Hello Talbot County public school staff and students and families, I wanted to share with you. We do our monthly webinars for our students and families, and this month it is going to be learning more so about our Yellow Ribbon suicide prevention program and to county public schools and how this even came to be. So my name is doctor Rob Schmidt. I have been working with Talbot County Public Schools as the mental health coordinator for the past 24 years, and in mental health for the past 33 years. And I wanted to share with you a really important preventative program that we have, that we have since incorporated or adopted in Talbot County schools since 2003. But it didn't. It became implemented in 2004. And it's called the Yellow Ribbon Suicide Prevention Program. It's an international program actually out of and born out of Westminster, Colorado. In fact, this year, 2024 is exactly the 30th a year since the Yellow Ribbon program began. And unfortunately, it's 30 years ago since Mr. and Mrs. Emmy lost their high school student to suicide, their high school son. And it's called the Yellow Ribbon Suicide Prevention Program. And it is totally rooted in prevention, identification, education, awareness and everything else that we could do across the tiers of public health to never happen to never allow a suicide to take place, to do everything we can possibly, whether it's the community or also it's in a school district somewhere or in another country. So do everything we can. And so I'm going to share with you with Tulsa County Public Schools does and how we adopted this program and implemented this program. But also, I would be remiss if I did not share some of the most recent data across the country, in the United States about youth suicide and suicide prevention. So in the next slide is. Okay, there we go. So this was written, let me go back. I want to give, first of all an update, about you know, the public health model and prevention, primary prevention, which is where this is the first of three tiers. So in the journal of the American Medical Association, back in 2005, Columbia University did an incredible study that talked about the myth and face the myth with some data that if you talk about it, you're going to make my kid. If you talk about suicide, you're going to make my kid think about an attempt suicide and spur thoughts. And that was actually not the case. And it is not the case. And across all models, no matter what the topic is, it could be, smoking cessation drug, you know, prevention of drug use and abuse and, unprotected sex and everything else. And that that's, that's taught it's all about identity, identifying a need and preventing it from happening. And the need is when I talk about what the need is, the need is to prevention suicide. And we need to talk about it because what Columbia University found in this incredible study that allows children and teens to unburden themselves, to say, hey, you know what? It's okay to talk about this stuff if I keep it in their thoughts word that they felt, in contrast, that no one really cared about them. And they take the absolute word absorbing a signal, saying that, you know, if I talk about it, if I don't talk about it, I'm afraid that other people like if I can't talk about it, other people are going to think that they're going to minimize me. And so what am I going to do with all of these thoughts? And we do know through the suicide continuum that these thoughts increase. And when they increase with no intervention and ambivalence and everything else associated with that is that it will lead to an attempt. So just to let everyone know right here that there are a lot of topics that are hard to talk about, but they need to be talked about to prevent it from happening. Suicide prevention and suicide is one of those topics. And this was from, Joan Ryan, a columnist from the San Francisco Times, back in 2007 when she lost her nephew to suicide. A child, nephew, much younger in I think it was middle school. And she said, as a family, we always wondered and worried never, you know, we worried, you know, for a second or. But we never worried for a second about suicide. We always worried about the, the common kinds of things like drugs and alcohol and everything else that you know, about maybe somebody taking my child and kidnaping and everything else. But we never thought for a second about suicide. And she said that I often wonder how we keep, you know, all of our children safe when the greatest danger of all might come from within. And you may have heard in the past that suicide is a silent killer. Because if we don't talk about it, the isolated effect comes in isolation effect. And, yeah, it is a silent killer. And that's why we need to think about this thing holistically. And there's no greater place to provide a prevention intervention program than in our schools. It's well documented in literature. Schools can offer so much more than educate, because we can't educate if someone's really struggling with themselves or with a with a situation. So the some of the latest information it's called the why IRBs. It's the center for Disease Control. And every couple of years they surveyed our kids middle and high school around the United States, anywhere from 15 to 21,000 youth. And they look at the most risk taking behavior and a category of that is related to suicide in depression. And so if you can think about, like our average classroom size in the United States right now, in 2024, 25 school year, it's 25 kids in a classroom, public schools. That is so 42% felt sad or hopeless almost every day for two weeks, 70% of LGBTQ plus experienced persistent feelings of sadness or hopelessness. Persistent means a constant state of sadness and hopelessness. So if you think about 22% report seriously considering attempting suicide. So if you look at a classroom of 25, that's 1 in 5 students in that classroom, that's a lot, right? That's about five students. Native American youth have the highest rates of youth suicide, 27%. It's off the charts. 18% or 1 in 6 students made a suicide plan, which really is a significant increase in the number of kids. It ups the ante quite a bit when you're when you are orchestrating your own death or planning how to get out of a situation, 1 in 11 or 10% may be suicide attempt and 1 in 40 high school students made a suicide attempt requiring medical attention. Most suicide attempts do not require medical attention from our kids because they hide that they hide their injury very well. Some of the some of the, some of the youth suicide data and some of the research that I have done over the past 33 years specializing in youth suicide and suicide evaluation and having done suicide assessments, thousands and thousands of them across the lifespan, from age four all the way up in the 90s. A lot of a lot of parents and a lot of mental health practitioners minimize the risk level in the youngest of kids and really don't become aware of a child's perception of death from preschool, pre-kindergarten, kindergarten, first and second grades and Piaget in, you know, we look back at some of the incredible research that was done by him and his child, developmental models ages 2 to 7, which is called the pre operational phase. Believe that test as being reversible. So kids believe death is reversal. So I could come back to life. Mom or dad who passed away can come back to life. My dog, my goldfish. They'll bounce back. They'll come back to life. Kind of like the Bugs Bunny roadrunner who gets smashed by a boulder and bounces back up and continues on. The permanence of death was too hard to understand because it it calls for our developmental process of obtaining abstract thinking. And that is abstract thinking is kind of like deductive reasoning of how we can solve a problem or own problem by taking away the things that aren't contributing to the problem, like some of them, some of the resources, some of the solutions. We are unable to do that till at a at about, you know, developmentally could be between 10 and 12, but pretty much on average at about age 11, that is viewed as being alive and doesn't have an understanding of like time, like, well, they're going to come back, they're going to wake up. Might be a year from now, don't wake up tomorrow, but don't have that understanding about time and place of death. I'm coming back that it's reversible. It's not reversible. And they don't understand that at that age that is more so viewed as sleep and coping with their perceived problem, given the limited developmental reasoning skills or the ability to even problem solve. And so what happens is if I fail, I could die, but I can come back to life. So it's viewed as sleep. And we need to understand this because right now the the youngest of our kids have the most significant increase in suicidal thoughts and behaviors. So if we look at ages 3 to 7, it's identified kids that are identified as presenting with suicidal thoughts or ideation are four times greater to have suicidal thoughts in later school years. Remember, across the lifespan, the the peak of having suicidal thoughts is in our transitional grades. Transition grades are grades six and nine. The completed suicides are in the middle age 45 to 55 range. But the thoughts the life span peak of having suicidal thoughts is actually in our in our school age children, age four has the ability to understand death, the ability to think of suicide, and our own ability to act on thoughts to bring an end that is different from sleep. So then at age four, we're starting to see a turn that this might be a little bit different from sleep and a lot of different studies. So another thing that, a lot of times that staff and parents will minimize just in general without any sort of training, is that they don't understand that 95% of first and second graders already reported what killing oneself actually means. They understand that now they they may not have been introduced to the word suicide, but they know what killing oneself means. And a lot of times practitioners and even in the air will minimize that and say that they're just having thoughts or actions or related to a situation. They, they don't know what they're doing, but they do, believe me, they do. Ages 7 to 11, Piaget identified a child's thought processes entering into a more interactive phase, and that is a cause and effect relationship. If I do this, this will happen. And this is what I want to happen. I want to achieve this not knowing the permanence of death that I can't come back. So by the same time, they're also starting to understand the finality of death, that I can't come back. It's not reversible. So developmentally you can have a better understanding of this. This is just a brief overview of some research that I put together in a book. So, we need to take any time someone talks about suicide or hurting themselves or not wanting to be here any longer serious, especially in our youngest school age children. So let's think about the key constructs related to suicidal thoughts and behaviors. Key constructs are our feelings or our emotions surrounding these thoughts. Being, being, or feeling sad or depressed most of the day for nearly every day, hopelessness, cheerfulness, sadness, diminished loss of activities or pleasure. Not doing things that I normally would do, weight loss or weight gain. I can't sleep or overeat. Remember, depression routes itself into our soul very differently in each individual. In other words, it may affect me where I'm tired all the time, I can't sleep, and other people, it might increase a heightened sense of activity. So or I lose, I can't eat, I overeat to fill that void, I can't sleep, I oversleep, I feel fatigued, other people are hyper feeling worthlessness. I feel like a burden. If I do this, maybe it'll bring Mom and dad back together or excessive guilt. Everything that's happening is my fault. And, you know, our teachers are great because they can also see decrease ability to concentrate, increase irritability, anger, short and fuze, unexplained physical symptoms, headaches, stomach aches. And if you talk with our wellness center nurses, our nurses that are in our schools, that they will let you know that 65 to 70% of all of their visits kids come in are related to somatic type complaints, and these are complaints that are like physical complaints that are not found. It we can't we don't have I don't there's no source of this. So it's got to be psychological. Where are we storing our sadness or our anger or thoughts or anxiety? Typically in school age you population. So being absorbed in social media, gaming, phone, computer, isolating myself in my room, parents tend to have a tendency to think that out of sight, out of mind that, Rob is in his room, is quiet. It's no worries. He's a great kid. But why is he in his room so much? That's kind of, like, not normal. We need to be interactive. We need people. Need. We're social beings. We need to be participating in something, a sense of hopelessness. Now, if you can imagine a sense of hopelessness and what that even in means, a sense of hopelessness means that there's simply no way of solving a problem. There's no way out of this situation. There's no way there's no end in sight. There's no foreseeable solution. It'll never change. Things will always be this way. And I can't do this anymore. At school, it's very noticeable. Decrease grades going back to, inability to concentrate. If I can't concentrate, I'm all over the place. There's attendance problems, maybe disciplinary referrals, you know, changes in behavior, sharing with friends about having thoughts of hurting themselves, notes, messaging, social media. Again, because. Because we're not born to kill ourselves, we will send. It's called the ambivalence factor. And we will send messages out to our friends and as parents, as teachers, as staff or grandparents. We're the last to find this out. But your child's classmate or best friends that are shared with them first. So that's why it's really important. And one of the great things about the Yellow Ribbon Suicide Prevention program is that we teach our kids. We empower them to simply ask for help, either for themselves or on behalf of their friends. And we'll share more about this in the coming slides. Typically. Well, actually, every year in the month of September, the Yellow Ribbon Suicide Prevention Program is provided and implemented in Talbot County Public Schools. Each child is given one of these cards that use cards that you see. And if you haven't noticed, your child usually has been wearing that beautiful gray t shirt that's on the back. It says it's okay to ask for help. It's a lifelong skill that hopefully throughout life because life is hard sometimes, that the number on their on the back backside of the shirt, it says it's okay to ask for help. And it's A988 number. The National Suicide Crisis Hotline number that can be called anytime, day or night. So this card is given to each each of our students in grades three through 12. And they're given a yellow ribbon suicide prevention t shirt with wristbands that says it's okay to ask for. I'll be a link and save a life. And we empower the kids in grades three through 12 what they can do if they hear someone talking about not wanting to be here anymore, about hurting themselves, or even killing themselves, or going through a rough time, they know what to do. And first and foremost, we want them to to get a hold of a trusted adult. You know, letting mom or dad know their grandparent, know whomever you may live with to get that information out there and to make sure that, you know, we can unburden the child from feeling like they don't like their they don't want to snitch or talk or share any of this information, but empower them that you're actually saving a life. You're getting this information out there. And when someone comes to our staff, our school counselors, or our school mental health practitioners or a teacher or even a custodian, you know, the message is that we never bring the other child's name up. We just say that your classmates, you're really worried about you, they care about you, and they want to make sure you're okay. So they brought it to our attention that you're seeing, like you're going to a really rough time right now. And our job is to make sure that you're going to get through this. And we want to get you through this together. And we also want to get the people involved to help you get through this situation that you're experiencing, because it is going to be temporary and we're going to get through this. So the messaging is that your classmates really care about you when they come on behalf or speak on behalf of their classmate. Now, when students bring their card, sometimes they're so sad that they don't want to talk initially and they will present that card to the school counselor typically. And then the school counselor will enact the school crisis team. And then we figure this out together and we may even do a risk two plus assessment. The risk identification suicide kit. They figure this out so that we can make a reasonable recommendations and action steps of what we could do to help and intercept these thoughts based on whatever the risk level that comes out of this risk two plus assessment tool that is validated. So we use that, predominantly to figure out, engage the best mode of treatment options that we can offer to the families, and what we could do to help escort the families and access these services. So that's what we do. And we have this card in Spanish, in English. And if you can look here now, since we got the program in 2003 as a community, as Talbot County, before the county council, we went presented there. And then in 2004, we presented we began implementing this program. And you could see the number of students through the through a long time is 20 years actually, what, 20 years ish? 21 I'm sorry, 21 ish since we started this program and the number of kids now, these are the only only students that we are aware of that actually use these cards. We don't know how many use them in the community. And we do know that every September when we when we give out these cards and we talk about the signs and symptoms of, you know what, depression and sadness and situational depression is and biological depression it is. And then in high school, we talked a little bit about in specific to high school postpartum depression and what that looks like, because we try to build in the skills down later in life. If you're ever feeling like this, it's okay to ask for help. It's simply it's okay to ask for help too. Don't keep this inside because it's only going to get worse. So it's a lot of students and 97 students. And during the 2324 school year, which was last year, we had six students use this card. But anyway, getting back because I was a little off track whenever we do this program in September every year, the National Month of Suicide Prevention, we also get information that wherever, wherever the students live, that the number of calls to the National Crisis Hotline geographically increases. And it just doesn't have to be about suicide. It could be, you know, I'm having a really a bad night. Something's going on. I feel like I have nobody to talk to. I can always call this number. And we also share with the students that it is not a hotline like math phone number. So you can't call to talk with, a tutor or anything like that related to that. But, you know, if it's just feel like you're being bullied, if it's outside of school hours, it's summertime, you can call the number and talk about whatever that is that problem may be. If it's during school hours, we let them know that there's so many people in our buildings that care about you, and we want to help you. And we're trained specific to do this. And so, you know, they know that they can come down and talk with the school counselor, or they can talk with the school social worker if they're an already enrolled in one of our mental health practitioners or agencies that come into the school and they're on their caseload, they can talk with them. But we do everything we can to talk with the students. As soon as we are made aware of that, somebody is just struggling or going through a difficult time because life again for all of us does get difficult. And sometimes we're so enmeshed in it that when we get enmeshed in it, we can't think of our own solutions, even though they're right in front of us. And so sometimes, because of the ambivalence, like we don't want to hurt ourselves, we will share with a classmate. And and that's when our classmates know the flag goes up in their head, hey, I can I can really help out Rob right now because he's telling me this stuff. And I can let let a trusted adult at school know if it's any sort of social media that takes place after hours. They know that they can contact a trusted adult at home or call the 988 number. And they will also direct and get resources available to them instantly. So this is a part of a series, the Yellow Ribbon Suicide Prevention, presentation that you're receiving right now is just one in a series of a quick snippet about what we do in Talbot County schools and what we do to prevent and identify and also prevent and educate. Our students and staff and our parents, because being a parent is very difficult so that we can get this information out there to, to you and make it readily available. And then if this sparks conversation or questions that you may have, you know, I'm just a phone call away and we'll get back to you within a reasonable time, and then we can talk about or I can clarify anything that you feel that needs to be talked about or shared. And more   specifically to whatever your question may be. So we're going to be talking next about what what is sex trafficking? And we did partner with, the Eastern Police Department and the sheriff's department about this. And so we'll share that information and you can see a list of upcoming topics. Now, all of these are not in submit. We may change these given if there's something really urgent that needs to be shared like in June. We may bump that up about about being our kids, being addicted to gaming or social media, that we might bump that up just before maybe in December actually, and then move that back. But we feel like whatever the most pressing topic is that we're getting information from the community. What will actually change things around just a little bit. So here are some resources in Talbot County. And then on the mid shore, if you have any questions related to any of the symptoms that were shared earlier about what depression in the and observers in our kids, any mood changes, mood swings, constant state of sadness, maybe crying? I don't know why or why is my child so sad when so many great things are going on? You can always reach out and contact. First of all, you can contact me here at the Board of Education and Talbot County Public Schools. Or you can call one of the numbers listed here and and feel free to reach out. And we do offer school based counseling and mental health in our schools. And we can also get you hooked up to decrease some of the barriers that often affect accessing services. Because maybe I don't have transportation or I'm working late, at least my child can be seen by a licensed mental health practitioner here at school, and it is confidential. So we can talk more so about that. Should you have any questions at all, here's my information. You can call me anytime. And like I said, please leave a message. We want the same thing you want. We want first of our kids to academically succeed, do well. But we also understand that there are some neighborhood and some family problems. Sometimes that happen and interfere with that ability. And we want to offset that by meeting some of these needs and barriers to learning, by offering these supports in our schools. And we can do this. And again, we just want the same thing that you want. And how we do that. We do everything we can to provide a safe learning environment. And we do understand again that some things just happen in life and that affects our kids. And we got to figure this out together and that's all that we want to do. And we do have these services available at school again in the community. Should you have any questions for any specialty providers that are specific to like eating disorders or anxiety or depression, you can also let me know and call me and I will get back to you and try to steer you in that right direction. And again, I can't thank you enough for trusting us, and we'll do everything we can to be here for you. We're just a phone call away. And thank you very much.