lastly, implementation and dissemination. how do you do it? several performs, the garrett lee smith memorial act, youth suicide grants across the country, many tribal entities also to do suicide prevention have showed some effectiveness. the suicide prevention lifeline, 1-800-273-talk, has shown that it can get people to call or get someone to call on behalf of someone else, and then there's also a national registry of evidence-based policies that give some policies that have proven to be successful in regards to suicide prevention. so in conclusion, suicide is a significant public health problem, results from an interaction of fact factors. there's no one thing, but it's often times an interaction. bullying can be one of the precipitating factors, but often times it's something that is added on to the other risk factors that an adolescent might

have. there's a broad respondent for addressing the problem. it's not just the schools, not just law enforcement, not just social service, it's all of them together, working together to prevent suicide behavior. and there's multiple opportunities for action. there's a lot of places that the skills of all the different disciplines, of all those different organizations can bring to bear on actually preventing suicide. thank you very much. [applause] >> okay. and thank you, alex. and we're going to pass it over to iris prettypaint. do you want to stand? okay, yeah, it's kind of hard -- if you haven't been up here, we can see about three seats, and everything else is empty, so -- thank you, iris. >> thanks. i just realized i couldn't see over the top of that table. i was going to sit down. well, i want to share some thoughts today about the work that we do particularly our project called native

aspirations. and so in looking at the whole issue of bullying which is one of the focuses in the project, i realize that everyone comes at defining their issue in a particular way if it connects up to whatever school system they might be connected to, if they're working, you know, whatever elementary or secondary or even postsecondary. but one of the things that was striking to me as i looked at this definition is that for the work that we do we have to look through the cultural lens of the communities that we engage. and in looking at that cultural lens we have to look at the history. and if looking at the history -- in looking at the history of the issue of violation, because suicide is violence, bullying is violence, and in looking at that

contagion i began to realize that we have to come to an understanding in the way that we communicated with our communities about where some of these issues originated. and so it's so important to me in the definition of bullying that you take the time if you're going to work with native populations to look to the history. and when you look at the history, you have to understand some concepts. one of them is colonization, the other is the whole notion of war, and as you look at those things that are in the center on this slide, you realize that many times you're dealing with communities that have been relocated from maybe where they originated, and they've been put on reservations. and maybe many times those reservations have numerous tribes that are living together,

but historically they were not even from the same region sometimes. in looking at bullying and understanding the historical context, one of the concepts that comes forward is the issue of historical trauma. and how would you feel if someone took away your ability to speak your language, outlawed it? how would it feel if someone created situations where you could not practice your spiritual faith, your fellowship? and over time when you look at the history of native populations, they went through many over generations of losing their land base. and all of that sort of comes together in a way where you look at a young person's identity of who am i?

we're the only race of people, i believe, in this world that have to prove our membership through a blood quantum to belong to our tribes. and so if you have that kind of definition of membership and you're not enough to be enrolled but you've been raised in that community, that's a source of bullying that many times our communities are unable to talk about. but it's very painful, very hurtful. and so, you know, people are addressing those issues today. i come to the point where i find myself helping people to understand the complexity of this issue. and i look at all the data, i look at all of the statistics that face the communities, and i look at the alcohol rates. i look at the connection between suicide, bullying and alcohol

abuse. i have to. because many times when we're listening to what's going on in our communities, those situations come out of alcohol abuse. and so you have to pay attention to everything that surrounds that issue. if you look at all of these circles here, when you enter these communities, you have to be prepared to enter communities that are multicultural, they're multijurisdictional, they're multiinstitutional. so if you're going to bring an approach forward, and we've learned this through native aspirations, that you have to deal with so many different systems and people that are layered in your community that you have to be aware of sort of what you're taking on. and so at native aspirations,

you know, some of the stories that have been shared with us about what works are many times not in the literature, they're not in the research because they're embedded in the community of the people. and they're looking to their own cultural ways of healing. they're looking to their own practices of how can we -- i like the word restorative. how can we restore our balance? how can we create situations of facilitation? because as you study oppression, one of the first skills that you lose is the ability to plan. and so you have to go back and teach those basic skills many times in the communities. so i want to show you a map here. these are the 65 different federally-recognized tribes that native aspirations works with today. we have several regions, and i

appreciated the earlier map about the rocky mountains because that's basically where native aspirations began. when we have a suicide cluster in our communities, you know, those rates can go ten times higher than any place in the country. and we're looking at communities, you know, up in alaska that have 19 young people, young males under the age of 18 that are taking their lives. and yet they come from such remote villages that there are maybe 2-300 people that live in the village, they're a fly-in community meaning there are no roads, there is no access. they have a very different structure around subsistence. and all of those regional differences come to bear on the work that we do. we take the communities through what we call the native aspirations journey. and we have lessons all along

this journey that we've learned from communities around the issue of bullying. what do you do when you have an elected leadership, an elected tribal council that are bullies in your community? how do you, how do you engage that level of leadership? how do you bring them to the table? and one community in wisconsin told us we don't know what native aspirations did to us, but for some reason we learned to forgive each other, and we worked together. we brought everybody to the table whereas historically there were, there were a lot of issues, and people could not come together to work on what they needed to do. and so in closing today i just want to show you as we do our assessment looking at all the cultural strengths of our people and building plans that are grounded in these issues as opposed to the deficits, it's

very easy to go to what a community doesn't have as opposed to what they've survived with, what they've tapped into and what they build prevention from. we have used a lot of evidence-based interventions, but we're finding in these communities that the culture-based innovations and all these other examples are what they're using to go forward, and bullying needs to be interwoven among all of these. thank you. [applause] >> thank you, iris. and now we're going to turn it over to alan acosta. >> they didn't tell us the hardest part of this would be getting in and out of the chairs. well, thank you for this

opportunity to talk to you today. i'm here to talk about project spin, suicide prevention and intervention now, which is a collaboration among the l.a. gay and lesbian center to end suicidal ideation and reduce homophobia in the l.a. unified schools. just some quick basics. the l.a. center is the largest lgbt organization in the world. 320 staff, a budget of over $60 million, 300,000 client visits a year. we do a wide range of medical and mental health services for our clients who could not afford to get them otherwise. the l.a. unified school district, second largest in the country, 665,000 students more or less, more than a thousand schools. and they've also been a pioneer in addressing issues that face lgbtq kids. and many, many years ago started project ten which was a project for lgbt kids within the schools.

i won't spend much time on these statistics because robert mcgarry did a great job yesterday in his presentation, most of -- i'm not going ahead. i'm sorry, i should be -- there. that's all the statistics i just talked about. i'll remember now. um, robert did a great job yesterday of talking about these statistics. i will say that, um, there hasn't been a lot of data collected on lgbt people and in particular youth, and i'd like to just sort of give props to the obama administration for if many of their departments -- in many of their departments being real leaders in this area, beginning to collect those statistics which will give us the data to come up with programs and strategies that are appropriate for the degree of the problem. what little data we do have shows it's clear enough, though, the negative impact of homophobia and transphobia means that lgbtqouth are at greater

risk of dropping out of school, and they experience depression, violence, harassment, substance abuse, homelessness, hiv infection and suicidal ideation at much higher rates than their heterosexual counterparts. towards the end of 2010, um, it was in this context that we, all of us thought about suicide among lgbt youth, but particularly at the end of 2010 with the media coverage of some very high profile suicides from the lgbtq kids. and you should say i'm using lgbtq as a shorthand, but in this presentation i also mean those who are presumed to be such, those who are defined as such by others who may not actually be lgbt. they suffer from the same discrimination and violence that lgbt kids do. so maybe gender nonconforming is

a synonym for that as well. but at the end of 2010 we saw this coverage, this media coverage of very high profile suicides among tyler yes minutety and others, and we got together the executive staff at the center and thought this is a particular moment in time that we have the, we have the attention of people, and what is our responsibility as one of, you know, one of the leading lgbt organizations in the country? and we didn't want to just issue a press release and say how terrible this was, because it is terrible. but we'd known this had been going on for a long time. this was not news to us. so we decided what we were going to do was call up the president of the l.a. unified school board and just say we want to have a meeting with you. she was very open to that. we scheduled the meeting, and we had about an hour meeting with monica garcia, the president of the school board. it was an interesting meeting because we went in saying we didn't want -- of course we

wanted to solve the problem of lgbt suicide, but we wanted to deal with the conditions in which lgbtq kids would even consider suicide. so we were talking about a much broader kind of mental health perspective than just suicide, um, and, you know, it's -- i'm sure if you work for a school district, you have a lot of people coming in and telling you what you should be doing and probably saying and you should do that without us giving you any money, by the way. so monica, though, was very attentive, and at the end she said i get what you're talk talg about, you're talking about changing the culture of the l.a. unified schools. and we said that's exactly what we're talking about. from that moment on we had a very strong partnership with the school district leadership and the people who are working in this area. um, i am -- oh, i'm going backwards? oh, that's why. i just can't get this.

okay, there we go. so, um, we'd like to talk about some core principles we have here that, um, we're looking at this issue in a holistic way meaning that the problem is not youth, it's society, it's transphobia and homophobia. we want to look at it holistically in that we want to get beyond just a discussion of bullying that even though we see the connection and perhaps the catalytic nature of that, and we also wanted to talk about suicidal ideation, not just suicide. in order to address those large issues, we had to take a comprehensive approach, so this is the kind of practice we're using which was to attend to issues in a number of different areas. a number of them have been mentioned already today, mental health, family acceptance -- which we think is very important. carolyn ryan, if you haven't seen her work with regard to

lgbtq youth, it's really important work. community involvement, getting churches involved, law enforcement and cbos and school safety. and the key kind of practical way of implementing this would be through collaboration. there's great work being done in l.a. usd, and there are a lot of groups out there doing really great work in this area, and we weren't going to reinvent the area. we don't have lapd on here, but they are involved as well. in addition to trevor project, glsen, pflag and others, we also have the county department of meant aal health. a great -- mental health. a great number of groups have gotten involved with us and are sitting on the steering committee. in addition, from the l.a. usd we have the office of mental health and the school board.

this is the model, basically, it establishes work groups around each of those areas that i've just talked about. and it's very practical. this is, work needs to be done in these areas, and we assigned people who are coming to the steering committee to these various areas. the one area that seems like perhaps wasn't completely practice-oriented was transgender support, and that's primarily because we saw as in society at large, the discrimination, the violation, the mental health and health issues that the transgender community faces are so much more severe than anybody else, and we really wanted to put special attention on that. we began, um, partially with bully prevention because the lausd has done some really good work on that, and they have created a model that is quite good. some of you may know dr. judy chasten who has really been a

pioneer in putting together some of these workshops and trainings. so the work we do supports work that is already existing at lausd. we're not there to tell them what to do. we've felt that part of this holistic approach is we think this could have a broader impact by teaching skills that would apply to all forms of bias, and we hope that work will make those commitments more safe and have a better educational experience as well. gender nonconforming youth in general, persons with disabilities, youth with different physical appearance, youth from diverse religious communities and recent immigrants and children of immigrants. and, of course, in southern california it's a very, very important issue for us. um, we have seen sort of the demonization of those groups, and it's very important to work to help them. challenges, working with different cultural backgrounds,

90 languages in the lausd, many different cultural perspectives. bridging cultures and ours as a cbo, allying values with practice. often times you see things at the top of these organizations that don't always get implemented at the ground level, so that's within a challenge -- that's been a challenge as well. we've had -- i will just quickly go over our achievements. we've really changed the tone of the discussion in the lausd. we've greatly increased the number of trainings that are going on. now we're beginning to train the trainers which we think is very important and will leverage our work even further. i'm going to end with just a little bit of a pep talk because this is a huge, huge challenge to solve these problems. we didn't -- in many ways, we're experts in certain areas, but we certainly weren't expert in other areas, but we felt that something needed to be done, and we couldn't wait for somebody else to take leadership in that

area. so i would just encourage people , in our small group yesterday when we were talking about improving communication among groups, um, we came up with two words, convene and galvanize. and i guess the advice i would give is don't wait for somebody else to do that. convene people, and galvanize the efforts, leverage what you're doing already into something greater. thank you. [applause] >> thank you, alan. and now we'll turn it other to nicole cardarelli from afsp. >> hi, everyone. thank you to start to dr. temkin and the other federal partners here today, um, for organizing this summit and for giving afsp the opportunity to participate in this very important panel. i wanted to start out today by identifying some of the positive

and problematic results of the recent emphasis that we've seen predominantly in the media, but also within the bullying prevention movement itself on bullying and suicide and the link between the two. i'll then briefly present the model for understanding youth suicide in the context of multiple risk and protective factors, although we've already covered some of this today, so i won't go into too much detail there. and then the majority of this today will really focus on emphasizing and offering guidance on safe messaging around bullying and suicide. so over the past couple of years we really have seen a very unprecedented attention by the international, national and local media, by social media, by advocacy groups, politicians, entertainers, film makers. there's now all of this attention on bullying and suicide. this has actually had a positive impact on the discussion. we have a much wider recognition

of the serious harm that bullying inflicts. we are seeing increased awareness of the disproportionate burden borne by the most vulnerable youth. we're seeing a boost in anti-bullying legislation and programs at the federal, state and local level, so all levels of government. and we're also taking part in a very compelling national and grassroots conversation about these issues which has been really great. however, there's also a downside to this heightened attention that i want to highlight here. um, we are seeing very frequent rhetoric that includes use of terms epidemic, suicide epidemic or bullying epidemic or the use of the term bullycide, and i'm going to go into much greater detail on why these terms are problematic on the next slide. we also have an increased lack of clarity around what bullying actually is. we have no standard definition among states and school districts, researchers and within the media, and we also

realize that bullying may have different meanings for youth and for adults. so we're now seeing a very wide variance in estimates of the actual prevalence of bullying, and we're also seeing wide variety in legal and disciplinary measures as well. there's also now this expectation that bullying is a factor in any suicide that occurs, especially among youth. but this is regardless of any evidence of there being a link to that effect. and we're also seeing very frequent violations of our media recommendations for reporting on suicide safely. some of those, some of the reasons that we're interested in these recommendations is that there are very numerous research studies worldwide that have found that certain types of news coverage can actually increase the likelihood of suicide in vulnerable individuals, and that's based on the amount, duration and prominence of the media coverage. the risk of additional suicide

actually increases when the story explicitly describes the suicide method, when the coverage uses very graphic or dramatic headlineses or images, and when there's repeated or extensive coverage that sensationalizes or glamourizes death by suicide. and this is actually what we're seeing in the reports of bullying and suicide as of late. they are very sensationalized in the headlines, we're seeing little attention paid to other suicide risk factors that we've covered today, most notably depression and other mental illness which we know is present in upwards of 90% of suicide deaths. we're seeing a focus on personal details and the methods of suicide and repeated references to prior suicides of bullied youth. and this is actually creating a narrative of death by bullying or this bullycide narrative. and this is very problematic. those of us in the suicide

prevention movement are very, very concerned about this. first and foremost, this death by bullying narrative is really normalizing suicide as a reaction to being bullied. it's empathizing frequency and similarities among teen suicide deaths, and that's making suicide seem normal, common or acceptable. and this increases the risk of suicide contagion or those copycat or imitation suicides that we can see in those clusters. this narrative also fosters an emphasis on blame and punishment, and it's misdirecting our attention away from some of the bigger issues that we would rather focus on, notably getting help, support and treatment for youth who are bullied and also those who bully others as we heard today that both of those groups and young people who are involved in both types of behaviors are at risk. and we're also not keeping our attention on the bigger picture. which is recognizing and addressing those social values that actually provide models for

bullying in greater society. this death by bullying narrative also advances significant misinformation about the causes of suicide and how it can be prevented. this narrative is implying that adverse life events lead directly to suicide regardless of individual vulnerabilities in the young person who died. it's focusing on a single factor is causing suicide which is rarely the case, as we saw today, a very, very complex relationship. suicide is most often caused by a number of factors, internal and external, to the individual. this narrative also views any attention that we pay to those individual vulnerabilities and differences within the youth as blaming the victim, and we're not trying to do that at all. we're actually trying to amend the conversation to make it more safe for young people who may currently be at risk. so what does the research tell us about this relationship? i'm not going to go into detail, you heard there some great

experts today. but first and foremost, the studies are consistently showing that youth who have been bullied, those who bully others are more likely to report depression, suicidal thoughts, attempts. however, suicidal ideation and attempts occur in a very small percentage of youth involved in bullying, and that's the message we want to convey. the longitudinal studies are showing that when you look at youth who are bullied and also depressed, those are the youth who are later at greater risk. if you take depression and other mental disorders out of the equation, the link between bullying and suicide decreases significantly. i'm going to skip over this here. oops. so this model here, this dual risk model is really just answering the question what does cause suicide in youth. to put it in summary form, there's a difference between

individuals who are resilient or in a resilient state and those who are vulnerable. we see that in a resilient state people generally adopt to both negative and positive events, so regardless of whether or not there are stressors in their life, they can adapt to both situations equally well. in a vulnerable state, on the contrary, people adapt when things are going well, but when they're having a difficult time, when they're faced with negative or adverse events or stressors, this is when the consequences that we're seeing negative outcomes. and resiliency and vulnerability are influenced by a multitude of factors. um, those that contribute to vulnerability to suicide or that die wrath sis, the red line that you see here that goes down into the negative outcome, factors that contribute to that vulnerability include genetic influences, having a family history of depression or suicide, early adverse events, childhood neglect and abuse and

things like that, developmental and mental disorders, depression, anxiety, bipolar disorder, physical disabilities and chronic illnesses, certain personality traits, certain psychological and emotional characteristics, intense emotional states like despair, hopelessness and then also having a history of ideation or attempts. all of these different factors can contribute to vulnerability in young people. and then there are also factors that contribute to risk in already-vulnerable youth. these include later childhood/early adolescent stressors like bullying and peer relationship problems, also substance use, access to lethal means and that normal ideation of suicide or that death by bullying narrative that i talked about earlier. there's a very complex relationship between bullying and other factors, and we found a really great slide that had lots of arrows, and you can see it's not just a single one cause

that results in suicide among young people, but a varying number of factors. but what i really wanted to focus on today was the safe messaging piece. and there are two really, really great resources that are available that give guidance about safe messaging on bullying and suicide so we can avoid, um, that contagion or that unsafe messaging that so often happens when we're talking about them in a very direct way. we want to encourage accurate and safe portrayal of suicide in all forms of the media, and these two resources to help with that. they basically are etch sizing the -- emphasizing the potential of the media to change public misconceptions and correctness about suicide, and they actually encourage the media to take a more active role in encouraging vulnerable people to get help. these two resources describe how media coverage can increase and decrease the likelihood of suicide in vulnerable persons. they emphasize the complexity of

suicide causation, they encourage the media to offer hope and information about resources and provide recommendations for safe and sensitive language and reporting about suicide. the one on the right is available at reportingonsuicide.org. it offers a lot of really practical do this, not that type of information. the other talking about suicide in lgbt populations that you see on the left, we're actually going to have those available later at the mix and mingle, talk specifically about lgbt populations and also bullying and suicide and how we can talk more safely about those issues. that's it, thank you. [applause] >> thank you, nicole. and finally, we'll turn it over to michele ybarra. >> hi. wow, what a great panel, what an amazing morning it has been. also a lot of words, right? a lot of slides. thank you so much for sticking it in, sticking it through. you can notice i'm at the end

which mean we are all getting towards the end. this is good news. so what i'm going to be doing today is, um, perhaps maybe pulling it all together, the panel all together, and at the same time doing a deeper dive, um, into some of these issues. we're going to get into some data and, um, give some numbers to some of the things that we're talking about in terms of bullying and suicidal ideation. as we've been talking about today, and i know that this is not the first time we've discussed it at this panel -- rather, at this, um, this conference. even last year there was this discussion about the relationship between suicide and bullying. and certainly the media seems to have made a decision that there is a strong link. if you were to do a search on bullying suicide, this is the first web site that comes up. very clearly they say there's a strong link. so the media have decided, but what do the data say? well, as we've talked about already, suicide's the third

most common cause of death among clements. suicidal ideation is important because it can be a precursor to suicide. so certainly not everybody who thinks about, um, dying by suicide does, but it certainly is an important warning factor that we can take a look at. and as we've been talking about in emerging risk factor in the literature for suicidal ideation and behavior is bullying. what we need to do, how far, and as we've talked about in this panel is understand how bullying fits within this larger context of other characteristics of other risk factors that we know also can contribute to an increased risk for suicidal behavior and ideation. so today i'll be sharing some data from what we're talling the teen health and technology survey. we were in field in 2010 and 2011. multiple partners, which means we had a lot of ethical boards looking at our plans and approved, um, what we did. we did have parental permission

waived because we were asking very sensitive questions, and we wanted to make sure our young people were safe and they weren't put in harm's way by taking part in our survey. we did do the survey online, and our participants were about 13-18 years of age. so we are talking about adolescents in middle school and high school. purposefully, we wanted to make sure that our groups were, um, that we had sort of a nice representation of age across, so it would make sense that our average is 15.6 years of age. and about on purpose half of our kids were male and half of our kids were female. and then we weighted the data so they approximate a nationally representative sampling, so about 70% are white, 20% hispanic, 7% represent, self-reported to be lgbq, about a third are suburban and about one in four report being born-again christian. so i think it's really important when we talk about, um, data

that we are really clear about what exactly it is that we're talking about, and the only way to know that is to, number one, understand where our data are coming from and, number two, understanding how we're measuring what we're talking about. so in our survey what we did was we took an item from a well validated scale of depression called the cesdr, and there's an item on that scale, and it says i wish i were dead. and we asked young people how often did you feel this way in the last two weeks. and they had five different options from not at all or less than one day in the last week to nearly every day for two weeks. so what we'll be looking at today are those young people who said that i felt, i wished i were dead one or two days in the last week or more frequently. the issue of how to measure in surveys bullying is an ongoing discussion, and that is beyond the scope of what we'll be talking about today. but i do want to be clear about how we measured it in our

survey. we spent a lot of time thinking about how we can understand where bullying is happening across these multiple different modes, across these multiple different environments that young people have to try to figure out how to safely navigate in their lives and at the same time not double count, right? especially with convergence of technology, you can be online with your phone while you're at school. and so how do we ask these questions so that we can understand what's going on? and the way that we now do it is that we ask about mode, and we ask about type. so we said bullying can happen anywhere. like, at school, at home or other places you hang out, so not just at school. bullying can happen other places n. the past 12 months, how often or but you bullied or harassed in person, by phone, through text, online or some other way. and then we asked young people about seven different types. we said, you know, again, in the past 12 months how often have others your age bullied or harassed you, and then there's

seven different types, pushing or shoving would be one example. okay? young people who said they had been bullied either through the mode or any type, then we asked a follow-up question about differential power. and as you know, differential power is a key piece of what distinguishes bullying from other more generalized forms of aggression. so we said thinking about the last 12 months were you ever bullied or harassed by somebody who had more power or strength than you? this could be because the person was bigger than you, had more friends, was more popular or had more power than you in another way. so we wanted to be sure that we were broad in our discussion about what power meant so that when young people, um, responded, that they had lots of different ways to determine whether or not their bully had more power. so in our sample what we looked at, what we'll be looking at today are young people who said, no, i have not been bullied or harassed through any of those modes or through any of those ways. and it's hard for me to now see

that number. the number is 46%, it's that purple part of that slide. 46% said no to everything, okay? then we had 45% who said, yes, i have been bullied either through these modes and/or in these ways. and then we had 15% who said, yes, and my bully had more power. so what we'll do from here on out, we'll talk about those 15% as being bullied, and we'll talk about those 45% as being victims of general aggression. now, on the right-hand side what i want to share with you is recent suicidal ideation. 88% of our kids said, no, i haven't wished i were dead in the last two weeks. 1% said -- 12% said yes. and you can see the frequency. 6% said one or two days in the past two weeks i did wish i were dead, and then another 6% said they felt that way three or four times -- days or more frequently. so when we put it together, when

we say, okay, young people who report being victim of nonbullying aggression and of bullying, what are their odds of reporting suicidal ideation compared to young people of who have not been victimized by peer aggression in the last year? what this slide shows is among all youth which is that left-hand side that young people who have been victims of peer aggression are 1.4 times or 40% more likely to report suicidal ideation in the past two weeks compared to those who report not being victimized. and that those who report being bullied -- again, the difference is the differential power -- those who report being bullied are 3.6 times more likely to report suicidal ideation. and when we look at by males and females separately, and that's the middle and the right hand, that we see similar associations, right? is that in both -- so that in both cases nonbullying peer

aggression is slightly higher than young people who have not been victims, but those who have been bullied, males are three times more likely and females are four times more likely to report suicidal ideation compared to nonvictims. as we've talked about, however, there is, um, a large contextual sphere that we need to take into account as we understand what's happening with our young people. and once we do that, once we take into account all of these things that we show on the slide -- sexual orientation, depressive symptomtology, self-esteem, social support -- what we see is that the relationship between bullying and suicidal ideation goes away. so that the bars are slightly higher than one, but nothing is statistically significant, so what i'm going to do is i'm going to go here, and then i'm going to go here, right? so there is an association. absolutely. and once you take into account

what else is going on with these young people's lives, it appears that other factors including depression, self-esteem and coercive discipline by parents actually are stronger predicters of suicidal ideation for young people. um, i'm going the wrong way for lots of reasons. okay. [laughter] what i want to do because i know that we also are interested, are concerned about sort of online bullying versus in-person bullying, i'm actually going to go back. so this looks at it by mode, and the point of this slide here is that young people are much more likely to be bullied in person than through any ore way. and -- any other way. and so, for example, we've got more than -- and i'm trying to do the math in my head, we've got 38% who say they've been bullied in person in the last year compared to 17% who have been bullied online. so that's twice as likely to be bullied in person.

so i think that's an important contextual factor. why do i keep doing that? so when we look at it across mode, there is, again, what we see is being bullied is associated with suicidal ideation, and when we take into account other important contextual factors, the other factors seem to be more important in many ways, um, in understanding suicidal ideation. so i'mgoing to leave it here, um, but i would like to acknowledge our funding from the nichd. thank you so much. [applause] >> some reminders, if you have questions, please, write them on the cards, and then we'll get them up here and read them out loud and have the panelists answer them. again, if you have a specific panelist, please, write that. if you don't write anything, we'll assume it's anyone who would like to answer it can answer it. [inaudible conversations]

>> okay. this one is for iris. in your work with youth in tribal commitments, have you found that feeling isolated from perceives cultural insignificance in relation to nonnative cultures contributes to suicide? in your work with youth in tribal communities, have you found that feeling isolated from nontribal communities and perceived cultural insignificance in relation to nonnative cultures contributes to negative behaviors and suicide? >> well, some of the, some of the issues that, you know, intersect with that is there's a lot of border communities to these reservations.

and, you know, recently i was looking at some data about rape and the increase of rape. and 75% of the rapes were from nontribal members. and when i looked at that piece of information, i was surprised, and i thought, you know, i thought we made a lot of progress. i thought we'd come a long ways. but yet we still have a lot of work to do. so, yeah, i think there's a lot of intersecting issues that come to play on, you know, the communities themselves and the ones that surround the reservation. >> thank you. >> i'm going to read one. it says a challenge in the muslim community is to encourage a healthy identity and a school and societal system that may be working to undermine that identity. what are practical methods of encouraging a change in culture? >> i'll address part of that.

um, and i think also alan, alan is -- in terms of his conversation with l.a. unified schools, has also talked about that. i think that part of that is engaging the administration of the school, engaging students in the school, engaging faculty and staff in the school in understanding some of the sensitivities that are there. and just like there have been some very successful bullying prevention program like the all wise program in which part of what they do is try to change the entire culture of the school such that bullying is not tolerated by anyone. if you see it, you're going to say something about it, you're going to report it. so i think similarly, you know, in terms of promoting the positive aspects of culture is you have to get that whole school involved with seeing, you know, there are strengths, there are weaknesses, there are positive things about diversity in our school. we have to, um, encourage and

strengthen and promote all the different backgrounds that people come from so that it's not looked down upon, it's not, um, those people are not ostracized. >> perfect. and, alan, maybe you can expand on this. um, i know we focus a lot about the school district in the schools, but a lot of times they spend so much more time in the communities. so how do we foster that system of change? >> well, we're trying to work with those groups, with religious groups and some of the people of color groups in the community to see how we might best implement some of that at home and at some of the institutions in which they -- churches and wherever else people might gather. um, i do think that training beginning in elementary school for respect for all cultures is really important. i've said this over and over, but by the time kids get to the schoolyard, they've experienced -- in our case, in the lgbt community, a lifetime of homophobic images and

culture, and it's just got to start before they get there. and also this notion that, um, a lot of the teachers and administrators in schools really do want to do what's right, but they don't know what's right. and they're fearful of doing something wrong. so the training of teachers and administrators is really, really important. >> thank you. >> can i just say one thing about that? you know, i think it's important that you empower young people to be the leaders in training so that, you know, the adults have a perspective of the world. but when you train young people to embrace what those strategies might be, they do things by themselves, you know, you see all kinds of really wonderful things happen. >> perfect, thank you. and we have about, i think we have about ten different note cards. we're going to get through as many as we can today, but great questions. >> all right. we have a question for one of the students, and it doesn't say it's for nicole, but since you

talked about this in your presentation, if you would take the first go at this, nicole. bullying and suicide have been lumped together by the term bullycide, do you believe it forces bullies to associate their experiences with suicide? >> thank you for the question. i think that is something that we are most concerned about. we think that it is drawing that link between bullying and suicide especially for young people who may be at risk. so they may be struggling with bullying, they may be having thoughts of suicide, and then seeing the images and seeing and hearing the word bullycide may make them think that that is a normal reaction or that is something that is expected. or on the contrary, it may be the only way that they see they can get their voices heard, and that is all very, very dangerous, and we really don't want to draw that association for them, and we really want to change the dialogue into more encouraging, help-seeking and making sure that the young

people know that there are supports out there for them. >> thank you. anybody, my other responses? okay. thanks. >> michelle, i think i have several questions, so i'll try to combine them into one. but it's more about your final point, and is there or isn't there a causal relationship between suicide and bullying when taking into other factors, especially about when we're focusing on prevention? so -- >> so my training's in public health, and so when we use the word causal, i, i don't think we have the data to say that yet. i'm not aware of anybody who has the data to say that. what we do see is that there is a direct, when we look directly, there does seem to be a relationship. and then when we zoom out and take the young person in the context of their lives, we see that there are other factors -- self-esteem, discipline from

their parents, depressive symptomtology more generally -- that seem to be more helpful in explaining the relationship with suicidal ideation and bullying. so as we've been talking about, bullying can be one factor, but that is a multiple hit. young people do not start thinking about suicide, and they don't attempt suicide because of one particular reason. there are a multitude of factors, and bullying may be within the pathway, um, but what we're seeing is there are other factors that we need to be paying more attention to. >> and then there was another question, michelle, for you. do we need to start separating general aggression from bullying when talking about prevention strategies? >> i think that we need to stop feeling the immediate to call it bullying in order to give it weight. we need to acknowledge that there is a spectrum of aggression, and bullying has a very particular type of definition that for researchers is important so that when we

talk, when we use the same word, we're really clear about what we're talking about. but young people who don't necessarily fit that description but are still being adepressed upon, it's important that people are paying attention to them. from a prevention perspective, what we are seeing is that, for example, young people who say yes to differential power, yes, my bully had more power than me, those kids look different than kids who say, no, actually, we were of the same strength. so in terms of prevention programs, i think we want to talk about aggression generally. but we also do want to recognize that there are more serious forms, for example, bullying that we need to pay particular attention to. >> could i just add? um, i think it's really important because, um, i wouldn't say -- probably the most common thing you hear, it feels like aggression to lgbt kids in schools is that's so gay. that's not bullying, really, that is a comment that's not

directed at an individual. but when an lgbtq kid hears that, it's aggression. it's aggression that's very personally felt, so i think that's a really important point. >> thank you. and i know we didn't highlight this specifically, but i wanted to open it up for comments about elementary youth. that also have effects of bullying and how that kind of carries and what are some of the strategies that we're using right now. >> be right. so, um, what we do, we work with our families' coalition, and we have a family services department at the center. so there are ways to talk about these issues that don't, um -- well, first, i'd say piss off parents because when you say you're going to talk about these issues for a lot of elementary school parents, they think you're going to talk to them about sex, and you're not. you're going to talk to them about respectful behavior and forming a community in a respectful way. so we are doing a lot of training of elementary school

teachers, and almost more importantly particularly in a really diverse, culturally-diverse district, parents. we're doing a lot of training of parents. that has to start in the home, that respect. and, again, a lot of times what we've found with lgbtq kids or issues that parents just don't know, and they are actually quite embracing once they learn. and we've also found it can't just be one session, that we have to do it repetitively both with youth and with parents. >> i'll just add a piece on to that is often times when we're talking about some of the prevention programs at the elementary school level and even sometimes in the preschool level, we're talking about things like teaching these children, um, coping skills, teaching them pro-social skills. so you're not necessarily talking specifically about suicidal behavior or talking necessarily about sexual orientation, but you're teaching them how to work together and how to, um, cooperate on things. you know, one of the programs that has actually shown to be

successful in regards to preventing suicide is one that was developed through johns hopkins called the good behavior game in which what they do within the classroom is promote teamwork and how you accomplish goals within your classroom as you're working together so that all of you in your team are making progress and making positive strides. >> welcome to c-span2's booktv. >> cope with adverse events that occur in your life. who do can you go to? have you created some kind of networks and friends and family and others that when you do have trouble, you know who to go to and get some help. >> thank you. >> i think we're going to go with one final question, and then i know you're scheduled for a break. if people have additional questions and the panel's willing to stay, we can

certainly do that, but i don't want to intrude upon people's break, i know you've been sitting for a long time. so there's a question here about whether anyone on the panel or you're aware of anyone who has talked to the families or peers, friends of those who have, um, committed suicide and who were also bullied to gain a better insight about these other kinds of factors that you're talking about here. >> um, i can speak to that, actually, i personally have experienced a loss by suicide that was, um -- i lost my brother in 2004, and he was bullied online before he took his life. so i have a very deep personal connection to this issue, and i completely empathize with people who are also in that situation. um, it is very, very difficult to look at the person that you loved and were so close to and not think that this thing that happened to them right before they died was the reason why they took their life. in my brother's case specifically, he actually

indicated in his note that this other individual who was bullying him was the reason. so looking at that in the mix of all of your complicated grief and your guilt and your shame and all of that, it's really, really hard to say that that wasn't the only reason why he left us. um, so i completely everyone these with those -- empathize with those folks. it has taken me a long time to come to the other side and really start looking at it in a more, you know, that bigger context in what else was going on with greg and, you know, why was it when he was humiliated that he ended up taking his life whereas most kids in his situation don't? it's very, very difficult. you can get there, um, with a lot of support and, um, a lot of research and talking to people, and, um, starting to change the conversation, i think. >> perfect, thank you. and, um, michelle, were you able to contact a family through that study where the adults, um, asked as well, or was it just the youth between, i think, the ages of 13 and 18?

>> no, we just talked to the youth. because we want young people to feel free to be honest about what's going on, and we asked them a multitude of questions, we insure their confidentiality and their privacy. and in this particular survey we asked questions that were sensitive enough that we, actually, we don't have their name, we have no way to contact them for that reason. we really wanted to protect them. >> perfect. and i think, iris, you were going to add one thing, but i know it's very different in the native communities where the family is such a strong knit bond. so can you kind of speak a little bit about that? >> well, actually, just last week, you know, we had a murder/suicide in a very, two very prominent families. and in our cultures it's very important to involve the elders in everything that exists in the community. and i was just sitting here thinking about how even saying the word "suicide" is a cultural taboo for many traditional

communities because they believe that that word holds a spirit that you don't want to attract to yourself. so that you have to find ways to communicate things that allow you to be able to engage people. but that word in and of itself is really, you know, it's charged with a lot of energy. and so the healing has to come from within the family, and being able to involve older people in the community, you know, that have those life experiences are critical to the work that we do. >> thank you, iris. >> and thank you to the panel. they've been a fantastic panel. and thank you for your questions and attention. [applause] ♪ ♪