It’s not the usual crowd making its way into the classroom to learn about suicide prevention. Instead of students, it’s a mix of community members, teachers, counselors, parents, mental health providers and even bus drivers taking a seat. Once everyone is settled in, a video illuminates the screen with clips of scenarios showing people having thoughts of suicide. The discussion that follows gives participants the opportunity to share their own experiences and explore their attitudes about suicide. This training is part of a Mercy Care initiative to address the increase in local youth suicides by bolstering suicide prevention training in local schools and community organizations serving youth. “We want to make sure that school and community leaders are trained to recognize the signs when our children are having thoughts of suicide or mental health issues,” said Blythe FitzHarris, Mercy Care’s Chief Clinical Officer. “That’s why we’ve made this substantial investment of time, money and resources into increasing the reach of and access to this training. As a health care organization, we want healthier communities. We want to save lives. These trainings will help do that.”

Mercy Care, a Medicaid health plan, has been working since October 2018 with 40 school districts and community organizations serving youth to train individuals on how to deliver three evidence-based mental health and suicide prevention awareness programs: Youth Mental Health First Aid, Suicide Alertness for Everyone (safeTALK) and Applied Suicide Intervention Skills Training (ASIST).

Once they go through training, these people will be able to teach others about the signs that someone may display if they’re having thoughts of suicide. And, it will teach them how to connect people to the right resources. Mercy Care is providing the training and materials to ready these school staff to train others in their schools and their communities.
The timing of the training is also helping schools comply with a new Arizona law that requires school districts and charter schools to train school staff working with students in grades 6-12 on ways to identify the warning signs of suicidal behavior in students. The new law takes effect for the 2020-2021 school year.
“We could not have trained the number of people we trained without Mercy Care and their partnership,” said Brenda Ramos, director of Counseling and Social Services at Chandler Unified School District. She said they’ve already trained 100 counselors and 52 health assistants.

Training saves lives

Research shows that training and suicide prevention awareness works. By February 2020, Mercy Care expects to train 60 Mental Health First Aid trainers, 97 safeTALK trainers and 59 ASIST trainers. Those trainers will go on to train the rest of the staff at schools and community organizations. These trainings have a ripple effect. That means that each person touched by the training reaches out to others, and they, in turn, also touch others around them. Consider that in one year, the ASIST trainers will have spread their knowledge to some 7,830 people. Evidence-based studies show this translates into a collective impact of about 19,400 lives saved. It’s similar with the safeTALK training. Mercy Care expects to reach 8,100 people with safeTALK training. This training could account for as many as 12,600 lives saved.

Heather Brown, Mercy Care’s Prevention Administrator, said that these trainings help save lives because they allow people to have honest discussions about suicide and offer them insight into what is helpful – from the perspective of the person who is having thoughts of suicide. “When people feel comfortable talking about suicide, they’re able to more easily reach out when they notice signs that someone may be having thoughts of suicide,” Brown said. “It’s during those conversations when people realize that they’re not alone and that someone cares about them.”

Youth suicides are preventable

Teen suicide is an ongoing health concern. It’s the second-leading cause of death for young people ages 15 to 24, surpassed only by accidents, according to the U.S. Centers for Disease Control and Prevention. In Arizona, almost twice as many people die by suicide annually than by homicide. It’s the 8th leading cause of death overall, the 2nd leading cause of death for youth ages 15-34.
But it can be prevented, especially when people are aware of potential warning signs.

Psychological, environmental and social factors often contribute to thoughts of suicide. Some sources of stress could be disciplinary problems, interpersonal losses, family violence, sexual orientation confusion, physical and sexual abuse and being the victim of bullying. The risk for suicide often happens when an overwhelmed and vulnerable teen is facing a combination of these factors but isn’t able to cope. Sometimes, they’re more susceptible to thoughts of suicide because of a mental disorder and/or a substance use disorder.
Ramos says that sometimes children and teens struggle with expressing how they feel. “They end up at the Health Office over and over again, saying, ‘I don’t feel good.’ Sometimes they may have a panic attack, or a headache or stomachache. It’s about asking the right questions.” She said that’s precisely how the suicide prevention awareness training has helped in her school district.
“This training allows us to ask more poignant questions, to better determine whether it’s a physical health or mental health issues,” Ramos said. “This is especially vital when children have experienced trauma and aren’t able to express themselves or can’t describe what they’re feeling.”

Suicide prevention training

If other school districts or community organizations are interested in taking part in the train-the-trainer sessions, space is still available. You can reach out to Devonne Like, Mercy Care Special Projects Manager and Women’s Services Coordinator, at [email protected], or Heather Brown, Mercy Care Prevention Administrator at [email protected].
For information on upcoming suicide prevention training, visit https://www.mercycareaz.org/event.

Community resources
Mercy Care Crisis Line 602-222-9444 or 1-800-631-1314 (24 hours/7 days)
Teen Lifeline 602-248-TEEN (8336) (24 hours/7 days) text chat 3-9pm only
National Suicide Prevention Lifeline 1-800-273-TALK (8255) (24 hours/7 days)
Crisis Text Line 741741

Mercy Care suicide prevention awareness partners
Mercy Care is also working with the following schools and districts as part of our comprehensive health focus on school-based services:

• Cartwright School District
• Deer Valley Unified School District
• East Valley Institute of Technology
• Glendale Community College
• Madison School District
• Mesa Public Schools
• Roosevelt School District
• ASU Preparatory Academy
• Tempe Elementary School District
• Tolleson School District
• Washington Elementary School District

Community organizations and providers working with Mercy Care to get their staff trained so they can deliver mental health and suicide prevention awareness training include:

• American Foundation for Suicide Prevention-AZ Chapter
• Arizona Council of Human Service Providers
• Aurora Behavioral Health
• Chandler Coalition on Youth Substance Abuse
• Child Crisis Arizona
• Community Bridges
• Chicanos por la Causa
• Crisis Response Network
• Devereux
• EMPACT/LaFrontera
• Harmony Health & Wellness
• Horizon Health and Wellness
• ICAN/Chandler Coalition on Youth Substance Abuse
• Jem Foundation
• Jewish Family and Children’s Services
• MIKID
• Native Health
• NotMyKid
• Phoenix Children Hospital
• Phoenix Indian Center
• Phoenix PD
• Southwest Human Development
• Southwest Behavioral and Health Services
• Tanner Community Development Corporation
• Teen Lifeline
• Terros
• Touchstone
• Valle Del Sol

Warning Signs for Suicide

Some behaviors may indicate that a person is at immediate risk for suicide. The following three should prompt you to immediately call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or a mental health professional.

Talking about wanting to die or to kill oneself
Looking for a way to kill oneself, such as searching online or obtaining a gun
Talking about feeling hopeless or having no reason to live

Other behaviors may also indicate a serious risk—especially if the behavior is new; has increased; and/or seems related to a painful event, loss, or change.
Talking about feeling trapped or in unbearable pain
Talking about being a burden to others
Increasing the use of alcohol or drugs
Acting anxious or agitated; behaving recklessly
Sleeping too little or too much
Withdrawing or feeling isolated
Showing rage or talking about seeking revenge
Displaying extreme mood swings

Suicide training that can help you help others

About safeTALK
safeTALK is a half-day alertness training that prepares anyone 15 or older, regardless of prior experience or training, to become a suicide-alert helper. Most people with thoughts of suicide don’t truly want to die, but are struggling with the pain in their lives. Through their words and actions, they invite help to stay alive. safeTALK-trained helpers can recognize these invitations and take action by connecting them with life-saving intervention resources, such as caregivers trained in ASIST. https://www.livingworks.net/programs/safetalk/

About ASIST
Applied Suicide Intervention Skills Training (ASIST) is a two-day interactive workshop in suicide first aid. ASIST teaches participants to recognize when someone may have thoughts of suicide and work with them to create a plan that will support their immediate safety. Although ASIST is widely used by healthcare providers, participants don’t need any formal training to attend the workshop—anyone 16 or older can learn and use the ASIST model. Since its development in 1983, ASIST has received regular updates to reflect improvements in knowledge and practice, and over 2,000,000 people have taken the workshop. Studies show that the ASIST method helps reduce suicidal feelings in those at risk and is a cost-effective way to help address the problem of suicide. https://www.livingworks.net/programs/asist/

About Mental Health First Aid
Mental Health First Aid is a groundbreaking public education program that introduces participants to risk factors and warning signs of mental health problems, builds understanding of their impact, and overviews common treatments. Mental Health First Aid is a live training course, which uses role-playing and simulations to demonstrate how to assess a mental health crisis; select interventions and provide initial help; and connect persons to professional, peer and social supports as well as self-help resources.