Components of School Based Suicide Prevention



COMPONENTS OF SCHOOL-BASED SUICIDE PREVENTION

It takes a community effort to prevent suicide. Suicide affects numerous people and is a complex public health problem that we need to fight together. To help us fight the battle against suicide we need a plan. Youth suicide prevention curriculum is not only mandated by the state (WI statute 118.01 (2)(d)7) for districts to educate youth on suicide prevention, it is essential for staff, administration, parents, and community to do together. The Federal Safe and Drug-Free Schools Act Mandates prevention activities and a crisis management plan. The following are 11 components which should ideally be a part of a school based suicide prevention plan. Following the components are appendices with handouts and facts on suicide for schools to use. A reference is located at the end, for the examples listed in each of the components. Keep in mind that postvention after a crisis is also prevention of future crises and suicide contagion (See Appendix A: Prevention Facts and Helpful Resources).

1. Develop a broad-based Coalition to oversee suicide prevention program development within the school and community. A coalition could include: school staff, mental and physical health clinicians, crisis center workers, EMT/Fire/Rescue/1st responders/police, clergy, county human/social services, child welfare, juvenile justice, coroner, media, parents, youth, and other interested community members.

For examples see Alliance for Youth(1), Prevention Institute(14), or Suicide Prevention Resource Center(18).

2. Develop and implement a Crisis Plan/Policy with administrative and coalition support. The plan should include knowledge of liability of suicide to a district, and incorporate crisis team protocols within the school/community. The crisis team would consist of pupil services and administration staff. All staff should be trained yearly and have a copy of the crisis plan. School protocols should clarify roles in suicide prevention and intervention with those who threaten or attempt suicide, or those at risk for suicide and updated yearly. Crisis plans should also include input from law enforcement, hospital, fire department, mental health providers, parents, and other community partners. Maintain contact with mental health providers, pupil services professionals, or clergy to help in the time of crisis. Provide one contact for media and be prepared to educate media on how to report on a suicide. (see Suicide Intervention section).

For examples see The Youth Suicide Prevention School-Based Guide(21), American Association of Suicidology(2), Suicide Prevention Resource Center (18), and Department of Health and Family Services(6).

3. Support a Pupil Services/Student Services Department in schools to include school counselors, nurses, social workers, and psychologists. These people should be a resource to others in reporting of suicide, neglect, and abuse. The pupil services staff should work with the coalition and outside health professionals on referrals, releases, insurance coordination, and mental health resources. They should help make other staff aware and provide support services for academic, personal, social, and emotional services, including crisis centers. Pupil Services should also receive supplemental education and training in screening, intervention and referral of suicidal students. Pupil Services should discuss case management and transition of students back to school and meet regularly.

4. Implement Gatekeeper Training on suicide prevention for youth, staff and adults in the community. The training should include risk factors, warning signs, how to refer a suicidal person, restricting lethal means, and available resources. Lethal means restriction should encompass use of gun locks, storing of guns and ammunition, monitoring of pharmaceuticals, and substance use/abuse. This training should be made available to school personnel, including administrators, teachers, custodians, cooks, coaches, bus drivers, secretaries, assistants and other support staff. This training can also be made available to coalition members, parents, and other interested community members.

Examples include Question, Persuade, and Refer(15), Department of Public Instruction Suicide Prevention Training(7), ASIST(3), and Crisis Intervention Training(4) (see Appendix A: Prevention Facts and Helpful Resources and Appendix B: Intervention/Postvention Sample Handouts).

5. Implement a Screening Tool within the school district to help identify students at-risk for suicide. Make plans for using Signs of Suicide(SOS), Teen Screen, or C-Care/CAST, all evidence based screening tools. Make plans to screen all students at least once within school career, and provide follow-up, support, and resources to students. Screening should be offered only after a crisis plan is developed and school personnel are trained to administer screening tools.

For examples see Signs of Suicide(17), Teen Screen(19), C-Care/CAST(5).

6. Offer suicide prevention education for students within health education classes. Suicide Awareness Curriculum offers students information about the myths and facts of suicide, risk factors, warning signs, and resources to get help. Curriculum should be 3-5 lessons in length. Examples include: DPI’s suicide prevention curriculum(7), Lifelines(11), or Reconnecting Youth(16), Signs of Suicide (17).

7. Support Services should be made available to at-risk students. Services from pupil services staff, health educators, and at-risk staff could include student assistance programs, classes, or groups for students to learn problem-solving skills, conflict resolution, coping skills, anti-bullying/anger management techniques, and social/life skills. Mentoring programs also help at-risk students by identifying or modeling after an adult or mature student. These programs should enhance protective factors for students and can include after school activities. All services offered should encompass how students can get help for themselves or peers at-risk. Staff should discuss case management of these students, how to identify them, and refer them for needed services. These services could include substance abuse prevention, mental health services, and law enforcement officer inclusion.

Examples include DPI Bullying Prevention Curriculum(8), Reconnecting Youth(16), and Think First(20) (see Appendix A: Prevention Facts and Helpful Resources).

8. Develop a Safe Climate within school districts that incorporates policy and procedures for anti-harassment, bullying, discipline, civil rights, dress code, school curriculum on tolerance, problem-solving, and mental health stigma reduction. Having a safe climate includes safe and clean school grounds, meaningful participation opportunities for students at school, crowd control, and resources for when students do not feel safe. Staff should have safety procedures to follow and should be knowledgeable, informed, and caring. Increase student ownership in school with showing school projects, asking for their input, and merit awards for good behavior. Increasing parent involvement will also benefit student and school personnel. Examples include The Youth Suicide Prevention School-Based Guide(21), Eliminating Barriers Initiative(8), and DPI Bullying Prevention Curriculum(8).

9. Maintain Survey and Evaluation Procedures to measure and evaluate the impact and maintenance of programs within the school. The Youth Risk Behavior Survey(23) measures engagement in healthy or risky behaviors of students. An infrastructure survey or community survey from Suicide Prevention Resource Center(18) would measure the strengths and weaknesses of a community or coalition. These tools/instruments would help determine whether programs are working and/or need improvement. They also assist in grant or research purposes.

10. Provide Resources to staff, students, parents, and the community. Resources should include local contacts with county, city, and private mental and physical health providers, police, fire and rescue, and other contacts. The National Suicide Prevention Lifeline number (1-800-273-TALK)(13), along with regional or local hotline information should be included in all resources.

11. Promote comprehensive suicide prevention in the community. Use posters, billboards, and Websites containing suicide prevention resource information. Publish articles in the local newspaper and parent newsletters regarding upcoming events on youth suicide prevention in schools. Update information on suicide support groups and special events in the community. Inform and communicate regularly with the coalition and community on education and prevention materials. These promotions should occur only after the development of crisis plans and gatekeeper training is completed so that the school is prepared to respond to requests for assistance.

References:

1. Alliance for Youth

Works to support and enhance the capacity of coalitions in their prevention and positive youth development efforts.

(800)442-5772



2. American Association of Suicidology (AAS)

Promotes research, public awareness programs, public education, and training for mental health professionals, researchers, suicide prevention/crisis intervention centers, school districts, survivors of suicide and a variety of lay persons who have an interest in suicide prevention.

(202)237-2280



3. ASIST

A two-day gatekeeper training based on knowledge and skills for suicide prevention that teaches the warning signs of suicide and how to intervene.

(403)209-0242



4. Crisis Intervention Training (CIT)

A program for police officers to educate and prepare for coming in contact with people with a mental illness or psychiatric crisis.



5. C-Care (Counselor-Care)/CAST(Coping and Support Training)

A school-based small group and counselor intervention/suicide prevention program for students at-risk in grades 9-12. The program offers skills training, adult and peer support, crisis response plan, and parent involvement.

(425)861-1177

@

6. Department of Health and Family Services(DHFS) – Wisconsin Crisis Network

A statewide crisis intervention network meets quarterly to review trends, problem solve and keep up to date on current legislation.

(608)261-7800

dhfs.

7. Department of Public Instruction (DPI)

Student Services/Prevention and Wellness Team

Provides technical assistance, training and education, and facilitates school district and community efforts to meet specific needs of students.



8. DPI Bullying Prevention Curriculum

Classroom Instructional Units for grades 3-5 and 6-8, extended from the Sticks n’ Stones Bullying Prevention Curriculum. These are important for elementary and middle school teachers, based on knowledge, skill, and disposition.



9. Eliminating Barriers Initiative (EBI)

A gatekeeper training for classroom teachers, with the goal to reduce stigma surrounding mental illness. A four-module training on social-emotional development, mental health stigma reduction, and positive classroom climate promotion.

(414)276-3122



10. Helping Others Prevent & Educate about Suicide (HOPES)

A nonprofit organization composed of volunteers. Web-site includes a local Survivors of Suicide group listing, resources for survivors, and free support for communities working to end suicide.

hopes-

11. Lifelines

A school-based suicide prevention curriculum for grades 6-12 that includes information about suicide, help seeking, school resources, discussion of warning signs, and role-play.

(732)445-2000 Ext. 121

kalafat@rci.rutgers.edu

12. Madison Metropolitan School District Model

A model of sudden Death-Suicide-Critical Incident, Crisis Response Procedures for Principals and Student Services Staff at the Madison Metropolitan School District.

(608)663-8422

khalley@madison.k12.wi.us

13. The National Suicide Prevention Lifeline

A national helpline that is answered regionally and available to anyone in suicide crisis. Their mission is “to provide immediate assistance to anyone seeking mental health services.”

(800)273-TALK (8255)



14. The Prevention Institute

The Eight Steps to Developing an Effective Coalition Tip Sheet

eightstep.html

15. Question, Persuade, Refer (QPR)

QPR is a community-based gatekeeper training and suicide prevention program. The focus is on asking the question if someone is thinking about suicide, persuading them to get the help that they need, and referring them to someone who can help.



16. Reconnecting Youth

A school-based suicide prevention program for grades 9-12 who are at-risk. It is a class that focuses on self-esteem, decision making, personal control, and interpersonal communication. It includes social activities, school bonding, crisis response plan, and parent involvement.

(425)861-1177

@

17. Signs of Suicide (SOS)

A school-based educational and screening tool that contains a middle and high school version. It incorporates a video with vignettes and interviews, a counselor referral card, depression screening tool, and resource cards.

(781)239-0071



18. Suicide Prevention Resource Center (SPRC)

SPRC provides prevention support, training, and resources to assist organizations a individuals to develop suicide prevention programs, interventions, and policies, and to advance the National Strategy for Suicide Prevention. It includes a registry of evidence-based practices.

(877)GET-SPRC (438-7772)



19. Teen Screen

A comprehensive mental health screening tool for middle and high school students. Included are the mental health screening tools, parent consent forms, interview, and case management.

(646)443-8199



20. Think First

A conflict resolution and violence prevention curriculum that addresses aggressive behavior in secondary schools.



21. The Youth Suicide Prevention School-Based Guide

The Guide offers information and checklists for developing a school-based crisis response plan. Developed by the Louis de la Parte Florida Mental Institute at the University of South Florida.



22. Yellow Ribbon Suicide Prevention Program

A school- and community-based suicide prevention program that includes increasing public awareness, training gatekeepers, and “Ask for Help” cards.

(303)429-3530



23. Youth Risk Behavior Survey (YRBS)

This evaluation tool to measure student risky behaviors is available to all schools in Wisconsin online or by paper/pencil through the Department of Public Instruction (DPI).



24. Maine Youth Suicide Prevention Guidelines

This model lays out the components of Maine’s school-based youth suicide prevention, intervention, and postvention policies and protocols.



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