When you teach about self-inflicted death, be guided by these principles:

Work with a small group where you can maintain eye contact with every young person in the room. Do not have assemblies on these topics. Work in a lighted setting even when showing videos; avoid movies that must be shown in the dark. Be explicit that the topic is prevention, so you have the freedom to cut off "how to do it" and "my family's story" descriptions. Keep reinforcing the theme, "If you suspect a friend is considering suicide, take it seriously and get help."

Preview all films and videos. Reject anything that intuitively feels wrong to you. Stories that use threats of damnation, pile on guilt trips, reinforce the pain of survivors, or rely on shock can backfire. These appeals are clear to stable youth remote from suicidal thoughts, but they play right into the hands of a pained teenager who does not see the world in a rational way. Suicidal teens are often eager to cause pain for others, get revenge, get attention, or end their pain with one outrageous act everyone will talk about and remember.

One television special several years ago emphasized the brutality of the emergency room experience where a teenager who had overdosed drugs was stripped naked, strapped down, had a pipe forced down her throat, and was berated for causing her family pain. While the intentional message was to discourage suicide, the unintentional message said, "If you intervene to save a friend, the help they get may be worse than the dying."

Avoid out-of-town experts. Select speakers who live in the community and are available to youth as a future resource. Have an adult present who knows the group well. Identify local resource people, hot lines, help centers, and mental health facilities.

Finally, if anyone becomes visibly distressed or fearful during an educational program, go with him or her to get help. If the person appears excessively avoidant, unwilling to watch a video or speak a word, make sure that a skilled professional talks with him or her to find out if there is reason for concern.

A Note To Teachers

These ideas about suicide prevention and mental health education are relatively conservative. They reflect the clinical and research conclusions of the psychiatrists and psychologists at the University of Minnesota Medical School who work on the Circle of Support team.

- In a suicide prevention strategy, the focus should be on depression and self-destructive behavior instead of on suicide itself. The focus on depression with its associated anger and isolation allows you to consider the whole range of self-destructive behavior in which young people engage. Chronic alcohol and drug use, drinking and driving, abusive sexual relationships, extreme risk-taking, self-mutilation, and suicide attempts commonly precede suicide.

- Talk about suicide will not cause emotionally healthy young people to attempt suicide.

- Unstable young people already contemplating suicide are likely to listen selectively, hear what they want to hear, and become confused or upset by discussions of suicide.

- Be clear about your own comfort level, values, and beliefs before you introduce the topic of suicide.

- Do not allow discussions to dwell on suicide methods and personal horror stories.

Following a suicide, bring skilled professionals into the group or school to lead frank discussions necessary to respond to the grief, anger, abandonment, pain and fright, youth and adults normally will experience.

Prevention requires that we intervene prior to a suicide; therefore, we must be alert to the warning signs.