Emotional Distress/Suicide Risk

Definition

A person who appears distressed may or may not be in imminent danger of harm. A person observing the distressed individual should take steps to help following the guidelines below.

Signs of distress include, but are not limited to,
  • Nervousness, agitation, or irritability
  • Infrequent class or work attendance
  • Tearfulness
  • Changes in academic or work performance
  • Changes in personal, classroom, or work relationships
  • Undue aggressiveness or abrasive behavior
  • Fearfulness
  • Dependency (e.g., excessively clingy)
  • Frequent alcohol and/or drug use
Your actions when observing signs of distress
  • Express your concerns to the person, point out your observations, and ask about his/her situation.
Warning signs the person may be unsafe include, but are not limited to,
  • Withdrawal from others (isolation)
  • Talks about or threatens suicide
  • Makes statements such as “I want this all to end.” or “I can’t go on anymore.”
  • Significant confusion
  • Behavior is bizarre, alarming, and/or dangerous.
  • Makes statements about hurting or killing others
  • Marked change in behavior, mood, and/or hygiene
  • Appears depressed (e.g., frequent crying, insomnia, over-sleeping, weight loss/gain, loss of pleasure, etc.)
  • Appears/reports hopelessness or helplessness
  • Engagement in self-harm (e.g., cutting)
Your actions when observing warning signs the person may be unsafe
  • Directly ask “Do you want to end your life?” or “Do you want to kill yourself?”
  • Directly ask about suicidal and/or homicidal thoughts. Ask if they have intent, a plan, and access to a means to follow through with harming themselves or harming someone else.
If you believe there is imminent danger
  • Examples
    • Person found unconscious or unresponsive
    • Person is clearly incapable of keeping him/herself safe (e.g., highly intoxicated, experiencing hallucinations or delusions, speech is incoherent, or person exhibits non-goal directed behavior, etc.)
    • Person tells you they have ingested pills beyond the recommended dose, whether confirmed suicidal intent or not
    • Person threatens immediate danger to self (e.g., ingests pills, shoots self, cuts self, jumps, etc.)
    • Person attempts or threatens physical harm to someone else or people in general
SUICIDE ATTEMPT/THREAT

All suicide threats/attempts must be taken seriously. Warning signs of suicide can include:
  • Threatening to hurt or kill oneself
  • Seeking access to means to hurt or kill oneself
  • Talking or writing about death, dying, or suicide
  • Expressing hopelessness or helplessness
  • Acting recklessly or engaging in risky activities
  • Increased use of alcohol or drugs
  • Withdrawing from family, friends, or society
  • Appearing agitated or angry
  • Having a dramatic change in mood
Your actions should an individual make the threat in person while on campus
  • If possible, do not leave the person unattended or allow the person to leave the premises; however, do not attempt to physically restrain the person. If he or she leaves, pass along information about what he or she was wearing, where he or she might be going, and a vehicle description.
  • If the person of concern is a student, CALL - NEVER EMAIL - ATSU security and vice president for student affairs (Missouri campus) or associate vice president for student affairs (Arizona Campus) and ATSU mental health wellness counseling. The vice president for student affairs or associate vice president for student affairs will work with the appropriate campus staff to determine whether any additional notifications is necessary and appropriate. 
  • If the person of concern is an ATSU employee, notify campus security and assistant vice president for human resources (Missouri campus) or director of human resources (Arizona campus).
Your actions should an individual make the threat in person while at another location at a work/school related activity (e.g., rotation site, clinic, event, etc.)
  • Do not leave the person unattended or allow the person to leave the premises. (If possible, do not attempt to physically restrain the person.)
  • If possible, enlist the help of someone else to dial 911 or the National Suicide Prevention Lifeline at 800.273.8255 or make the call yourself.
  • If the person of concern is a student, in addition to dialing 911 or the National Suicide Prevention Lifeline, CALLNEVER EMAIL – the highest level ATSU administrator at that site and vice president for student affairs (Missouri campus) and/or associate vice president for student affairs (Arizona campus) who will work with the appropriate campus staff to determine if any additional notification or action is appropriate.
  • If the person of concern is an ATSU employee, in addition to dialing 911 or the National Suicide Prevention Lifeline at 800.273.8255, CALLNEVER EMAIL – the person’s direct supervisor and assistant vice president for human resources (Missouri campus) and/or director of human resources (Arizona campus).
Your actions should an individual make the threat by phone
  • Attempt to keep the person on the telephone by encouraging the person to talk while simultaneously gathering as much information as possible.
  • While the person is on the telephone, try to enlist help from someone else to dial 911 (if you know the person is local) or the National Suicide Prevention Lifeline at 800.273.8255 (if the person is believed to be outside the local area), especially when the person says he or she has a weapon, has taken pills, or sounds incoherent or intoxicated.
  • If it is not possible to keep the person on the phone, and/or no one else is available to assist, write down the phone number for the person and where you believe he or she may be and CALL the police (911) or the National Suicide Prevention Lifeline.
    • If the person of concern is a student, CALLNEVER EMAIL – the vice president for student affairs (Missouri campus) or associate vice president for student affairs (Arizona campus) and ATSU mental health wellness counseling. The vice president or associate vice president for student affairs will work with the appropriate staff to determine whether any additional notification is necessary and appropriate.
    • If the person of concern is an ATSU employee, CALLNEVER EMAIL – the vice president for human resources (Missouri campus) and/or director of human resources (Arizona campus). The assistant vice president for human resources and director of human resources will work together with the appropriate University staff to determine if any additional notification or action is appropriate.
If you are unsure whether there is imminent danger
  • Examples
    • Person reports history of self-injury (e.g., cutting or burning) and now states a desire to engage in this behavior again.
    • Person is found intoxicated or appears to be under the influence of sedatives.
    • Person makes statements suggestive of suicidal/homicidal thinking (e.g., “I don’t know if I can keep going.”) that are not overtly indicative of imminent danger.
    • Person appears emotionally distraught and does not respond to your attempt to calm him/her.
    • Person experiences a sudden stressful event (e.g., death, breakup, divorce, etc.) and does not appear able to regulate emotions, is inconsolable, or response seems unusual (e.g., uncontrollable crying over a failed exam, no apparent response to the death of immediate family member, etc.).
    • Person’s work, assignments, and/or communications contain material that raises concerns about suicide, homicide, and/or violence.
  • Actions to take
    • Call – NEVER EMAIL – one or more of the following and provide the relevant information for which you know. These persons are not on call 24/7, so consider the need to contact a crisis line or call 911.
      • For a student, call an ATSU mental health wellness counselor, vice president for student affairs (Missouri campus), or associate vice president for student affairs (Arizona campus).
      • For an employee, call supervisor, dean, assistant vice president for human resources (Missouri campus), or director of human resources (Arizona campus).
If imminent danger is clearly not present
  • Examples
    • You observe a person crying after getting off the phone. She reports she is sad about the end of a romantic relationship. She denies suicidal/homicidal thoughts and shows no other warning signs.
    • A student is struggling in your class due to academic skill deficits and test anxiety. He denies suicidal/homicidal thoughts and shows no other warning signs.
  • Actions to take
    • Listen, and provide support. Refer to resources or services available on campus or in the community.
    • Continue to follow up with the person, as appropriate.
    • Watch for signs that the person’s “imminent danger” status may have changed, and take actions accordingly.
Available training

ATSU offers two trainings on suicide prevention and mental health crisis intervention: Ask-Listen-Refer and Mental Health First Aid. All employees and students are encouraged to take one or both of these trainings.

1. Ask-Listen-Refer is an online, self-directed, suicide prevention training created for college and university campuses that takes between 20-40 minutes to complete. Participants will learn to identify warning signs of suicide, gain instruction in intervening to keep someone safe, and get to the help they need. To take the training 24/7/365, go to asklistenrefer.org/atsu

2. Mental Health First Aid is an eight-hour certification training that teaches participants to assist someone experiencing a mental health or substance use-related crisis. Mental Health First Aid covers risk factors and warning signs for mental health and addiction concerns, strategies for helping someone in both crisis and non-crisis situations, and where to turn for help. The training focuses on:
  • Depression and mood disorders
  • Anxiety disorders
  • Trauma
  • Psychosis
  • Substance use disorders
To request Mental Health First Aid certification training, contact an ATSU mental health wellness counselor.


Telephone numbers
ATSU Campus Security

    AZ campus – Dial *7 from any campus landline or 480.342.9075
    MO campus – Dial 33 from any campus landline or 660.349.9513

ATSU Mental Health Wellness counselors (for students)

    AZ campus – Art Matthews, 480.219.6170 (office) or 480.359.6570 (cell)
    MO campus – Thom Van Vleck, 660.626.2424 (office) or 660.341.1755 (cell)
    MO campus – Sarah Thomas, 660.626.2424 (office) or 660.651.6779 (cell)

ATSU Student Affairs

    AZ campus – Beth Poppre, associate vice president, 480.219.6126
    MO campus – Lori Haxton, vice president, 660.626.2236

ATSU Human Resources

    AZ campus – Tonya Fitch, director of human resources, 480.219.6007
    MO campus – Donna Brown, assistant vice president, 660.626.2792

Kirksville and Mesa Emergency Numbers

KIRKSVILLE CAMPUS

Security Emergency and non-emergency 
(On Campus) ext. 33
(Off Campus) 1-660-349-9513

Kirksville Police: 
(On Campus) Dial 9-911 
(Off Campus) Dial 911

MESA CAMPUS

Security Office: *7 from any campus phone
Switchboard : 0 
Security Phone: 480-341-9075

Security *Emergencies Only*
(On Campus) *7 from any campus phone

Mesa Police: 
(On Campus) Dial 911 
(Off Campus) Dial 911



http://www.suicidepreventionlifeline.org/

Ċ
Robert Frazier,
Nov 11, 2015, 3:42 AM
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