practices.
https://rems.ed.gov/docs/PracticalInformationonCrisisPlanning.pdf
Crisis Text Line
Crisis Text Line provides free emotional support and information to teens in any type of crisis, including feeling suicidal. Individuals can text with a trained specialist 24 hours a day. Text
“HOME” to 741741.
http://www.crisistextline.org/

Postvention Guidelines
Practical guide from Australia, designed to assist schools in responding to the tragic occurrence of suicide or attempted suicide within their student community. Includes actionable items and suggested timeline for schools in the process of responding to a suicide.
https://www.education.sa.gov.au/doc/suicide-postvention-guidelines

Postvention Manual
Guide for schools and communities to develop their own postvention procedures.
https://www.starcenter.pitt.edu/Files/PDF/Manuals/Postvention.pdf

Children, Teens, and Suicide Loss
Plain language guide for parents & families on how to support youth through loss of a loved one to suicide.
https://afsp.org/find-support/ive-lost-someone/resources-loss-survivors/children-teens-suicideloss/

Jason Foundation Parent Resource Program
Website containing basic information about suicide and how families can help prevent youth suicide. It also has a video of a parent and community seminar that includes basic information on suicide and provides awareness and suicide prevention strategies for parents and other adults.
http://jasonfoundation.com/get-involved/parent/parent-resource-program/

Society for the Prevention of Teen Suicide
Website’s parent section provides information to help families talk with teens about suicide or the death of a friend by suicide. It includes a link to the video Not My Kid:

What Every Parent
Should Know, which features eight parents from culturally diverse backgrounds asking two experts common questions about youth suicide.
http://www.sptsusa.org/parents/

Social Media
Tips on Social Media from Riverside Trauma Center
Numerous resources from Riverside Trauma Center, including talking to children about 13 Reasons Why; responding to a traumatic event; and tips on social media after a suicide loss for students, school administrators, and parents.
http://riversidetraumacenter.org/trauma-center-resources/

How to Use Social Media for Suicide Prevention
Resource from California Mental Health Services Authority to help organizations or communities evaluate if use of social media for suicide prevention is right for them, and if so, tips for how to implement safe, effective messages into organizations’ social messaging.
http://eiconline.org/teamup/wp-content/files/13-CALM-0106-Socialmedia_Guide_FNL.pdf

Recommendations for Reporting on Suicide
Guidelines developed by leading experts in suicide prevention for safe media reporting on suicide.
http://www.reportingonsuicide.org
Action Alliance Framework for Successful Messaging
Research-based resource to improve public messaging about suicide.
http://suicidepreventionmessaging.org/

Suicide Clusters and Contagion
Journal article from Principal Leadership providing an overview of the concept of suicide contagion, factors driving suicide contagion, and how school leadership may prevent or disrupt contagion.
http://cdpsdocs.state.co.us/safeschools/Resources/Suicide

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