Focus

Student Suicide Prevention Begins With Recognition

by KEITH A. KING


Since the 1950s, the suicide rate among adolescents has more than tripled. Suicide today is the second leading cause of death among adolescents. More teen-agers die each year due to suicide than to homicide.

Based on these tragic findings, school administrators are beginning to investigate comprehensive school suicide-prevention programs aimed at training school professionals to identify students at risk for suicidal behavior.

Since school administrators serve as "empowerers" of teachers, promoters and protectors of school values, leaders of instruction and managers of school climate, they play, not surprisingly, a crucial role in developing and implementing an effective and comprehensive school suicide-prevention program.

The following steps are based on the professional literature.

A Place for Policy
  • Develop a districtwide policy. A districtwide student suicide-prevention policy formally recognizes that the school district has an important role and commitment to student suicide prevention. Such a policy greatly increases the likelihood that a school suicide-prevention program will be consistently implemented throughout the school system. Without a district policy, school programs are not likely to survive for the long term.

     

  • Establish crisis intervention teams in each school. These school-based teams should include a diverse group of school professionals (principal, counselor, teacher and school nurse). This team should develop a formal school suicide-intervention plan to be carried out when a student threatens or attempts suicide. A designated team leader should oversee implementation of all steps during an actual intervention.

     

     

  • Provide training for school professionals about adolescent suicide. All school professionals should feel confident in identifying students at risk and be willing to refer at-risk students to school counselors. In-service training can help to educate school staff on suicide prevention.

     

    My colleagues and I recently discovered that only one in 10 high school health teachers said they were confident about identifying a student at risk for suicide. However, those at schools offering recent suicide-prevention training felt significantly more secure in identifying at-risk students.

     

  • Ensure that school professionals know the appropriate steps to take when a student threatens suicide. Schools should annually rehearse what steps to take when a student threatens or attempts suicide. While every school routinely practices fire drills, few practice annual suicide-intervention rehearsals, even though significantly more adolescents die each year from suicide than from fire.

     

    School professionals should follow four basic intervention steps: 1) Alert the school intervention team; 2) Ensure students’ safety; 3) Determine what services are needed; and 4) Inform parents and family. Care and concern should be consistently displayed.

     

  • Include suicide-prevention education in the curriculum. Only two in three school districts nationwide require teaching about suicide, and about half of schools actually teach about suicide prevention. Many school professionals balk at the idea of teaching about suicide prevention because they believe educating students only serves to provide students with ideas and methods about killing themselves. This is a myth.

     

    When issues concerning suicide are taught in a sensitive and educational context they do not lead to or cause further suicidal behaviors. In addition, peer assistance programs (programs that help students to identify peers at risk and refer them to counselors) have shown much success. Increases in student knowledge about suicidal warning signs and helpful resources, as well as a greater willingness to refer peers at risk to school counselors, are a few of the positive outcomes.

  • Followup Strategies
  • Establish a school suicide-postvention plan. Suicide clusters are well established among adolescents. School suicide postvention refers to the critical steps a school takes following a student suicide. Schools with preplanned postvention activities tend to be in a more effective position to prevent copycat suicides and hysteria following a suicide.

    Effective postvention plans include acting in a concerned and conservative manner; appropriately informing staff, parents, students and school board members; assigning a liaison to handle media inquiries; and providing counseling sites throughout the school.

     

  • Develop positive relations with parents. When schools have positive dealings with parents, parents are more likely to cooperate with school efforts. Also, students feel most competent when their schools and families deliver clear, consistent messages. Administrators should inform parents of suicide-prevention programs and encourage school-parent collaboration. In so doing, broader community support for suicide prevention may be gained.

     

     

  • Develop positive relations with community agencies. School administrators should be aware, well in advance, of the existing agencies and services in the community they can contact following a student suicide threat or attempt. Such community agencies may include the police, hospital emergency department and psychiatric facilities.

     

     

  • Strive to increase students’ sense of school connectedness. The National Longitudinal Study on Adolescent Health, a study of more than 90,000 7th through 12th graders, found adolescents’ perceived school connectedness was the leading school protective factor against student suicidal behavior. Students who felt connected to their school were least likely to have seriously considered or attempted suicide in the past year.

     

    Thus, a school environment in which students believe they fit in and are comfortable in approaching a staff member for help when needed is encouraged. Building positive connections is the key.

    Keith King is an assistant professor of health promotion at the University of Cincinnati, P.O. Box 210022, Cincinnati, OH 45221. E-mail: keith.king@uc.edu

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