Florida School Toolkit for K-12 Educators to Prevent Suicide

41. Students who engage in repetitive self- injury, i.e., cutting and burning, do they ever become suicidal? N on-suicidal self-injury (NSSI) is a coping mechanism as a way of regulating emotions and releasing endorphins to feel better. NSSI has diminishing returns and likely is not working as well for an adolescent today as it was three or four months ago. The literature emphasizes that engaging in NSSI is a way of acquiring the capability of suicide as students become comfortable with harming their body. Many of the NSSI cases that I know well, it was a suicide attempt that actually uncovered a long pattern of a student’s cutting behavior. A review of the literature says we should keep these things in mind when trying to determine which of the large number of students engaging in NSSI might ultimately make a suicide attempt. Have they engaged in self-injury over an extended period of time? Have they utilized multiple methods to self-injure? Do they experience little pain when they self-injure? Do they disassociate when engaging in self-injury? I believe it’s very important when we know the student is engaging in NSSI to ask them directly about suicidal thoughts, plans, and actions. 42. With regards to self-injury, what do you think are the greatest resources for school personnel to review? I’m a very big fan of the Cornell Self-injury and Recovery Resource website ( selfinjury .bctr.cornell.edu) and, additionally, for the state of Florida I created a video where I interviewed two young women who spoke very eloquently about their struggle with self-injury as they both received a national mental health award. The video entitled, Critical Insight and Testimony on Self-injury , is available under training videos at my university website nova .edu/suicideprevention . 43. You have stressed in your presentations the importance that means matter and specifically emphasized removing guns from the ready access of suicidal youth. Why is that so important? I like to begin by giving you an example as my cousin called me asking for advice as he just arrived at his condo to learn that his neighbor Bob was seen holding a gun to his head in the parking lot only two days ago. My cousin asked what he should do. I responded by asking if anyone rushed Bob to the emergency room? The answer was nothing was done, and then I asked what about Bob’s guns, and my cousin responded he asked his wife about that but his wife said those guns are Bob’s and she couldn’t possibly remove them. My cousin asked what difference would that make anyway, as wouldn’t Bob just find another way. I spent considerable time explaining to my cousin about the website at Harvard called Means Matter ( meansmatter.com ) that summarized research all around the world that found removing the lethal means such as a gun or raising the barrier on the bridge saved lives. My cousin went on to say that Bob was suffering from Parkinson’s. I hypothesized that Bob was being treated for that disease but not for the accompanying depression. I’m very pleased to tell you that my cousin took steps to get the guns removed from Bob’s home and he accompanied Bob to the doctor where Bob shared his suicidal behavior with his physician. Bob is now receiving treatment for his depression and still alive now months later. Research says that guns are only used in 5 percent of suicide attempts yet result in approximately 50 percent of all suicide deaths in our country. Guns are extremely lethal and those that attempt with a gun rarely get a second chance. Florida S.T.E.P.S.