Light for Life Foundation – Please call the San Diego 24 hour Crisis Hotline at 1(800)479-3339, or the National Hotline at 1(888)SUICIDE, (784-2433) *If you are in need and don’t know how to ask for help please call these hotlines. Life is precious - I care and they care.

Are you, or do you know someone who is feeling depressed, with thoughts of taking their own life?

Please read on for help:

*For Depression or Suicidal Thoughts – please contact Light for Life Foundation. Call the San Diego 24 hour Crisis Hotline at 1(800)479-3339, or the National Hotline at 1(888)SUICIDE, (784-2433)

*If you are in need and don’t know how to ask for help please call these hotlines. Life is very precious -I care and they care – make the call for help. Sometimes life seems over-whelming-please make the call…

*A heartfelt thank you to the Light for Life Foundation of Southern California Chapter for sharing this valuable information. To call their local office direct for additional information and/or inviting one of their great speakers to your school or group please call (760)635-5904.

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Comprehensive Mental Health Care Service Phone Guide

Thinking About Suicide? Read This First!!!

24-Hour Crisis Response

Access and Crisis Line – 24-Hour County Suicide Hotline
24 hours/7 days – Consultation and suicide intervention by phone
(800) 479-3339Emergency Screening Unit (for Children and Adolescents)

24 hours/7 days – Emergency psychiatric evaluation, crisis stabilization, telephone crisis intervention and referral/hospitalization
(619) 421-6900

Heindorn Lifeline Crisis and Suicide Hotline
24 hours/7 days – Suicide assessment, information and referral, counseling and support; serving all members of the gay men’s and lesbian community

Psychiatric Emergency Response Team (PERT)
Hours – Call the local law enforcement agency – Specially trained police and sheriff personnel and licensed mental health counselors
Referrals through local law enforcement agencies or 911)

Hospitals with Emergency Psychiatric Facilities:

Bayview Hospital, Chula Vista
(619) 426-6310

Grossmont Hospital, La Mesa
(619) 465-0711

Mercy Hospital, San Diego
(619) 260-7000

Palomar Medical Center, Escondido
(760) 739-3300

Pomerado Hospital, Poway
(858) 613-4000

Paradise Valley Hospital, National City
(619) 470-4141

Sharp Mesa Vista Hospital, San Diego
(800) 82SHARP

Tri-City Hospital, Oceanside
(760) 724-8411

UCSD Medical Center, San Diego
(619) 543-6400

Pomerado Hospital, Poway
(858) 613-4000

Veteran’s Administration Hospital, La Jolla
(858) 552-8585 x 3386

Villa View Hospital, San Diego
(619) 582-3516

Additional Resources:

The Help Connection (A Roadmap for Mental Health Services)
http://www.sdchip.org/helpConnection/intro.html (In English) http://www.sdchip.org/helpConnection/spanish/certificado.html (In Spanish)

NAMI San Diego (San Diego’s Voice on Mental Illness)

http://www.namisandiego.org

San Diego City Kids (Comprehensive Local Youth Resource Listings)

http://www.child.net/sdkids.htm

After a Loss

Survivors of Suicide
(San Diego Chapter)
(619)482-0297

Jenna Druck Foundation
(Surviving the Loss of a Child, Celebrating the Future)
(619)294-8000

Compassionate Friends
(Our Children Loved, Missed, and Remembered)
(619)583-1555

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So that you’re aware of this important issue – please read the following and -Take Action!

How You Can Help a Suicidal Teenager or adult!

DEAL WITH YOUR OWN FEELINGS FIRST. The idea of young people wanting to kill themselves is difficult for adults to grasp. The first reaction is often shock or denial. TRUST YOUR FEELINGS WHEN YOU THINK SOMEONE MAY BE SUICIDAL. A second reaction might be efforts to argue, minimize, to discount the young person’s feelings of despair. Remember that most young people who contemplate or attempt suicide are not intent on dying. Rather, at the moment, the pain of living is more unbearable than the fear of dying.

LISTEN DON’T LECTURE. What the young person really needs in this crisis period is someone who will listen to what is being said. Try to understand from the teenager’s viewpoint.

ACCEPT WHAT IS SAID AND TREAT IT SERIOUSLY. Do not judge. Do not offer platitudes.

ASK DIRECTLY IF THE INDIVIDUAL IS THINKING OF SUICIDE. If the teenager has not been thinking of suicide, he or she will tell you. If the young person has been thinking of it, your asking allows the opportunity to bring it out in the open. Isolation and the feeling that there is no one to talk to compounds suicidal ideation. YOU WILL NOT CAUSE SOMEONE TO COMMIT SUICIDE BY ASKING THEM IF THEY ARE SUICIDAL.

TALK OPENLY AND FREELY AND TRY TO DETERMINE WHETHER THE PERSON HAS A PLAN FOR SUICIDE. The more detailed the plan, the greater the risk.

TRY TO FOCUS THE PROBLEM. Point out that depression causes people to see only the negatives in their lives and to be temporarily unable to see the positives. Elicit from the person’s past and present positive aspects which are being ignored.

HELP THE YOUNG PERSON TO INCREASE HIS/HER PERCEPTION OF ALTERNATIVES TO SUICIDE. Look at what the young person hopes to accomplish by suicide and generate alternative ways to reaching the same goals. Help determine what needs to be done or changed.

HELP THE PERSON RECALL HOW THEY USED TO COPE. Get the person to talk about a past problem and how it was resolved. What coping skills did he or she use?

EVALUATE THE RESOURCES AVAILABLE AND HELP IDENTIFY THE RESOURCES NEEDED TO IMPROVE THINGS. The individual may have both inner psychological resources and outer resources in the community which can be strengthened. If they are absent the problem is much more serious. Your continuing observation and support are vital.

DO NOT BE MISLED BY THE TEENAGER’S COMMENTS THAT HE/SHE IS PAST THE EMOTIONAL CRISIS. The person might feel initial relief after talking of suicide, but the same thinking could recur later.

ACT RESPECTFULLY. Do arrange with the person to be back in contact within a few hours. Offer yourself as a caring and concerned listener until professional assistance has been obtained.

DO NOT AVOID ASKING FOR ASSISTANCE AND CONSULTATION. Call upon whomever is needed, depending upon the severity of the case.

DO NOT TRY TO HANDLE EVERYTHING ALONE. Go to the child’s guidance counselor, principal, parents, minister, etc. Seek out referrals from hotlines, etc. Convey an attitude of firmness and composure so that the person will feel that something appropriate and realistic is being done.

Identifying Youth at Risk for Suicide

The “equation” for more successfully identifying youth at suicidal risk is to recognize items from both sides of this list. Warning signs alone are not enough to give adequate indicators. Including the risk factors give a more complete profile. Remember, however, ALL YOUTH ARE AT RISK. One is five has suicidal thoughts and one in ten will make an attempt.

Warning Signs Risk Factors

• Abrupt changes in personality
• Giving away possessions
• Previous suicide attempts
• Ending of a romance
• Inability to tolerate frustration
• Use of drugs and/or alcohol
• Depression. Lack of self esteem
• Change in eating patterns (significant weight changes)
• Unwillingness or inability to communicate
• Sexual promiscuity
• Extreme or extended boredom
• Inability to concentrate
• Accident prone (carelessness)
• Unusually long grief reaction
• Unusual sadness, discouragement and loneliness
• Hostile or reckless behavior
• Neglect of personal appearance
• Major loss (of loved one, home, loss through divorce, trauma, relationship)
• Running away from home, or truancy from school.
• Rebelliousness
• Withdrawal (from people, especially close friends, family and or favorite activities)
• Perfectionism
• Restless
• Anxiety — stress
• Problems with school or the law
• Unexpected pregnancy
• A stressful family life
• Parents who are substance abusers or depressed
• Family history of suicide
• Loss of self-esteem (humiliation)
• Tendency toward impulsiveness/anger
• Stress due to new situations: beginning new school, college or relocating to a new community
• Loss of security. Fear of higher ups, group or gang
• A serious illness or injury
• Failing in school or failing to pass an important test
• Remorse causing another person’s pain: a broken romance, an accident that injured another person
• Recognizing Possible Suicidal Behavior in the Classroom

The signs and symptoms of depression and suicidal behavior in adolescents are often observable behaviors first noticed by school personnel. The following lists common changes in classroom behavior which may reflect serious depression and/or suicidal behavior.

• ABRUPT CHANGES IN ATTENDANCE
• Remain alert to excessive absenteeism in a student with a good attendance record, particularly when the change is sudden.
• DWINDLING ACADEMIC PERFORMANCE
• Question any unexpected and sudden decreases in school performance, inability to concentrate is frequently found in depressed adolescents, leading to poor school performance.
• SUDDEN FAILURE TO COMPLETE ASSIGNMENTS
• This may be due to a variety of factors. However, this is often seen in depressed and suicidal youngsters.
• LACK OF INTEREST IN ACTIVITIES AND SURROUNDINGS
• It is difficult to maintain surveillance over so many adolescents. However, one of the first signs of a potentially suicidal adolescent is general withdrawal, disengagement and apathy.
• CHANGED RELATIONSHIPS WITH FRIENDS AND CLASSMATES
• Additional evidence of personal despair may be abrupt changes in friendships and social relationships.
• INCREASED IRRITABILITY, MOODINESS OR AGGRESSIVENESS
• Depressed, stressed and potentially suicidal individuals demonstrate wide mood swings and unexpected displays of emotion. Try to stay alert to times when a student’s reactions seem excessive.
• WITHDRAWAL AND DISPLAYS OF SADNESS
• Teachers sometimes give up on a chronic, nonparticipating students who do not cause problems in the classroom. Be sure that these students are, in fact, nonparticipants and not potentially suicidal.
• DEATH AND SUICIDAL THEMES EVIDENT IN READING SELECTIONS, WRITTEN ESSAYS
• The selection of materials centering on ideas about death or dying, the uselessness or worthlessness of life, or matters relating to persons who have committed suicide should be viewed as warning signs for teachers – particularly if this occurs on more than one occasion.
• Recognizing Possible Suicidal Behavior Out of the Classroom
• These signs are likely to be observed in a student’s general behavior and do not necessarily mean that someone is considering suicide. They are warning signs and should generate attention.
• NEGLECT/APATHY ABOUT PERSONAL HYGIENE AND APPEARANCE
• UNUSUAL CHANGES IN EATING OR SLEEPING PATTERNS
• There may be a noticeable decrease or increase in appetite with significant weight change, insomnia or a desire to sleep all of the time.
• OVERT SADNESS AND DEPRESSION
• The young person may often appear sad and depressed and show signs of tension and extreme anxiety.
• ACTING OUT BEHAVIOR
• Behavior may include substance abuse, refusal to go to school, sexual promiscuity, running away, fighting, recklessness, purposely hurting one’s body, delinquency, preoccupation with revenge.
• MARKED EMOTIONAL INSTABILITY
• Distraught students are likely to have wide and unpredictable mood swings. Particular attention should be given to a sudden change in mood from depression to cheerfulness, as if the answer to the problem is now clear.
• REMARKS INDICATING PROFOUND UNHAPPINESS OR DESPAIR
• Statements might include references to feeling constantly hassled, under stress or unable to concentrate or rest properly.
• LOSS OF INTEREST IN EXTRACURRICULAR ACTIVITIES
• PRIZED POSSESSION BEING GIVEN AWAY
• Students who do not care about the future or have decided that they will not be around are likely to give away possession that they value.
• DIRECT SUICIDE THREATS OR ATTEMPTS
• All suicide threats and attempts should be taken seriously. At added risk are students who have threatened or attempted suicide before. In the latter case, the usual inhibitions against hurting themselves have been removed.
• ESPECIALLY IF THERE HAS BEEN:
• A RECENT LOSS IN CLOSE RELATIONSHIPS
• Losses of significant others are misfortunes that adults learn to handle. For developing adolescents, these events can be devastating and can overtax their current coping skills. Examples are death or divorce of parents, losing a close friend, breaking up with a steady, being cut from an athletic team.
• HEAVY USE OF ALCOHOL OR DRUGS
• Students who are substance abusers tend to be at higher risk for suicide. Heavy drug and alcohol users are likely to be depressed youngsters who are seeking relief. Eventually these substances stop working and, in fact, contribute to a greater depression. These substances also contribute to impulsive behavior which often leads to accidents and suicide.
• A RECENT SUICIDE IN THE FAMILY OR OF A FRIEND
• A recent suicide in the family significantly increases the suicide risk of survivors for the following reasons: a) a pervading sense that they, too, are doomed to commit suicide; b) an unbearable grief, depression and/or guilt over the loss of a loved one; c) a fear of mental illness; and d) a realization that suicide presents an optional way out of an unwelcome and painfully unhappy life.

Do one thing…and then do another!

Want to help?

Many people want to help do something about suicide prevention, but may not know what to do. We have made it easy. Do anything on this “DO ONE THING” list and you will have made a difference for someone. Do them all, and maybe you can save a life.

• Talk to a young person about suicide. Ask them if they have ever had suicidal thoughts.
• Tell someone else about the Yellow Ribbon Program and ask them to tell someone.
• Join our organization. A small amount of money can save a young life.
• Write a letter to a Middle School, High School or College asking them to distribute Yellow Ribbon Information to students.
• Contact a youth director at a church or synagogue and ask them to use the Yellow Ribbon Program.
• Call a school principal and ask if they have a Yellow Ribbon Program.
• Show the video “No More Tomorrows” to someone.
• Give the video “No More Tomorrows” to a school, a church/synagogue or youth group.
• Wear a Yellow Ribbon pin and explain what it is to everyone who asks.
• Participate in Yellow Ribbon Week – the third full week of September.
• Contact a member of the U.S. House of Representatives or U.S. Senate and ask them to sponsor National Yellow Ribbon Week – the third full week of September.
• Contact your city or state government officials and ask when funding will be given for suicide prevention programs and tell them about the Yellow Ribbon Program.
• Tell a survivor of suicide that you care. (Survivors are people who have lost someone to suicide or people who survive an attempt.)
• Do something – now! Thank you for caring….

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From Connect For Kids Website:
Ribbons of Hope
by Lee Nelson

February 23, 2004

Jeff Knutson’s suicide prompted creation of a Yellow Ribbon chapter.
The family calls it the perfect suicide. Jeff Knutson had snuck into his father’s truck and taken the garage door opener to his grandparent’s home nearby. They were vacationing in Germany, so Jeff could easily get access to a hunting gun there and not be disturbed while carrying out his plan in their spare bedroom.

“He must have been thinking about it for a long time,” said his father, Brad Knutson of Park View, Iowa. Jeff even called 911 before he shot himself, so no one in the family would have to find him. The preparation for his death mimicked the way he planned out his life—well-organized and thought out. He wrote a good-bye note on the computer. He never mentioned depression or anger, just the love he felt for his family and friends.

Some Warning Signs

• Abrupt changes in personality.
• Giving away possessions.
• Previous suicide attempts.
• Use of drugs and/or alcohol.
• Depression.
• Lack of self-esteem.
• Withdrawal from people, especially close friends, family and/or favorite activities.
• Change in eating and sleeping patterns.
• Chronic pain.
• Restlessness, inability to concentrate.

Source: American Association of Suicidology

A Growing Movement

The death of this 16-year-old Eagle Scout, lifeguard and church youth group member in 1999 shocked everyone in his close-knit community. His parents say they will never understand why Jeff took his own life. But Brad and Dawn Knutson are doing what they can to make sure other teens in their area won’t ever feel that they have nowhere to turn when they feel depressed or suicidal.

They have joined a growing movement fueled largely by the volunteer efforts of families devastated by a teenager’s suicide, by establishing their own Iowa chapter of the Yellow Ribbon Suicide Prevention Program through the Light of Life Foundation International. They have traveled from school to school, church group to church group, giving presentations and information to thousands of students, parents and community members throughout eastern Iowa and western Illinois.

“We let them know he was an ordinary kid, an average kid,” Dawn said. “If we hadn’t starting sharing this with others, we would have gone around angry all the time. But now we realize that he’s gone but these kids are still here.”

How Yellow Ribbon Began

The collaborative, community-based program was created out of another tragedy. In 1994, Dar and Dale Emme of Colorado drove into their driveway seven minutes too late. Their 16-year-old son, Mike, had killed himself with a gun. Mike left a note telling them not to blame themselves and that he loved them.

The night he killed himself, Mike’s teenage friends gathered to comfort the family. They asked Dar what they could do to help. “Don’t do this. Don’t attempt suicide. If you are ever at this point of despair, please ask for help,” she told them.

Risk Factors

• Problems with school or the law.
• Breakup of a romance or unexpected pregnancy.
• A stressful family life. (Having parents who are depressed or are substance abusers. A family history of suicide).
• Loss of security. Fear of authority, peers, group or gang members.
• Stress due to new situations – beginning at a new school, college or relocating to a new community.
• Failing in school or failing to pass an important test.
• Issues concerning sexual orientation and/or identity.

Source: American Association of Suicidology

They took her plea to heart and began writing out homemade cards with a simple message, encouraging teens to reach out for help. The card said, “It’s OK to Ask4Help.” Small, yellow ribbon bows were attached to make the cards stand out. Mike had been well known for giving other teens rides in a bright yellow 1968 Ford Mustang that he and his father had rebuilt, earning the nickname “Mustang Mike.”

The idea flourished. Kids in Mike’s school sent cards to relatives and friends all over the nation. People began calling the Emmes about starting up a Yellow Ribbon program in their hometowns and schools. In February 1995, the Emmes set up a non-profit organization to foster the growing network of programs. In October of that year, the Emmes’ story was published in the book “Chicken Soup for the Teen Soul”. Thousands of letters poured in.

The family knew they had found a way to fill an important role in the lives of adolescents across the country.

What the Cards Do

They soon learned that an abundance of trained professionals with the skills to help depressed teens and an abundance of those who need help weren’t finding each other. The family researched every organization that had information on suicide and its prevention. They sought out professional advice from all over the country to come up with their program.

“We came in the middle to become that bridge to get those two sides together,” explains Dar.

It starts with education—volunteers speak to groups of young people about depression and suicide, and what their options are when they are feeling alone. Then there are the cards, the same size as an ordinary business card, handed out by the thousands by program volunteers.

The Yellow Ribbon cards have a dual purpose. One side tells teens where to get help and that if they feel overwhelmed or depressed, they should take their card to a counselor, teacher, clergy, doctor, parent or friend, and say, “I need to use my yellow ribbon.”

The other side of the card tells those who receive one from a teen what to do: stay with the person, listen to them, take their concerns seriously, and call for help. Each local chapter includes a 24-hour toll-free number on the card.

Dale Emme believes the program has grown so fast because it allows people to take positive action. “If somebody tells you about their issues or problems, you don’t have to be a therapist or counselor. All you have to do is be the link.”

Passionate Volunteers Fuel Growth

In the past 10 years, the Yellow Ribbon Suicide Prevention Program has grown to reach youth in all 50 states, as well as in Canada and 47 other countries. Ninety-five percent of those who volunteer for the organization are like the Knutsons and Emmes—survivors of the suicide of a loved one.

According to the organization, 42,000 letters asking for help and telling of lives saved have been received, and 5 million yellow ribbon cards distributed. The Emmes get phone calls each day from people who want to help, and from people who say the program saved their lives.

“Because of the nature of the people, this is passionate,” Dar said. “They have a reason to get out there and do it. I wouldn’t wish this on my worst enemy. What this can do to the human soul is beyond the human soul.”

Some days, they still feel the gaping hole of Mike’s absence. “But at the end of each day, our work has given us purpose again,” Dar said. “Maybe it was God’s will that we were healed to help others.”

Youth Suicide Facts

• Twelve young people between the ages of 15-24 die every day by suicide.
• Suicide ranks as the third leading cause of death for young people (ages 15-29), only accidents and homicides occur more frequently.
• Suicide rates for those between the ages of 10-14 increased 99 percent between 1980 and 1997.
• Research has shown that most adolescent suicides occur in the afternoon or early evening and in the teen’s home.
• Nationwide, nearly one in five high school students have stated on self-report surveys that they have seriously considered attempting suicide during the preceding 12 months.
• Firearms remain the most commonly used suicide method among youth, regardless of race or gender, accounting for almost three of five completed suicides.

Source: American Association of Suicidology

Helping a School Heal

Last fall, a 12-year-old student at the Maquoketa, Iowa Middle School shot and killed himself. Julie Kinrade, counselor at the school, says the school community has been helped by the expertise offered by the Knutsons.

“Our parents need the education that it can happen and what can we do so it doesn’t happen again. They need to know what is normal, what isn’t normal,” she said. “The myth is that if you talk about it, it will happen. But children need to know that there is nothing in this life that they can’t talk about with us. We all need to open up communications.”

The box of Yellow Ribbon cards and a drop box for notes outside Kinrade’s office has helped many of the students express themselves after the tragedy.

One Expert’s View of Yellow Ribbon

When Dr. David Litts first heard about the Yellow Ribbon Suicide Prevention Program, he was intrigued. It seemed to be a well-balanced program that could avoid some of the pitfalls of other programs.

“Over the past decade, there is a lot of controversy surrounding some of these programs, especially those that are awareness alone” said Litts, associate director of Suicide Prevention Resource Center in Washington, D.C. “Some people feel it may stir up angst among teens that have problems rather than build skills and offer students help. Everyone is looking for a simple solution. The fact is, suicide is a complex problem with no simple solutions.”

He sees the Emmes’ program as very comprehensive, designed to reach faculty, staff, counselors and mental health providers. Yellow Ribbon goes beyond the one-time school assembly by giving students effective ways to deal with the difficulties and stress of life. People are educated at all levels in the community to help.

“They don’t want to tell kids that it’s normal to think that suicide as the answer,” he added. “Suicide is an abnormal reaction. But the real thing to get across is that is it preventable.”

Carol Skiljan hears over and over again how grateful people are for the information provided by her San Diego Chapter of Yellow Ribbon, where she serves as executive director.

Skiljan and youth volunteers have recently embarked on a college project. The group is distributing refrigerator magnets that ask, “Are you Concerned about a Friend?” and list signs of depression and where to go for help.

“Being involved in Yellow Ribbon has changed my life in the sense that my involvement is not just about getting the message out there,” she said. “I am part of a movement to destigmatize mental illness and to prevent needless deaths because of the myths the general population believes about suicide.”