The federal Substance Abuse and Mental Health Services Administration has awarded the Campus Health Service at the University of Arizona a three-year, $306,000 grant to develop suicide prevention programs that can serve as a model for the nation's colleges and universities. Campus Health will match the funding to double the amount of the grant.
Suicide is the second leading cause of death among college students, behind accidental death and ahead of homicide. SAMHSA has funded a number of related programs across the country to address these numbers.
The goal is to develop a set of working models that will substantially reduce both suicides and attempted suicides among college students with mental or behavior health issues that put them at risk. Special emphasis is targeting three specific groups: Native Americans, military veterans and their families, and lesbian, gay, bisexual, transgender, queer and questioning, or LGBTQ, students.
"Our grant is meant to build infrastructure on campus, so that we have a network of 'gatekeepeers' who are trained to identify underlying symptoms or risk factors of potential suicidal behaviors and how to intervene appropriately," said Peggy Glider, a researcher in Campus Health.
Those gatekeepers are meant to include a wide cross-section of staff and faculty who are the most often in contact with students, as well as students in leadership positions, such as residence hall assistants and officers in student government.
The new project will help to expand services and link groups together, especially through faculty and staff from the College of Education, the Norton School of Family and Consumer Sciences, Veterans Education and Transition Services, LBGTQ Affairs and Native American communities. A new advisory committee linking everyone is also being planned, she said.
One program already in place at the UA is "Question, Persuade, Refer," or QPR, an interactive training session guided by a certified instructor. The two-hour program uses role-playing models to train people how to help someone who may be considering suicide. They are taught to know how to question a person about suicide, persuading the person to get help and referring them to the appropriate resource.
"We've been doing this (QPR) for a couple of years, really trying to reach the people who interact with students, and help them recognize the signs and how to intervene appropriately," said Lee Ann Hamilton, assistant director of health promotion and preventive services at Campus Health.
Hamilton likens QPR to CPR or the Heimlich maneuver, where "the goal isn't to treat them directly but to keep someone alive long enough to get them into tertiary care."
Campus Health also will offer a program twice a semester called Mental Health First Aid, also part of the federal grant. It is geared primarily toward residence hall personnel and is similar to QPR but covers a wider range of mental health issues beyond suicide.
A third program is offered at the UA by the national Suicide Prevention Resource Center specifically for mental health professionals who may not often deal with suicidal issues and gives them a way to sharpen their skills and update them on best approaches.
The state of Arizona will also make an online program, called Kognito, available soon. Kognito uses virtual environments and avatars to interact with those taking the program to guide them through the training. The advantage of the program, said Glider, is that faculty, staff and students can work on it on their personal computers and on their own time, and do not need to attend special presentations. She said Kognito will become available as soon as the University gets the site license for the software, which could be this month.
Glider said there are no solid numbers on attempted suicides at the UA or how the UA compares with other colleges and universities.
To aid in getting the SAMHSA grant, she added questions to the annual Health and Wellness Survey given to students in a random sample of classes during the spring semester. It included questions on whether students have ever attempted or seriously considered suicide within the school year.
Of the 2,500 students who took the survey, just over 6 percent of those who responded indicated that they had seriously considered it. Glider said 1 percent of the survey group reported that they had actually made an attempt, and in some cases tried several times.
The survey showed that nearly 11 percent of students had been diagnosed with depression, and slightly more indicated they had been diagnosed with anxiety, numbers that haven't changed significantly over time.
More than a quarter of the sample, 27 percent, said anxiety or depression made it somewhat or very difficult to work, study, go to class or get along with others, up from 24.3 percent in 2009. Of these students, nearly half said that they had not been diagnosed with either anxiety or depression.
On the question of overall stress experienced within the past school year, students reported:
- No stress – 2.4 percent
- Less than average stress – 8.4 percent
- Average stress – 37.9 percent
- More than average stress – 40.5 percent
- Tremendous stress – 10.9 percent
On the number of times students seriously thought about suicide during the past school year:
- 0 times – 94 percent
- 1-4 times – 4.8 percent
- 5-8 times – 0.8 percent
- 9 or more times – 0.4. percent
On the percent of times students attempted suicide during the past school year:
- 0 times – 99 percent
- 1-4 times – 0.6 percent
- 5-8 times – 0.2 percent
- 9 or more times – 0.2 percent
Hamilton said it is important for people to get over any taboos about talking about suicide. "A lot of people think if they talk about it, they'll somehow put the idea into people's minds. One of our clinical psychologists said it best – that if the thought crosses your mind, wondering if someone is contemplating killing himself or herself, you have to ask the question."
She said many people considering suicide find relief in just talking to someone about it. College students are at a greater risk because many of them have not yet matured emotionally, and see that suicide is a permanent solution to what is usually a temporary problem.
"It's often about loss," Hamilton said. "The breakup of a relationship can be devastating to them. Getting a bad grade, losing a scholarship, the loss of sense of who you are as a student are to most of us just minor blips in the course of life. But to them it can be a huge obstacle and they can't see any way around it. Dying is not their goal; they just want out of the situation and (the) pain," she said.
Broaching the subject, Hamilton said, can be as simple as asking "Hey, would you be willing to go and talk to somebody?"
If you fear for someone's safety, you can call the UA or Tucson police departments, she said, adding that the best thing to do is take the person to a counselor.
Glider has reached out to a number of campus groups to ask them to commit to working with her on expanding the QPR program, including faculty, student affairs and human resources as well as programs that serve student veterans, Native Americans and students who identify as LGBTQ.
"We've asked them to be on an advisory group to make sure that whatever materials we develop are appropriate for them. That means being able to change the scenarios in the QPR workshops to make them specific for that group, and developing brochures and other media that are appropriate for them. We're really trying to target everything we do to those populations."
For more information about QPR, contact Lee Ann Hamilton at 621-4967 or firstname.lastname@example.org.
For more information about Kognito or the project, contact Peggy Glider at 621-5973 or email@example.com.