Mental Health First Aid

Suicide: Prevention, Screening and Response

marge paccione phd
Margaret R. Paccione, PhD

by Margaret R. Paccione, PhD
Director of Clinical Innovation, Bradley Hospital

Youth suicide is a serious, but largely preventable public health challenge. A new community program at Bradley Hospital is helping to address this tragic problem.

In 2014, suicide became the second-leading cause of death among American teens ages 15 to 19, and the third leading cause of death among American children between the ages of 10 and 14.  Since 2007, the rate of suicide deaths among young teens (ages 10 to 14) has doubled. Although girls between the ages of 10 and 14 make up a very small portion of the total suicides in the U.S. population, they have experienced the largest percent increase in suicide deaths, tripling in the past 15 years.

Teen suicide attempts also are on the rise. The percentage of American children and teens hospitalized for suicidal thoughts or actions doubled between 2008 and 2015. The reasons for this upward trend are unclear, but rates of depression among American teens and young adults (aged 12 to 20) are increasing. A recent series of bullying-related suicides in the United States have drawn attention to the pervasiveness of bullying among students in grades 6 through 10. Nationwide, more than one out of every five students report being bullied. Even though the majority of youth victimized by bullying/cyberbullying do not commit suicide, in many cases bullying increases a young person’s risk of thinking about suicide and making a plan.

Rhode Island Youth Risk Behavior Survey

The statistics from Rhode Island validate the national trend.  The Rhode Island Youth Risk Behavior Survey (YRBS) is an anonymous survey of randomly sampled high school and middle school students, administered by the Rhode Island Departments of Health and Education in collaboration with the Centers for Disease Control and Prevention, to assess adolescent behavioral health risks.

The 2017 YRBS middle school data showed that 18 percent of Rhode Island students in grades 6 to 8 seriously considered attempting suicide. Of the students who contemplated suicide, 6.5 percent indicated they had attempted suicide in the past year. The 2017 Rhode Island high school YRBS found that 15.9 percent of high school students in grades 9 through 12 seriously considered attempting suicide, and 9.9 percent of students who contemplated suicide said they had attempted suicide in the past year. Needless to say, this data validate a highly concerning public health crisis that painfully touches the lives of many Rhode Islanders.

Warning Signs and Risk Factors

There are often warning signs you can look for if you suspect suicidal tendencies. A Rhode Island Child Death Review Team case review found that there was a documented history of suicide attempts and/or statements for 80 percent of children and youth who died by suicide. 

According to the US Centers for Disease Control and Prevention, youth who are at increased risk for suicide include those who:

  • Have a family history of suicide
  • Have a family history of child maltreatment
  • Experience barriers to accessing mental health treatment
  • Experience poverty
  • Have recently immigrated
  • Have easy access to lethal means (such as firearms or lethal drugs)

Individual characteristics that indicate an increased risk include:

  • A history of alcohol and substance abuse
  • Impulsive or aggressive tendencies
  • Sexual minority status
  • A history of mental health disorders (especially clinical depression)
  • Social isolation

Suicide: Prevention, Screening and Response for the General Public

Every 12 minutes, someone in the United States dies by suicide. Suicide is a preventable public health problem and prevention depends in large part on appropriate screening and response. The clinicians at Bradley Hospital designed a training program, specifically for individuals who do not have a background in behavioral health. Suicide: Prevention, Screening and Response is a 3-hour class offered to anyone in the community who may wish to learn more about suicide prevention. Educators, public safety personnel, family members, health care workers, faith leaders, transportation workers, food service employees, community members, in fact, anyone who interacts with children or adults will benefit.

Upon completion of this program, participants learn to administer the Columbia Suicide Severity Rating Scale-Screen Version (C-SSRS Screener) and learn how to respond appropriately to the needs of the individual being screened based on the results. The C-SSRS Screener is an evidence-based tool, consisting of a maximum of 6 questions, designed to be used by those without specialized training in suicide assessment.  Participants also review current Rhode Island and national statistics on suicide, and learn risk factors, warning signs, and myths and facts. Local resources will also be presented.

Participants have the opportunity to practice using the C-SSRS Screener in a safe, supportive environment through the use of video demonstrations, case studies and role plays.

Any member of the community can register to take the course. The cost is $39. For clinical information about this course or to obtain group rates, contact Scott Sylvester at 401-606-5754 or email

Learn more about mental health first aid