Youth Suicide - Information For Schools - Prevention
IDAHO GUIDELINES FOR SUICIDE PREVENTION IN SCHOOLS
School personnel spend more time with our children than any other professionals and are in a valuable position, through appropriate knowledge and action, to prevent suicide among students.
IDAPA 08.02.03.160(3a) states “Each public-school district shall adopt a policy on student suicide prevention. Such policy shall, at a minimum, address procedures relating to suicide prevention, intervention and postvention. As used in this paragraph, "postvention" means counseling or other social care given to students after another student’s suicide or attempted suicide.”
For extensive information on suicide prevention for schools, see Preventing Suicide: A Toolkit for High Schools published by SAMSHA.
Important factors to consider for suicide prevention in school settings include Student Well-Being, Staff Gatekeeper Training, Student Training and Student Screening.
Student Well-Being is complex as it relates to many aspects. Two aspects of importance in preventing suicide are documented by nationally known suicide expert, Dr. Thomas Joiner. In his book Why People Die by Suicide, Dr. Joiner points to failed belongingness and perceived burdensomeness as the two fundamental elements involved in the desire for suicide. School personnel can play a key role in increasing student feelings of belongingness and capability/effectiveness (non-burdensomeness). (See Belongingness and Capability Activities).
School climate is also critical to student well-being. School climate can have a profound impact on the emotional, physical, and psychological health and academic performance of students. School climate refers to the quality and character of school life as it relates to norms and values, interpersonal relations, and social interactions. School climate reflects how members of the school community experience the school and sets the tone for all the learning and teaching done in the school environment (https://healthyschoolscampaign.org/). Specific focus and effort on cultivating a supportive, respectful school climate through the implementation of school-wide strategies is a key component to effective prevention measures.
Staff Gatekeeper Training
Gatekeeper trainings provide participants with critical information on identifying, intervening with, and supporting individuals who may be suicidal. Gatekeeper trainings should include all school personnel: teachers, paraprofessionals, nurses, administrators, bus drivers, administrative assistants, volunteers, cafeteria personnel, parent representatives, and anyone who has regular contact with students. Trainings must be completed before any student suicide prevention activities or curricula are in place. For gatekeeper training to be effective, best practice dictates that school personnel receive gatekeeper training annually (See Youth Suicide: Helping Your Students).
For information on free gatekeeper trainings available through the State Department of Education, please see the Events and Training tab.
While certain elements of gatekeeper trainings are safe for youth, such as knowledge of warning signs and awareness of the hotline, gatekeeper training is not advised for youth. There are suicide prevention trainings that are safe for youth. See information about youth training below.
Gatekeeper training tools as well as a multitude of best practice prevention protocols are available on-line through www.sprc.org or www.afsp.org.
Great care must be taken in selecting any suicide prevention-related activities, training, or curricula for students. The following are guidelines to know before implementation of any youth training or curriculum.
- Training and Curricula Type: Training or curricula should be evidence-based and carefully chosen. They should be fully researched, age appropriate, and emphasize often that there is hope and help. Curricula should include warning signs, protective factors, available school and community mental health services, and a strong message of hope. To prevent suicide, the curriculum’s purpose should be to help students identify classmates or themselves and seek help from a trusted adult.
- Caution: Training and curricula should never normalize suicide, discuss means, or share suicide statistics. Curricula should iterate to students that suicide is rare and that recovery from suicidal thinking is the norm. Curricula need to address the code of silence among youth and remind them that trusted adults in their school and community are available to share concerns about a suicidal friend or themselves.
- Embedded Training: Training and curricula are best embedded in mental health units within regular school classes, such as health or teen living, that routinely and sensitively address these issues.
- Adult Training Importance: Training and curricula should be presented to students only after school personnel, parents, and community mental health providers are trained as gatekeepers so they can support any youth with suicide ideation.
- Training Group Size: Training and curricula should be presented in small groups (classrooms preferable) and with an additional adult present to watch for concerns and to provide support to vulnerable youth, while maintaining students’ rights to confidentiality. Schools should NOT hold assemblies or large group training because these do not allow for easy identification of students who may be at risk and can cause harm or trigger those with mental health issues.
- Exceptions for Vulnerable Youth: Training and curricula should be carefully considered for any students who have experienced a recent death or suicide attempt in their family or friend circle, who have made a recent suicide attempt themselves, or who may be affected by a mental health issue. These youth should receive the confidential offer to opt out of this unit. If these students decide to attend, they must be carefully monitored. If they show any signs of distress or inappropriate response to the material, they should be taken to the school mental health personnel.
- Suicide Attempters as Speakers: Training and curricula should not allow students who have attempted suicide to be speakers. Other students may identify with them in an unhealthy way or see them as receiving extra attention, which may increase risk. In addition, the student presenters sometimes receive backlash from other students that causes them emotional harm.
- Cultural Competence: Training and curricula must address cultural competence as suicide affects people of all races, ethnicities, genders, sexual orientations, and socio-economic groups. It is important to include the contributions, images, and experiences of diverse cultural groups in this unit of instruction. Be sure the school has access to interpreters and community mental health services that have experience with cultures/ethnic groups represented in your school.
- Parent and Community Involvement: Training and curricula will require entire school and school community support as their delivery requires sensitivity and understanding of the importance of the issue. The curriculum chosen might be presented to school staff, to community agencies connected to youth, and to parents/guardians or others who are in a position to follow up with students. Parents/guardians should be made aware the curriculum is being taught beforehand and be invited to review it online or at a presentation. Some ideas to accomplish this include back-to-school nights, brochures sent home with students, or messages from the school’s communication system.
- Co-Occurring Conditions: Training and curricula might emphasize the link between co-occurring mental health issues, such as suicide risk and substance abuse. Alcohol and other drug use may add to the risk for suicide attempts. If you suspect this is an issue, please consult with student services personnel in your school or a substance abuse counselor in your community before approaching this issue.
- Student Self-Evaluations: Training and curricula sometimes contain a self-evaluation survey to evaluate the mental health issues of students. Using these evaluations is not recommended. If you choose to do so, it is imperative that the teacher/student service provider review these completed surveys immediately and take action, when needed! For some vulnerable youth, completing these self-evaluations may trigger suicide ideation and heighten their risk for suicide. Parents/guardians must be notified before presentation of a survey. If a student is deemed to be at risk, the student must not be left alone, and parents/guardians must be notified immediately! Always guard the student’s right to confidentiality during this process. For more information on confidentiality, please see the Intervention Protocols.
- Caution During Postvention: Consult with suicide prevention experts to determine the readiness of the school and school community before conducting any suicide prevention training if within twelve months of a completed suicide that affected the school. Please see the Postvention Protocols for more guidance.
For sample curricula, contact the State Department of Education student health personnel or visit www.afsp.org, www.sprc.org, or www.samsha.gov.
For information on individual screening please see the Screener Protocol under the Intervention Protocols.
Exercise extreme caution if considering universal screening as many safeguards must be in place before administering. Legal issues may arise unless parents/guardians have consented to such screenings, and any identified students must have access to affordable, immediate, and appropriate mental health care.
Before implementing a school-wide screening:
- Schools should convene a working group that includes community mental health services, parents, community resource groups, school staff and support personnel, school administration, and other important representatives. This group will need to carefully determine the value of school-wide screening and connect with other schools that have completed school-wide screening to identify pros and cons.
- All school staff need to complete a gatekeeper training before implementing any school-wide or curriculum-based screening program.
- Schools should have a working crisis team and protocols for dealing with suicidal youth or staff members.
- All parents must “opt in” to any school-wide screening, be offered gatekeeper training, and be provided a copy of the screener. They must receive resource information to include free or sliding-scale mental health services and community resource lists that provide support for daily needs.
- Schools must provide clinicians who will offer immediate interviews to students who show signs of suicidality as there may be several false positives from screening programs.
- Schools must follow up to ensure that identified students receive mental health access.
For information on the controversial nature and efficacy of universal screenings, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879582/ or https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891889/
After a suicide attempt some students in the school are likely to have an increased risk of suicide. A serious attempt can affect a school and community as much as a suicide death. Schools have a responsibility is to keep other vulnerable youth safe, as suicide attempts can be "contagious," and parents need to know to watch their own children.