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Signs Of Suicide Trains Billings Students To Identify, Act

A group of boys read something on a desk together behind the words SOS Signs of Suicide Middle School Program.
Mindwise Innovations
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Mindwise Innovations
The SOS Signs of Suicide program by MindWise Innovations trains middle and high school students to identify signs of depression and suicide in themselves and peers.

A recent report on suicide prevention by the Montana Department of Public Health and Human Services revealed that one in 10 Montana high school students and one in seven middle school students reported attempting suicide in the last year.

Montana school districts are trying to turn those numbers around with programs from the health department and the Office of Public Instruction that work to raise awareness of suicide and reduce the stigma of depression.

On a Monday morning, a group of sixth graders at Riverside Middle School in Billings are in the library waiting for first period to begin. Normally they would be working off energy in the gym but not today.

"So this type of suicide training is actually something that will help prepare you if at any time you are faced with a situation a friend is telling you something that is concerning or a family member. It will prepare you for what to do if the topic of suicide comes up with a friend," says Crystal Knutson, counselor at Riverside. 

SOS: Signs of Suicide, a national program for middle school and high school students. It was developed more than a decade ago by behavioral health professionals to help students learn to talk openly about depression and suicide.

This is the third year Billings’ middle and high schools have been teaching Signs of Suicide.

The presentation takes about 45 minutes, or a single class period. The students watch a video featuring kids their own ages talking about real life situations about depression and suicide.

Through the video and guided discussion by a school counselor, the students learn the signs to look for, like a friend who had been really active on social media but suddenly disappears, or someone who is really angry or irritable most of the time.

The students are urged to ACT: acknowledge, care and tell when they hear something from a friend. That’s because most often troubled students turn to their friends with their concerns and worries.

"I think that’s an important message. It’s like If you hear something say something. And just find that trusted adult. If you can’t find someone at school, find someone at home. They’ll call the school, they’ll call the police. We just want to be sure everyone’s ok and safe," says Riverside Principal Kevin Kirkman. 

Here in Billings, Signs of Suicide is taught in sixth and ninth grades. But Riverside Middle School decided to have all three of their grades, sixth, seventh and eighth, go through the program.

Not only do all the students learn about the signs of suicide and depression but they also fill out a brief self-assessment questionnaire. It’s an effort to help the students better understand themselves and help the school counselors get to know the students better.

"And we’re able to identify kids that do need extra support that we weren’t aware of. And I think that’s the best part of this program is to be able to give them that additional support and let them know people care," says Tiffany Parish, another Riverside counselor. 

Signs of Suicide is an opt out program. The counselors report that out of 590 students at Riverside, only eight or nine opted out.

The counselors and principal say the parents who participate are very appreciative of what the school is doing and identifying if their student may be struggling.

"We’ve had some parents who were caught off guard. They didn’t realize that their child was really struggling in some areas. And so once again, very appreciate that it came to light. Kids hide it a lot. They know how to hide things. They know how to just talk to their friends. Now they know adults need to be involved," Knutson said. 

Studies have shown that the Signs of Suicide program leads to fewer suicide attempts. A study in 2015 found students in Connecticut who took Signs of Suicide were less likely to report suicidal behavior, planning and attempts. They still thought about it, but University of Connecticut researchers suggest the training may play a role in preventing a student progressing from thought to action. They also wrote the training may have an even greater impact on students who previously planned or attempted suicide.

Signs of Suicide is not the only suicide prevention resource available in Montana. Others include the Crisis Action School Toolkit on Suicide, or CAST-S, which provides schools the tools to develop their own plans for suicide prevention. There’s the PAX good Behavior Game, which teaches elementary age kids life coping skills, and QPR, a training program on the signs of suicide for teachers, bus drivers, janitors, anyone with contact with students.

Despite all of these resources, Montana’s numbers of suicide attempts are still some of the highest in the nation.

Part of the problem is many schools don’t use the resources.

"We can provide programs but we can’t make them use it," says Karl Rosston, suicide prevention coordinator with the state health department.

He points out that Montana has some 500 school districts that operate independently. Only 180 of them are currently teaching Signs of Suicide.

"Given the geography and demographics of the state it is hard to take these programs and take them to scale so all of the districts will use them," Rosston said. 

There was an attempt in the 2015 Montana Legislature to require teachers to receive two hours of suicide prevention training every five years for renewal of a teacher or specialist certificate. But when the Suicide Awareness and Prevention Act was signed into law, the word “required” was changed to “recommended.”

Dr. Lyle Seavy, director of Billings Clinic’s Psychiatry Department, says even with all the work done in the schools, the problems will not change overnight.

"A lot of the work we’re doing now around suicide prevention, at school levels, and in colleges, etcetera. We’re not going to see change in our overall per capita suicide rate until down the road," Seavy said. 

Seavy says a cultural sea-change is needed to truly address the issue.

"We don’t talk… particularly in Montana and a lot of the Rocky Mountain states. We don’t talk about our problems, we keep it in. We’ve got incredible access to weapons, alcohol and isolation, which are three really negative factors for suicidality," Seavy said. 

Karl Rosston with the health department agrees.

"We have that cowboy up mentality, sense of independence. We take care of our own. We really have a huge stigma when it comes to issues like depression and anxiety. Until we get over that we are going to continue to have that issue," Rosston said. 

Riverside Middle School Counselor Tiffany Parish says Signs of Suicide may be one of the ways of erasing the stigma of depression and suicide.

"These kids are our world and we need to do everything we can to help them cope with the difficult situations in their lives and let them know that suicide is not the answer," Parish said. 

Kay Erickson has been working in broadcasting in Billings for more than 20 years. She spent well over a decade as news assignment editor at KTVQ-TV before joining the staff at YPR. She is a graduate of Northern Illinois University, with a degree in broadcast journalism. Shortly after graduation she worked in Great Falls where she was one of the first female sports anchor and reporter in Montana.