Running Head: SUICIDE PREVENTION PROGRAM 1

Suicide Prevention Program

Healthy People 2020 Objective: Reduce Suicide Attempts of

Duval County High School Students

R. Elizabeth Coman

Casey Grove
 SUICIDE PREVENTION PROGRAM 2

Table of Contents

Section 1: Literature Review

Section 2: Needs Assessment

Section 3: Goals and Objective

Section 4: Activity/Intervention

Section 5: Evaluation

Section 5A: Impact Evaluation of Learner Objective

Section 5B: Impact Evaluation of Outcome Objective

Section 5C: Suicide Prevention Survey

Section 6: Budget

Section 7: Timeline

Section 8: References
 SUICIDE PREVENTION PROGRAM 3

Literature Review

Suicide is a major public health concern that claims the lives of nearly 5,000 US

adolescents (ages 10-24) each year (Centers for Disease Control [CDC], 2015). According to the

Centers for Disease Control (CDC), suicide is the second leading cause of death among

adolescents aged 15-19, only behind accidental injuries (CDC 2015). Though interventions and

prevention programs have been implemented across the country, the number of suicide attempts

continues to steadily rise. In 2017, 19.0% of students grades 9-12 attempted suicide, this is a

63% increase since 2013 (Duval County Public Schools, 2017). The CDC defines a suicide

attempt as one’s attempt to harm one’s self with the intent to end their life, but they do not die as

a result (CDC, 2018). The Youth Risk Behavior Surveillance (YRBS) found the percentage of

high school students who had made a suicide plan significantly increased by 19% from 2013 to

2017, and 7.4% of high school students had made a suicide attempt one or more times in the past

year (CDC 2017). Statewide, 13.8% of high school students seriously contemplated attempting

suicide, 10.7% created a plan on how they would attempt suicide, and 7.6% made a suicide

attempt (CDC 2017). Of the 3,187 reported suicide deaths in Florida for 2017, 155 of those

occurred in Duval county (Florida Department of Health [DOH], 2017). Prevention of suicide

attempts is crucial to the health and future of today’s youth. Focusing efforts on suicide

prevention for high school adolescents is critical not only because of the tragedy of the act itself,

but attempts are often associated with hospitalization, future attempts at suicide, death by

suicide, and death by causes other than suicide (Pena, Kuerbis, Lee, & Herman, 2018).
 SUICIDE PREVENTION PROGRAM 4

Although suicide attempts are committed by all genders, races, and religions, there are

several disparities present when examining pre-existing data on suicide attempts at the national,

state, and local levels. The three greatest disparities that exist in suicide attempt rates are age,

race, and gender (National Institute of Mental Health [NIMH], 2018). Suicide attempts are

highest among young adults and adolescents, specifically between the ages of 12 and 24 (NIMH,

2018). White adolescents (10-19 years old) are twice as likely to attempt suicide compared to

black adolescents of the same age group (NIMH, 2018). Disparities in suicide rates is perhaps

the most extreme between genders. The prevalence of contemplating suicide and attempting

suicide is nearly twice as high in females as in male high school students (Duval County Public

Schools, 2017). Female adolescents are twice as likely to consider and attempt suicide in

comparison to their male counterparts (King, Horwitz, Czyz, Lindsay 2017). Although males

have a higher suicide fatality rate at 5.7%, females’ attempts were only 1.2% fatal, a

phenomenon known as the “gender paradox” (Horwitz, Czyz, Lindsay, 2017). This is due mainly

to the fact that males are more likely to use more lethal methods such as suicide by firearm,

noose, or other violent actions (Horwitz, Czyz, Lindsay, 2017).

According to a recent study conducted by J. Pena, A. Kuerbis, R. Lee, and D. Herman

(2018), to help effectively reduce suicide attempt rates, risk profiles should be used to bring

attention to potentially suicidal students. They determined four areas of risk that can be used to

prioritize risk: suicidal behaviors, depressed mood/suicide ideation, substance abuse, and

engaging in violent behaviors (Pena et al., 2018). First, to measure suicidal behaviors or

depressed mood, the YRBS contains questions regarding mood, feelings of hopelessness, or

contemplation of suicide. Secondly, indicators of substance abuse are assessed with questions

concerning use of substances such as alcohol, marijuana, cocaine, inhalants, and heroin. Lastly,
 SUICIDE PREVENTION PROGRAM 5

questions regarding the ownership or handling of weapons such as knives, guns, or clubs, and

frequency of physical fights were used to assess violent and threatening behavior (Pena et. al.,

2018).

Certain predisposing, enabling, and reinforcing factors are also contributing to the

alarming number of suicide attempts in Duval County high school students. Predisposing factors

include knowledge, beliefs, and existing skills. In terms of suicide attempts, examples are

knowledge to recognize signs of depression, knowledge pertaining where to receive help, coping

and stress management skills, and beliefs that seeking assistance will make others think

differently about them. Reinforcing factors affecting suicide attempts include peer pressure, peer

judgment, and family and social support. Enabling factors affecting Duval county high school

students include availability and accessibility to helpful resources, current curriculums that

involve lessons on mental health, recognition of signs, and ways to receive help for yourself or

another.

To find a way to successfully create and implement our prevention program, we first

looked at current programs to find what methods have shown success, and what areas could use

improvement. There have been prevention programs and surveys administered throughout

different schools for adolescents. A specific prevention program that has been replicated and

reevaluated multiple times is the “SOS Suicide Prevention Program”. SOS stands for signs of

suicide. This program consists of a pre-test and post-test along with trainings and teachings

(videos and discussions) in between. There is major focus throughout these programs on “the

reduction of suicidal behaviors among adolescents” (Aseltine RH Jr., & DeMartino R., 2011).

These programs want everyone to be more aware of suicide and depression, along with an

improved attitude toward these serious topics. The SOS program aims to help individuals
 SUICIDE PREVENTION PROGRAM 6

understand the signs of troubled thoughts and to know it’s okay to find help for yourself and

those around you, as well as intervene in a safe and appropriate way. This intervention is done

through the acronym ACT, which stands for acknowledge, care, and tell (Aseltine RH Jr., &

DeMartino R., 2011). To acknowledge that an individual is showing the specific signs, let that

individual know they are cared about and that others want to help them, and finally, find and tell

an adult who can help. By providing these videos and discussions shown to the randomized high

schools, the lessons taught to these adolescents are in hope that there is an increase in helping

others, an increase in knowledge, and a decrease of depression and suicidal behaviors.

According to a study conducted by Schilling, Aseltine Jr, & James (2016), after

implementation of the SOS program, approximately 64% of students were more likely to report

suicide attempts in the three months following completion of the program. It is important to

understand that the SOS prevention program is universal for all schools and has seen positive

results. Suicide rates for the youth have tripled since 1950s (Aseltine RH Jr., & DeMartino R.,

2004), which is why development and implementation of suicide prevention programs is a

priority to public health and community professionals.

A second study, conducted by Phoenix, Ting, and Mei (2018), provided information on a

new and promising approach for suicide prevention is through a “gatekeeper.” Gatekeepers are

defined as “individuals in the community who have face to face contact with large numbers of

community members. (Phoenix, H., Mo, T., & Mei, Q., 2018)” Gatekeepers are trained and

placed into the schools to recognize and identify signs of depression, suicide, and at risk-

students. Due to their ease of access to the students, the gatekeeper can intervene in an

appropriate and timely manner and assist the student with the resources they need in order to get

help (Suicide Prevention Resource Center, 2013). Examples of currently implemented

 SUICIDE PREVENTION PROGRAM 7

gatekeeper programs are Question, Persuade, and Refer (QPR), and Applied Suicide Intervention

Skills Training (ASIST). QPR focuses mainly on the certification of teachers, counselors,

teaching staff and administrators. Faculty is taught the warning signs of suicide and how to

intervene and assist the student. QPR is a 2-day workshop focused primarily on helping

gatekeepers gain confidence and understanding about suicide. (Phoenix, H., Mo, T., & Mei, Q.,

2018). Based on the promising success of currently implemented gatekeeper programs, we have

decided to use gatekeeping as one of the elements in our suicide prevention program.

The CDC states that some of the greatest risk factors for suicide attempts in high school

students include mental disorders (specifically clinical depression), struggles with sexual

orientation, and bullying (CDC, 2017). However, clinical depression seemed to be the highest

factor driving students to attempt suicide. Clinical depression can be defined as feeling sad or

hopeless almost every day for two or more weeks in a row (CDC, 2017). In Health Zone 2 of

Duval County (HZ2), 36.4% of students had signs of clinical depression, In the same district,

23.3% of students reported being bullied on school property and 20.0% were bullied online.

Another 17.0% of high school students in HZ2 were victims of teasing or name calling because

of their sexuality (Duval County Public Schools, 2017). These percentages are the highest for all

three categories in comparison to the other 5 health zones, Duval County as a whole, and all

Florida high school students.

While creating our prevention program, we focused on Duval county high school

students (grades 9-12) located in Health Zone 2 of Jacksonville. After researching programs that

had previously worked such as Behavior Risk Surveys, Pre-test Post-test trials, and curriculums

implemented in the school to provide the students with knowledge of warning signs, and where

to receive help. We have decided to create a new program based off the success of the past
 SUICIDE PREVENTION PROGRAM 8

prevention programs. Our adolescent suicide attempt prevention program will begin with a pre-

test to obtain a baseline of the current knowledge of mental health and available resources in

their area. It will also test the student on what they should do if one of their classmates or peers is

exhibiting signs of depression or potential suicidal behaviors. Our teaching materials on

prevention, recognition, and seeking help will be obtained from previously used evidence-based

prevention programs such as SOS. Teachers and school officials will be trained as gatekeepers to

recognize signs of at-risk students and refer them to the correct place to receive help.

In addition to the teaching materials, our program will use pamphlets to teach the

students of local resources and where to obtain help free of charge. Students will also be given a

card containing a hotline number to our Health Educator Resource Center, where we will have

counselors and mental health professional available to speak with. In the case that a student calls

after hours, they will be directed to the National Suicide Prevention Hotline. In addition, high

school students will attend bi-monthly mental health workshops that will focus on helping

students communicate with each other and teach important stress management skills. Our post-

test will be administered in the same fashion that the pre-test was. Students will receive

incentives such as extra credit points, a free homework pass, or amazon gift cards to be honest

and complete the post-test to the full extent of their knowledge.

While the importance of mental health education for adolescents is well known, the

Duval high school curriculum lacks any courses focusing specifically to mental health and where

to seek help if a student is feeling depressed, alone, or confused. According to the Duval County

Public Schools curriculum guide (2018), the only classes currently in effect that pertain to mental

health are HOPE and Life Management Skills. HOPE is a year-long course and Life

Management skills is only a semester. Though HOPE touches on the importance of mental
 SUICIDE PREVENTION PROGRAM 9

health, it also requires coverage of a variety of other health topics including physical health and

fitness, nutrition, diseases and disorders, first aid, drug and alcohol prevention, sexual education,

and internet safety (Duval County Public Schools, 2018). These courses are often taught by

teachers certified in physical education, so topics out of the instructors’ comfort zones, such as

sexual education and mental health, are briefly discussed compared to physical health topics.

Time spent discussing the required topics is at the teacher’s discretion. Therefore, there is no

way of knowing if they are sufficiently addressing all of the class topics, including mental health

material.

In conclusion, suicide is recognized as a serious public health concern and needs to be

handled accordingly. In the US, many students struggle to seek assistance from professional

organizations or community outreach programs in dealing with depression or suicidal thoughts

(Phoenix, H., Mo, T., & Mei, Q., 2018). Due to this obstacle, schools provide an ideal platform

for reaching students on important and sensitive topics. By granting students access to resources

that do not require them to explore on their own for a community or professional program to

provide help, students will be more likely to seek out help from peer educators and school

officials. By developing our program using a combination of previously proved methods, the

goal of our program is to reduce suicide attempts in high school students in HZ2.
 SUICIDE PREVENTION PROGRAM 10

Needs Assessment

Duval county is located on the northeast coast of Florida. Jacksonville is the largest city

in the contiguous United States. Jacksonville is home to nearly 865,000 residents. Of these

residents, there are an estimated 128,463 students attending one of the 197 schools located in

Duval county (Duval County Public Schools 2018). Due to the differing geographical and

economic statuses of specific part of Duval, the CDC has split it into six different Health Zones

(HZ) (Florida Department of Health, 2012).

To determine the area of greatest need, we first examined data provided by the CDC’s

Youth Risk Behavior Surveillance (YRBS) survey. After researching the statistical data,

focusing specifically on Duval county in Jacksonville, Florida, we discovered that nearly 1 in 5

Duval County high school students have attempted suicide, which is 11.2% higher than the rest

of Florida (CDC, 2017). These astonishing numbers indicate that the current curriculum in place

is not providing sufficient mental health education for its students. Upon further investigation,

we have decided to implement our prevention program in Health Zone 2 (HZ2) of Duval county.
 SUICIDE PREVENTION PROGRAM 11

HZ2 had the highest rate of attempted suicide among high school students at 24.5% (Duval

County Public Schools, 2017). This is over 100% of those who had seriously considered

attempting suicide (24.0%) according to the 2017 YRBS (Duval County Public Schools, 2017).

Due to the alarming number of adolescents who had attempted suicide in HZ2, our target

population will be High School students, grades 9-12th, and will be sampled from the four public

high schools in the Health Zone (Terry Parker, Sandalwood, Douglas Anderson, and Englewood

(Duval County Public Schools, 2017). A sample of approximately 500 students will be selected

to take our needs assessment survey. The needs assessment survey is comprised of a selection of

questions chosen from the 2019 YRBS survey. The assessment will be administered by our

selected prevention program health educators with the assistance of the high school health

teachers and personnel. The selected sample will be provided incentives to increase response

rate. Incentives include, but are not limited to: Homework passes, an approved off campus lunch

break (for junior and senior level students), amazon gift cards, and gift baskets put together by

our program community volunteers. The two schools determined to have the greatest need will

be chosen to have our prevention program implemented the following school year. One school

will be given the resources, access to our facilities, and training to implement our program, and

the other will be a minimal intervention control to determine the success rate of our prevention

program.
 SUICIDE PREVENTION PROGRAM 12

Goals and Objective

Goal: To reduce suicide attempts among high school adolescents in Jacksonville, Florida.

Objectives:

1. Process Objective: During program implementation, program facilitators will teach 3

information sessions for all staff, at all selected high schools.

2. Learner Objective: Three months after the program, 100% of participants will be able to

identify key signs of depression and suicidal behavior.

3. Behavioral Objective: Three months after the program, 100% of participants will be able to

identify key signs of depression and suicidal behavior.

 SUICIDE PREVENTION PROGRAM 13

4. Outcome/ Program Objective: Five years after implementation of the program, suicide

attempts among high school adolescents in Jacksonville, Florida will decrease by 10%.

Activity / Intervention

The learner objective that this activity aims to complete is “six months after completion

of the program, 100% of participants will be able to recognize and identify key signs of

depression and suicidal behavior.” Following completion of the program, participants will be

asked to take a posttest containing questions on information presented within our PowerPoint

and discussed throughout the education session. Our researchers will look at the posttest data to

see if 100% of participants correctly identified signs of depression and suicidal behavior.

The SOS program begins roughly 3 months before the school year begins. All faculty are

invited to attend information and training sessions to become a SOS program facilitator. During

this training, faculty will learn the core objectives of the SOS program and how to comfortably

address their students with a very sensitive topic. Facilitators will be taught how to identify at
 SUICIDE PREVENTION PROGRAM 14

risk students, approach the subject, and assist the student by guiding them to a local resource for

counseling.

The education session should be completed in a classroom setting with desks organized

so every student has a clear view of the presentation. The session should last roughly 90 minutes

with time left at the end to answer questions. Education sessions should be completed with an

average of 30 students per session. Materials include our suicide prevention PowerPoint

presentation, suicide prevention pamphlets, and suicide hotline cards (all materials will be

provided for the implementation of the program.) Each education session will be run by one of

our SOS program Health Educators along with the help of two volunteer trained facilitators. The

Health Educator will guide the session and present the Suicide Prevention Program PowerPoint

to the class.

Attached is the PowerPoint used in the education session that describes signs and

prevention tactics for suicidal attempts for Duval County high school students located in health

zone II. This PowerPoint will teach the following: preventative tactics, antecedents leading up to

a suicide attempt, and what to do after a suicide attempt. The preventative tactics will include but

are not limited to; how to detect signs of depression in youth, how to recognize populations with

an elevated risk of suicide, how to handle life events that act as stressors, and knowing the multi-

tier levels of precursors to suicide.

One of the main concepts taught in the SOS PowerPoint is ACT. ACT stands for

Acknowledge, Care, and Tell. Students will be taught how to help a peer in need by

acknowledging that there are signs of depression or suicide, letting them know they care, and

finally, telling a teacher or trusted faculty member about their concerns.

 SUICIDE PREVENTION PROGRAM 15

After the PowerPoint material has been covered, students will split into breakout groups

to engage in a guided discussion lead by the volunteer facilitator. Discussions will include

examples of situations in which the students practice “ACTing.” After completion of group

discussions each student will return to their seat to complete a mental health screening survey.

The health educators and assistant facilitators should pass each survey out in a manila folder and

remind students that it is important to put their name, however, their information will be kept

completely confidential.

After collecting all screening surveys, the SOS Health Educator will address any further

questions, concerns, or requests for clarification. Students will be given a business card that

contains the suicide hotline phone number as well as an information pamphlet with important

signs of suicidal behavior as well as reminder of where and how to seek help.

Evaluation

The purpose of evaluating the SOS program is to determine whether the program has an

impact on Jacksonville youth. Through the SOS program, we hope to help participants learn

warning signs and behaviors of depressed and suicidal individuals, as well as how and where to

seek help. We will also be giving free counseling sessions to any participant who would like to

speak to a mental health professional. The overall goal of the SOS program is to lower the rates

of suicide attempts and suicide in high school adolescents.

A sample of 500 high school students will be randomly selected to take our pretest. Terry

Parker students will receive the SOS intervention program and Douglas Anderson students will

serve as our control group. The pretest and posttest will be administered by our selected
 SUICIDE PREVENTION PROGRAM 16

prevention program health educators with the assistance of the high school health teachers and

personnel. Results from the evaluation of the SOS program will be shared with funding agencies

as well as other Florida schools for implementation if the program proves successful.

Impact Evaluation of Learner Objective

Learner Objective

 Six months after completion of the program, 100% of participants will be able to identify

key signs of depression and suicidal behavior.

A pretest and posttest will be administered to determine knowledge gained by participants

following completion of the program (see question 34). For the objective to have been met, we

will look at posttest results to determine if 100% of participants were able to correctly identify

key signs of depression and suicidal behavior.

Impact Evaluation of Behavioral Objective

Behavioral Objective:

 Six months after completion of the program, 75% of students who receive referrals to see

a mental health counselor will follow through with the recommendation within 60 days.

A pretest and posttest will be used to compare percentage of students who followed up with a

mental health counselor after receiving a referral from an SOS Health Specialist (see question

38). After completion of the posttest, we will be able to determine if at least 75% of students who

received a referral followed up and went to a counseling session with a mental health counselor
 SUICIDE PREVENTION PROGRAM 17

Impact Evaluation of Outcome Objective

Outcome Objective:

 Five years after completion of the program, suicide attempts among high school

adolescents in Jacksonville, Florida will decrease by 10%.

Five years after completion of the SOS program, we will compare Center for Disease Control

(CDC) data for Jacksonville, Florida from 2018 to current data in 2023 to see if there was a

10% decrease in suicide attempts.

 SUICIDE PREVENTION PROGRAM 18

Suicide Prevention Survey

This survey is a compilation of questions from the 2019 YRBS National Youth Risk
Behavior Survey. It has been developed so you can tell us what you do that may affect your
mental health. The information you give will be used to improve health education for
young people like yourself.

DO NOT write your name on this survey. The answers you give will be kept private. No
one will know what you write. Answer the questions based on what you really do.

Completing the survey is voluntary. Whether or not you answer the questions will not
affect your grade in this class. If you are not comfortable answering a question, just leave it
blank.

The questions that ask about your background will be used only to describe the types of
students completing this survey. The information will not be used to find out your name.
No names will ever be reported.

Make sure to read every question. Carefully circle your answer. When you are finished,
follow the instructions of the person giving you the survey.

Thank you very much for your help.

 SUICIDE PREVENTION PROGRAM 19

1. How old are you?

A. 12 years old or younger
B. 13 years old
C. 14 years old
D. 15 years old
E. 16 years old
F. 17 years old
G. 18 years old or older

2. What is your sex?

A. Female
B. Male

3. In what grade are you?

A. 9th grade
B. 10th grade
C. 11th grade
D. 12th grade
E. Ungraded or other grade

4. Are you Hispanic or Latino?

A. Yes
B. No

5. What is your race? (Select one or more responses.)

A. American Indian or Alaska Native
B. Asian
C. Black or African American
D. Native Hawaiian or Other Pacific Islander
E. White

The next 5 questions ask about sad feelings and attempted suicide. Sometimes people feel so
depressed about the future that they may consider attempting suicide, that is, taking some
action to end their own life.

6. During the past 12 months, did you ever feel so sad or hopeless almost every day for two
weeks or more in a row that you stopped doing some usual activities?
A. Yes
B. No

7. During the past 12 months, did you ever seriously consider attempting suicide?
A. Yes
B. No

8. During the past 12 months, did you make a plan about how you would attempt suicide?
 SUICIDE PREVENTION PROGRAM 20

A. Yes
B. No

9. During the past 12 months, how many times did you actually attempt suicide?
A. 0 times
B. 1 time
C. 2 or 3 times
D. 4 or 5 times
E. 6 or more times

10. If you attempted suicide during the past 12 months, did any attempt result in an injury,
poisoning, or overdose that had to be treated by a doctor or nurse?
A. I did not attempt suicide during the past 12 months
B. Yes
C. No

The next 2 questions ask about bullying. Bullying is when 1 or more students tease,
threaten, spread rumors about, hit, shove, or hurt another student over and over again. It
is not bullying when 2 students of about the same strength or power argue or fight or tease
each other in a friendly way.

11. During the past 12 months, have you ever been bullied on school property?
A. Yes
B. No

12. During the past 12 months, have you ever been electronically bullied? (Count being bullied
through texting, Instagram, Facebook, or other social media.)
A. Yes
B. No

The next 11 questions ask about violence-related behaviors.

13. During the past 30 days, on how many days did you carry a weapon such as a gun, knife, or
club on school property?
A. 0 days
B. 1 day
C. 2 or 3 days
D. 4 or 5 days
E. 6 or more days

14. During the past 12 months, on how many days did you carry a gun? (Do not count the days
when you carried a gun only for hunting or for a sport, such as target shooting.)
A. 0 days
B. 1 day
C. 2 or 3 days
D. 4 or 5 days
E. 6 or more days
 SUICIDE PREVENTION PROGRAM 21

15. During the past 30 days, on how many days did you not go to school because you felt you
would be unsafe at school or on your way to or from school?
A. 0 days
B. 1 day
C. 2 or 3 days
D. 4 or 5 days
E. 6 or more days

16. During the past 12 months, how many times has someone threatened or injured you with a
weapon such as a gun, knife, or club on school property?
A. 0 times
B. 1 time
C. 2 or 3 times
D. 4 or 5 times
E. 6 or 7 times
F. 8 or 9 times
G. 10 or 11 times
H. 12 or more times

17. During the past 12 months, how many times were you in a physical fight?
A. 0 times
B. 1 time
C. 2 or 3 times
D. 4 or 5 times
E. 6 or 7 times
F. 8 or 9 times
G. 10 or 11 times
H. 12 or more times

18. During the past 12 months, how many times were you in a physical fight on school property?
A. 0 times
B. 1 time
C. 2 or 3 times
D. 4 or 5 times
E. 6 or 7 times
F. 8 or 9 times
G. 10 or 11 times
H. 12 or more times
 SUICIDE PREVENTION PROGRAM 22

The next 11 questions address drug and alcohol usage.

19. During the past 30 days, on how many days did you smoke cigarettes?
A. 0 days
B. 1 or 2 days
C. 3 to 5 days
D. 6 to 9 days
E. 10 to 19 days
F. 20 to 29 days
G. All 30 days

20. During the past 30 days, on how many days did you use an electronic vapor product?
A. 0 days
B. 1 or 2 days
C. 3 to 5 days
D. 6 to 9 days
E. 10 to 19 days
F. 20 to 29 days
G. All 30 days

21. During the past 30 days, on how many days did you use chewing tobacco, snuff, dip, snus, or
dissolvable tobacco products, such as Copenhagen, Grizzly, Skoal, or Camel Snus? (Do not
count any electronic vapor products.)
A. 0 days
B. 1 or 2 days
C. 3 to 5 days
D. 6 to 9 days
E. 10 to 19 days
F. 20 to 29 days
G. All 30 days

22. During the past 30 days, on how many days did you smoke cigars, cigarillos, or little cigars?
A. 0 days
B. 1 or 2 days
C. 3 to 5 days
D. 6 to 9 days
E. 10 to 19 days
F. 20 to 29 days
G. All 30 days
 SUICIDE PREVENTION PROGRAM 23

23. During the past 30 days, on how many days did you have at least one drink of alcohol?
A. 0 days
B. 1 or 2 days
C. 3 to 5 days
D. 6 to 9 days
E. 10 to 19 days
F. 20 to 29 days
G. All 30 days

24. During the past 30 days, how many times did you use marijuana?
A. 0 times
B. 1 or 2 times
C. 3 to 9 times
D. 10 to 19 times
E. 20 to 39 times
F. 40 or more times

25. During your life, how many times have you taken prescription pain medicine without a
doctor's prescription or differently than how a doctor told you to use it?
A. 0 times
B. 1 or 2 times
C. 3 to 9 times
D. 10 to 19 times
E. 20 to 39 times
F. 40 or more times

26. During your life, how many times have you used any form of cocaine, including powder,
crack, or freebase?
A. 0 times
B. 1 or 2 times
C. 3 to 9 times
D. 10 to 19 times
E. 20 to 39 times
F. 40 or more times

27. During your life, how many times have you used heroin (also called smack, junk, or China
White)?
A. 0 times
B. 1 or 2 times
 SUICIDE PREVENTION PROGRAM 24

C. 3 to 9 times
D. 10 to 19 times
E. 20 to 39 times
F. 40 or more times

28. During your life, how many times have you used methamphetamines (also called speed,
crystal meth, crank, ice, or meth)?
A. 0 times
B. 1 or 2 times
C. 3 to 9 times
D. 10 to 19 times
E. 20 to 39 times
F. 40 or more times

29. During your life, how many times have you used ecstasy (also called MDMA)?
A. 0 times
B. 1 or 2 times
C. 3 to 9 times
D. 10 to 19 times
E. 20 to 39 times
F. 40 or more times

The next 6 questions address your knowledge and attitudes of depression and suicidal
behavior.

30. People who talk about suicide don’t really kill themselves.
A. True
B. False

31. Depression is an illness that doctors can treat?

A. True
B. False

32. If someone really wants to kill him/herself, there is not much I can do about it.
A. Strongly Agree
B. Agree
C. Neutral
D. Disagree
E. Strongly Disagree

33.If a friend told me he/she is thinking about committing suicide, I would keep it to myself.
A. Strongly Agree
B. Agree
C. Neutral
 SUICIDE PREVENTION PROGRAM 25

D. Disagree
E. Strongly Disagree

34. Please identify which of the following are key signs of depression and suicidal behavior.
A. Watching TV, playing video games with friends, eating 3 meals daily
B. Feeling hopeless, talking about suicide, loss of appetite, loss of interest in daily activities
C. Participating in fun activities, feelings of happiness, talking about homework

35. In the past 3 months have you you received treatment from a psychiatrist, psychologist, or
social worker because you were feeling depressed or suicidal?
A. Yes
B. No

36. In the past 3 months have you talked to some other adult (like a parent, teacher or guidance
counselor) because you were feeling depressed or suicidal?
A. Yes
B. No

37. In the past 3 months have you talked to an adult about a friend you thought was feeling
depressed or suicidal?
A. Yes
B. No

38. In the past 6 months did you follow up with a referral to see a mental health counselor?
A. Yes, I received a referral and saw a mental health counselor
B. No, I received a referral and did see a mental health counselor
C. I did not receive a referral

This is the end of the survey. Thank you very much for your help.
 SUICIDE PREVENTION PROGRAM 26

Budget
Income Amount

Grant $ 100,000

Expenses

Personnel
4 Program Educators - $16 per hour 28 / year (each) $1,792.00
 4 Training sessions at 4 hours each
 2 Program meetings at 2 hours each
 8 class lecture leads at 1 hour each

8 Program Assistants – In Kind $00.00

(Teachers, School counselors, Volunteering Parents)
 1 training session at 3 hours
 8 lecture assists at 1 hour each
5 Survey Data Entry Operators - $10 per hour 32/ year (each) $1,600.00
 8 intervention pretest referral entry sessions at 4 hours (each)

2 Program Counselors – $80 per hour 52 / Year (each)

 Walk - in counseling sessions
o Available 4 hours / 1 day per week 52 / Year (each) $33,280.00
1 External Program Evaluator $15,000.00
 SUICIDE PREVENTION PROGRAM 27

Total: $51,672.00

Materials and Supplies

 Office Supplies $ 10,000
 Suicide Prevention Pamphlets
 Suicide Hotline Business cards
 Posters
 Surveys
 DVDs
Pretest Incentives $2,875,00
 50 Amazon gift cards at $25 (each) 1250
 Pizza Parties – 1 / school at 250 students
o 83 cheese Pizzas at $ 12.50 (each)
o 42 Pepperoni Pizzas at $14.00 (each)
 Printed Homework passes – In Kind
Total: $12,875.00

Total Program Cost: $64,547.00

 SUICIDE PREVENTION PROGRAM 28

Timeline
 SUICIDE PREVENTION PROGRAM 29

References

Aseltine RH Jr., & DeMartino R. (2004). An outcome evaluation of the SOS suicide prevention

program. American Journal of Public Health, 94(3), 446–451.

https://doi.org/10.2105/AJPH.94.3.446

Center for Disease Control (2015). National Vital Statistics Reports. Deaths: Leading Causes for

1015. 66(5), 1-76. Retrieved from

https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_05.pdf

Center for Disease Control (2017) Youth Risk Behavior Surveillance. Morbidity and Mortality

Weekly report. 67(8), table 45-49. Retrieved from

https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf

Centers for Disease Control (2018). Violence Prevention. Preventing Suicide. Retrieved on 27

September 2018 from https://www.cdc.gov/violenceprevention/pdf/suicide-factsheet.pdf

Duval County Public Schools (2017). Youth Risk Behavior Survey Duval County High School

Students, 2017 Violence, Suicide, and Safety Behaviors. Retrieved on 26 September

2018 From http://duval.floridahealth.gov/programs-and-services/community-health-

planning-and-statistics/youth-risk-behavior-survey/_documents/hs-atod-report-2017.pdf

Duval County Public Schools (2018). Health Education / Course Information. Retrieved on 30

September from https://dcps.duvalschools.org/Page/17549

Duval County Public Schools (2018). About Us. #TeamDuval. Retrieved on October 1, 2018.

from https://dcps.duvalschools.org/domain/5268
 SUICIDE PREVENTION PROGRAM 30

Florida Department of Health (2017). Division of Public Health Statistics and Performance

Management. Suicide Deaths. Accessed on 27 September 2018 from

http://www.flhealthcharts.com/charts/DataViewer/DeathViewer/DeathViewer.aspx?indN

umber=0116

Florida Departments of Health (2012). Community Health Assessment and Community Health

Improvement Plan. Duval County, Florida. Accessed on October 1, 2018. Retrieved

from http://duval.floridahealth.gov/programs-and-services/community-health-planning-

and-statistics/_documents/chip.pdf

King, C., Horwitz, A., Czyz, E., & Lindsay, R. (2017). Suicide Risk Screening in Healthcare

Settings: Identifying Males and Females at Risk. Journal of Clinical Psychology in

Medical Settings, 24(1), 8–20. https://doi.org/10.1007/s10880-017-9486-y

National Institute of Mental Health, Science News. Age-Related Racial Disparity in Suicide

Rates Among US Youth. Accessed on 28 September 2018. Retrieved from

https://www.nimh.nih.gov/news/science-news/2018/age-related-racial-disparity-in-

suicide-rates-among-us-youth.shtml

Pena, J., Kueberis, A., Lee, R., & Herman, D. (2018). Risk profiles for suicide attempts,

drug use, and violence among dominican, mexican, puerto rican, and non-hispanic white

youth in new york city: Implications for suicide prevention initiatives. Centro Journal.

Vol 30 Issue 1, p. 82-104.

 SUICIDE PREVENTION PROGRAM 31

Phoenix K. H. Mo, Ting Ting Ko, & Mei Qi Xin. (2018). School-based gatekeeper training

programmes in enhancing gatekeepers’ cognitions and behaviours for adolescent suicide

prevention: a systematic review. Child and Adolescent Psychiatry and Mental Health,

Vol 12, Iss 1, Pp 1-24 (2018), (1), 1. https://doi-org.dax.lib.unf.edu/10.1186/s13034-018-

0233-4

Suicide Prevention Resource Center. (2013). Suicide among racial/ethnic populations in the

U.S.: Blacks. Waltham, MA: Education Development Center, Inc. Torcasso, G., & Hilt,

L. (2017). Suicide Prevention Among High School Students: Evaluation of a

Nonrandomized Trial of a Multi-stage Suicide Screening Program. Child & Youth Care

Forum, 46(1), 35–49. https://doi-org.dax.lib.unf.edu/10.1007/s10566-016-9366-x

Wyman, P. A., Brown, C. H., LoMurray, M., Schmeelk-Cone, K., Petrova, M., Yu, Q., … Wang,

W. (2010). An Outcome Evaluation of the Sources of Strength Suicide Prevention

Program Delivered by Adolescent Peer Leaders in High Schools. American Journal of

Public Health, 100(9), 1653–1661. Retrieved from

https://login.dax.lib.unf.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true

&db=s3h&AN=53737585&site=eds-live&scope=site