• Wait for students to raise their hands in response to the following questions. Who here has ever gotten the flu? Who here has ever broken a bone? And who here has ever had a headache? Alright, so each of us has been physically ill at some point. Is there anything wrong with being physically sick or injured? No. Are you considered weak if you get physically sick or injured? No. Getting sick or injured is part of life and it happens to everyone. No one thinks you are weak if you get the flu or break a bone because it can happen to anyone when exposed to the necessary circumstances.

• The same is true for mental illness. Can someone tell us what mental illness is? Allow a couple students to answer. Thank you for your answers. Mental illnesses are disorders of the brain that affect its processes and functions, and impacts how a person handles stress, relates to others, and makes choices. The most common mental illnesses are depression, bipolar, and anxiety. Can someone tell me anything about these illnesses? Allow a couple of students to respond. Depression causes someone to feel hopeless, constantly tired, and negative about life. Those with bipolar experience two extremes: mania and depression. Mania is a feeling of high excitement and invincibility. Bipolar causes an individual to switch between mania and depression. Anxiety causes excessive worry and fears without a reason.

• Does anyone know how to treat a mental illness? Allow a couple students to answer. Treatment can include using medication, attending counseling/therapy with a professional , education on managing mental health , and/ or social support.

• Also, remember, there is absolutely NOTHING wrong with having a mental illness and you should not be ashamed to seek help and talk about it. An important fact to remember is that a majority of people who experience mental illness are not suicidal, but over 90% of those who die by suicide have a diagnosable mental illness. Suicide occurs when someone believes that death is a better option than what they are experiencing in life. There are many events/feelings that could lead someone to consider suicide such as: feeling depressed, isolated, or alone, experience bullying, or abuse, easy access to guns, experience stressful events, lose a family member or friend to suicide, or have a previous suicide attempt.

• There are also many events/feelings that protects someone from suicide such as: feeling wanted, strong family and friend relationships, knowing how to solve problems without violence, access to a physical or mental health professional, and lack of access to guns.

• Can someone tell me what someone might do if they are considering suicide? Allow a couple of students to answer? Thank you for those answers. If someone is considering suicide they tend to feel worthless, hopeless, thinks no one cares about them, and feel like a burden to others. They may act differently by getting into fights, use drugs, drink alcohol, or talk, write, or draw about suicide. They may also change their behaviors by drinking alcohol, or talking, writing, or drawing about suicide. They may also change their behaviors by having mood swings, change in sleeping patterns, and lose interest in their favorite hobbies, or friends. Someone considering suicide may make threats to attempt suicide, talk about wanting to die, give away possessions, or hurt themselves. Those who are considering suicide may make a snap decision to attempt based off a stressful situation, including moving towns, or losing an important relationship.

• If you or any of your friends show these warning signs for suicide, PLEASE tell an adult right away. It can be hard to seek help for mental illness or considering suicide because those who experience it are labeled as "weak", "cowards", and other negative stereotypes. The best way to combat those stereotypes is to be kind and listen to those living with mental illness, not judging those individuals, not minimizing their feelings, and to not talk negatively about mental illness. Honestly, the best way to help those with mental illnesses is by sharing kindness at all times rather than judgement.

• With that in mind, I would like to challenge each of you to share kindness with at least one student today before you leave school today. Can you all promise that you will take the challenge and spread kindness in the school to help those who struggle with mental illnesses and suicide?

• Lunch time activity: Spread the Love Game

• Let's play a quick game of True or False. I'll read a statement and you tell me if you think it is true or false.

  • Once a person decides to complete suicide, there is nothing anyone can do to stop the person (F)

  • Only experts can prevent suicide(F)

  • If people in a crisis get the help he or she needs, the person will probably never be suicidal again.(T)

  • Asking someone directly about suicidal intent lowers anxiety, opens up communication, and lowers the risk of an impulsive act? (T)

  • Those people who talk about suicide don't attempt suicide (F)

  • Suicide is the most preventable kind of death and almost any positive action may save a life. (T)

  • Suicide prevention is everybody's business, and anyone can help prevent the tragedy of suicide. (T)

• What did you guys learn from that little game? Allow a couple of students to answer. Thank you; those are some really important things to know. Something I noticed while reading these statements is that anyone can help prevent suicide simply by reaching out. Do you guys have any ideas of how to reach out to a friend or classmate that you think may be struggling? Allow a couple students to answer. Those are some great ideas.

• Today, we are going to learn an approach called QPR. Question. Persuade. Refer. You use QPR when you notice that one of your friends or classmates may be having a rough time. You may notice some of the warning signs that we mentioned yesterday such as them saying things like "I wish I were dead" or ``I'm tired of life, I just can't go on". They may act differently by showing unexplained anger, aggression, irritability, anxiety, or depression, abuse drugs or alcohol, or giving away prized possessions. They may also be experiencing sudden changes in their life such as being expelled, the death of a loved one, financial problems, or becoming afraid of punishment or feeling embarrassed in front of friends. When your friend is having a hard time you want to be there for them and help them. QPR is a way for you to help your friend. There are 6 things to remember before approaching your friend:

  • 1) If you are in doubt if anything is wrong, don;t wait - ask them

  • 2) If your friend is reluctant, be persistent

  • 3) Give yourselves plenty of time so you won't be rushed.

  • 4) Talk to the person alone in a private setting.

  • 5) Allow your friend to talk freely. Try not to interrupt.

  • 6) Have resources available, such as: phone numbers, counselor's name, and any other information that may help.

• The first step of QPR is to question your friend. Remember to be sensitive and not to sound judgemental when asking your friend if they are struggling. There are two kinds of questions you can ask: indirect questions and direct questions. Some possible indirect questions you could ask are:

  • * Have you been very unhappy lately?

  • * Have you been so unhappy lately that you've been thinking about ending your life?

  • * Do you ever wish you could go to sleep and never wake up?

• And some possible direct questions you could ask are:

  • * You know, when people are as upset as you seem to be, they sometimes wish they were dead. I'm wondering if you are feeling that way too.

  • * You look pretty miserable. I wonder if you are thinking about suicide.

  • * Are you thinking about killing yourself?

• Also, remember that how the question is not as important as actually the question. If you feel like you can't ask the question, please find someone who can.

• The second step in QPR is to persuade your friend to stay alive. If your friend tells you thay they are considering suicide they are having difficulty in seeing the point of living and don't think people will miss them. Show them they are wrong by showing them that YOU care about them. You can show you care by saying things like "I'm concerned about you" and "Will you go with me to get help?" Show that you genuinely care about them and their challenges. Be patient with your friend. Remember, they don't see suicide as the problem, but as the only solution to a perceived unsolvable problem. Be persistent with them. Do not give up on them if they are reluctant to get help. Listen to their problems and give them your full attention. Put away any and all distractions. Do not rush to judgement. And ALWAYS offer hope in ANY form. Your friend needs to see that you truly care about them and want them to stay alive.

• The third step is to refer your friend to help. Now, your friend may believe that they cannot be helped, but there IS help available. Whether it is getting a hold of a teacher, parent, coach, or mental health professional, there is someone who can help your friend. Even if your friend does not want to reach out for help. It is your responsibility to tell an adult that your friend is considering suicide. It is for their safety. they may be mad at you, but it is better to have a mad friend than a dead friend.

• Let's do a quick review. QPR. Question, Persuade. Refer. Question your friend to see if they are okay. Persuade your friend to stay alive. Refer your friend to seek help. The simplest way to save a life is to reach out, ask, and show concern. With that in mind, I would like to challenge all of you to keep an eye out and reach out to those that may be struggling today and days to come. Can you promise me that you will reach out and help anyone that may be struggling?

• Lunch time activity: Are You OK? Candies

Day 3: Grieving

• Before the training session begins, hand out cutouts of the Inside Out characters and the corresponding 5 stages of grief descriptions to 5 different students.

  • Joy - acceptance

  • Disgust - bargaining

  • Fear - denial

  • Anger - anger

  • Sadness - depression

• Today, we are going to discuss something everyone will experience at some point in their life: grief. Who can tell me what grief is? Allow a couple of students to answer. Thank you for your answers. Grief is a normal reaction to a major loss in either your or another person's life, such as the loss of a life, major relationship, or health. Everyone experiences grief differently, in their own way, and on their own time. There are 5 stages to the grieving process, however, someone may experience many of the stages at the same time or not at all. Again, everyone grieves differently. These stages include denial, anger, bargaining, depression, and acceptance. Before we started today, I handed out descriptions about these stages.

• Can (insert student's name) show and read the description for denial.

• Denial

  • I'm in denial because I don't believe in what happened and act as if nothing has changed. I am scared to admit the truth of what happened. If I deny the reality I don't have to feel the pain of my loss.

• Can (insert student's name) show and read the description for anger.

• Anger

  • What I am experiencing is too much to handle so I try suppressing it. I am angry about what happened and I want to blame someone for it.

• Can (insert student's name) show and read the description for bargaining.

• Bargaining

  • I am in disgust about what happened and I want it to change back. Please, I'll do anything. Just let everything go back to the way it was before.

• Can (insert student's name) show and read the description for depression

• Depression

  • I am starting to accept the truth about what happened, but I am still really sad about it. But I know it is normal to feel sad, lonely, fear, or regret in response to what has happened.

• Can (insert student's name) show and read the description for acceptance.

• Acceptance

  • I recognize and accept what has happened and how it has changed my life. I am now able to look forward and begin learning how to be happy again. I may still feel pain and sadness, but I know I can continue on with my life.

• If you notice one of your friends is grieving there are a few different things you can do to help. The first, and probably most important, thing you could do is to be a good listener and be available. When you listen you let your friend know that you care and want to help and be there for them so they don't have to go through this loss alone. If your friend lost a family member or another friend, allow them to share memories, and if you knew the person who has died , share some of your memories too. It is helpful for both of you. There are also things that you should not say including: "I know how you feel" or "They are in a better place now." Both phrases come across as you minimizing your friend's feelings and not really caring about them.

• Again, everyone grieves differently, but there are healthy ways to grieve and unhealthy ways to grieve. Can someone give me an example of a healthy way to grieve or an unhealthy way to grieve? Allow a couple students to answer. Those are some great ideas. Some other unhealthy ways to grieve are: spending all your time on social media, participating in risky behaviors such as drugs and alcohol, oversleeping, isolating yourself from family and friends, not doing what you used to love, and even putting on a "brave" face. However, there are plenty of healthy ways to grieve including, asking and getting professional help if needed, talking about loss and grief, turning grief into creative energy, and nurturing yourself.

• We're about done for today, but just as a quick review, there are 5 stages of grief: denial, anger, bargaining, depression, and acceptance. Also, remember, it is okay to grieve. It is perfectly normal to grieve when something bad happens. But, sometimes that can be hard to remember. So, I want to challenge each of you to remember and help others remember what the five stages of grief are and that it is okay to grieve. Can you promise that when something bad happens you will allow yourself and others to grieve healthily so you can heal?

• Lunch time activity: Stages of Grief Matching Game

• Okay, I want everyone to sit in their chair and to relax. Talk in a calm, soothing voice until you begin to ask questions. Now, close your eyes and follow my instructions.

• Roll your shoulders forward.....and now roll your shoulders back. Clench your hands into fists......hold......and release. Stretch your arms out and stretch your hands wide open, reaching up above your head. Spread your fingers wide. Reach your arms high. Now relax your hands and lower your arms. Lower your shoulders, away from your ears. Ease your shoulders back slightly. Let your shoulders relax. Relax your jaw by dropping the lower jaw slightly. Make sure your teeth are not touching. Now count silently as you breathe.

• Inhale....two, three, four......pause......two, three.......exhale........two, three, four, five.....

• Now, open your eyes. Alright, how do you guys feel right now? Allow a couple of students to answer. Good, so you guys feel well relaxed and destressed, right? Why is it good to relax and destress on occasion? Allow a couple of students to answer. Thank you for those great answers. Just to let you guys know, there are actually 3 types of stress: Acute stress, episodic acute stress, and chronic stress.

• Acute stress occurs when you are facing a stressor that you feel like you can't handle. An example of acute stress is the stress you feel when you are rushing to finish a project the night before it is due.

• Episodic acute stress occurs when you experience acute constantly which causes a continual state of nervousness and anxiety.

• And chronic stress occurs when you see no end to the constant stress you are experiencing.

• Remember, stress can be good and motivating. If experienced in small doses, but when you have too much stress it can be detrimental to your health. If stress is not properly managed it can lead to muscle pain, digestive issues, insomnia, depression, heart disease, etc. What may be some poor ways to manage stress? Allow a couple of students to answer. Those are good answers. Just like we talked about yesterday, some poor ways to manage stress is changing your eating habits, drugs, alcohol, or changing your sleeping patterns. These may seem like they work in the beginning, but over time these behaviors will harm your body and mind. Now, what are some good ways to manage stress? Allow a couple of students to answer. Great answers, thank you. Some other healthy ways to manage stress is to identify and break down the problem so you can solve smaller and easier issues. If you can, avoid the stressor or accept that you may not be able to change the situation. Some behavior changes you can practice are to exercise because it has an immediate positive effect on your wellbeing, take a break and relax, which we did today, eat healthy foods, and sleep well.

• Again, just to reiterate, you need to take time for yourself and destress to be healthy. In small amounts stress can be helpful in getting you motivated and accomplishing things, but too much stress can be damaging to you. Because of that, please remember to relax and destress often. In fact, today, I want to challenge you to take some time to use any of the suggestions we went over to destress before you go home today. Can you promise me to take some time for your health and destress and relax?

• Lunch time activity: Dance Party

• Today we are going to talk about something that each of us hopes never happens, but it is important to address. So, please, be respectful and considerate as it may be a very difficult topic for someone. We are talking about what to do if someone in our school does die by suicide. It is already hard enough to lose a fellow classmate or friend in a car accident or any other way; it's even harder knowing a friend's death was suicide. If that ever happens, there are 6 things to remember:

• 1) Suicide is complex - It's perfectly normal to try to understand why this happened and to ask questions. However, suicide is not caused by a single event. Oftentimes suicide is a result of lots of little things building up over a period of time, and may very well have included a mental illness the person may or may not have known about. It's important to remember that a mental illness is not something to be ashamed of and help is available to you.

• 2) You are not responsible for their death - Your classmate chose this action and you had no control over their behavior. Please do not blame yourself for their actions. It is not your fault.

• 3) You are not alone and you don't have to handle their death alone - While grieving the loss of a friend or classmate you may feel isolated, lost, and alone, but you are not. Your other classmates and teachers are feeling the pain of losing someone as well. You don't need to feel ashamed or afraid to reach out to others for support. Find a friend, teacher, or professional that you can trust and rely on for support and help during this difficult time.

• 4) Be patient with yourself - After losing someone to suicide it is completely normal to have physical and emotional reactions, such as: insomnia, fatigue, changes in appetite, anxiety, anger, sadness, guilt, difficulty concentrating, poor memory, and missing school. It takes everyone time to readjust to life after a death. Don't stress if you are having a hard time keeping up with everything you used to do. Be patient and give yourself a chance to grieve. Does anyone have suggestions of how someone can be more patient with themselves? Allow a couple students to answer.

• 5) Keep a normal routine - It can be helpful to try to keep a normal routine and participate in activities that you enjoy doing. It will distract you for a while and help you relax.

• 6) Take care of yourself - Keep doing what you know to be healthy: eat and sleep well, exercise, and avoid drugs and alcohol. Poor health behaviors can make it even more difficult to work through your feelings regarding your friend or or classmate's death. Anyone have ideas of how to practice self-care while grieving? Allow a couple of students to answer.

• We also recognize that you are going to want to recognize, honor, and pay your respects in some manner to your friend or classmate. However, when doing so we want to be careful not to do it in a manner that may encourage another to die by suicide. Sometimes, without trying to, we may glorify or romanticize a suicide death which will actually increase the likelihood that someone else will attempt suicide. Does anyone have any ideas of how to honor a friend in a respectful manner without glorifying or romanticizing suicide? Allow a couple of students to answer. Those are some really great ideas, thank you. Some options available include: attending the funeral, creating a book where students and teachers can write messages and memories of the deceased that will be given as a gift to the family from the school community, volunteering at a crisis hotline, or sponsor a mental health awareness day or fundraising event for mental health or suicide prevention.

• As much as it is important to support our friends, classmates, teachers, and ourselves after a suicide, it is just as important to support everyone before and during a suicide death. So, with that in mind, I want to challenge each of you to come up with a way you can support your classmates before, during, and after a suicide and begin offering that support before you leave school today. Can you promise me that you will take that challenge and begin supporting your classmates today?

• Lunch time activity: I Pledge Support Activity