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Suicide: Unsettling Worry for Schools

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Every day, about 18 young people somewhere in the United States commit suicide, and experts estimate that at least 50 to 100 more attempt it.

Youth suicides, occurring at more than double the 1960 rate and now the third-leading cause of death among adolescents 15 to 24 years old, have focused nationwide attention on what those involved in the field call "the last taboo." And parents, educators, and community-service workers are frantically searching for ways to understand the phenomenon and help prevent more deaths.

Heightening concern has been the recent epidemic of suicide "clusters," or groups of deaths in a single locality.

These clusters have occurred in New York's northern suburbs of Westchester, Putnam, and Rockland counties, where 36 teen-agers have killed themselves in 22 months; in Plano, Tex., where 7 teen-agers committed suicide between February 1983 and February 1984; and most recently, in Clear Lake, Tex., a suburb of Houston, where 6 teen-agers have killed themselves since Aug. 9. In some incidents, some of the victims knew each other; in others, the suicides seem completely unrelated.

National Response

Among the responses have been steps taken at the national and state level to provide more information on this relatively new field of study. These include:

The establishment of the National Committee on Youth Suicide this past summer, with representation from every state. Its goals are to provide a clearinghouse for information on programs that are effective, help focus public attention on the issue, and push for federal legislation to fund research, compile national statistics on youth suicide, and provide information on existing suicide-prevention programs.

Although the National Center for Health Statistics currently collects data on youth suicides, there is a two-year lag time, experts note. They believe that such suicides are significantly underreported because of their stigma, and that more efforts need to be made to gather accurate information.

Research projects on adolescent suicide funded by the National Institute of Mental Health of the U.S. Department of Health and Human Services. About 13 studies are in progress around the country in addition to the research conducted by the institute itself. hhs has set as a national objective to decrease the rate of adolescent suicide from 12.3 per 100,000 young people in 1981 to 11 per 100,000 by 1990.

The Senate Subcommittee on Juvenile Justice called a Congressional hearing last month to determine what action the federal government should take to stop the rapid rise in adolescent suicide.

Two states, California and Florida, have passed laws requiring schools to offer suicide-prevention programs at the secondary level, and at least two other states, New York and New Jersey, are considering legislation related to youth suicide programs.

"There is a great need for research into the extent of the problem and causes," said David Tooley, a special assistant to Lt. Gov. Alfred DelBello of New York, who has been actively concerned with the suicide situation. "There is no central clearinghouse for information on programs that are effective, which could be transferable and adaptable by states and local school districts. The situation cries out for federal leadership. At this point, every time a school district wants to start a suicide-pre-vention program, it essentially has to reinvent the wheel."

Schools' Role

As is so often the case with problems related to youths, experts say, school officials are caught in the middle, afraid to act, yet afraid not to. Charlotte Ross, executive director of the suicide-prevention and crisis center of San Mateo County, Calif., and co-chairman of the National Committee on Youth Suicide, commented that "schools are afraid if they talk about it, they may cause it."

"Well, that's like sex--if we don't talk about it, it won't happen,'' she said. "We all know that's not true."

School programs devoted exclu6sively to the issue of suicide prevention are, for the most part, relatively new. But in many communities, particularly those where suicide clusters have developed, mental-health professionals are now helping provide guidance for teachers and students on how to confront and perhaps control the mounting number of suicides.

Ms. Ross helped begin one of the first school-based programs in the country in 1975 in San Mateo County, just outside of San Francisco.

"We began when there was an escalating rate of youth suicide in the county and a drying-up of mental-health funds," she said. "We were looking at a way to have an impact on youth suicide that could be short-term, inexpensive, and have a broad impact."

Ms. Ross said her organization found that teachers did not know how to deal with adolescent depression.

"We had cases where an English teacher would grade an essay by a student on suicide and return it corrected for grammar," she said.

Along with training school staff members in identifying possible suicidal tendencies and how to help prevent suicide, Ms. Ross compiled a pamphlet on the phenomenon for teachers and a companion guide for teen-agers on how to help themselves and their peers.

"The program not only did not start a run of suicides, as some had feared, but it reduced them," she said. In 1975, 11 adolescents killed themselves in San Mateo County, but that number has now been reduced to two or three a year, according to Ms. Ross.

State Legislation

Other California districts became interested in the program, she said, noting that last year the state legislature passed a bill that calls for a statewide program of youth-suicide awareness in the schools.

The $315,000 program, which went into effect in July, includes requirements for teacher training, parent-awareness programs, and incorporating into the school curriculum a minimum of five hours a year on suicide prevention. Ms. Ross said she had received requests from many other states looking into similar legislation.

"The bottom line is that teachers have a responsibility," Ms. Ross argued. "And they are entitled to help."

A recently enacted Florida law requires that suicide-prevention programs be a part of the life-management classes that will be offered to 9th and 10th graders starting next year. The legislation also stipulates that to be eligible for certification, teacher candidates must receive suicide-prevention training so that they can "recognize signs of emotional distress in students and [learn] techniques of crisis intervention, with emphasis on suicide pre-vention and positive emotional development," according to Gale Dickert, a member of the state task force on suicide prevention. Ms. Dickert said she started lobbying for the bill last year after her teen-age son killed himself.

Although it did not include an appropriation for the purpose, the bill also mandates suicide-prevention training programs for teachers, parents, and law-enforcement officers.

New Jersey Program

Officials in Bergen County, N.J., say they have one of the largest school-based suicide-prevention programs in the country. Started four years ago, the program is run out of two community mental-health centers in cooperation with schools in the area. Since its inception, the coordinators of the program have trained educators, parents, and students in 37 secondary schools in the area.

Diane Ryerson, director of the adolescent-suicide-awareness program of the South Bergen Mental Health Center, said a group of mental health professionals first visits the schools and asks guidance counselors and other pupil-personnel staff members for their help.

"This is a critical link between the school and community mental-health services," Ms. Ryerson said. "They can make sure the adolescent gets to us."

The mental-health professionals and the school personnel then conduct a two-hour training session with all educators and administrators. The first part consists of current facts and statistics, followed by a movie. Then the participants meet in small groups, led by a therapist and a school representative.

"There, we talk about the nitty-gritty--what is current school procedure, what community resources are available, how to use them," Ms. Ryerson said. "Teachers want to know this information. They are frightened by the fact there's been a rise in youth suicide, and they know there's a good chance they will deal with at least one seriously depressed youth in their career."

Ms. Ryerson said the schools usually request a second training program for parents. She said that usually two are conducted, one offering basic information and a second designed for parents interested in pursuing the subject.

The program then provides two intensive two-hour student workshops aimed specifically at 9th and 10th graders.

"We inform them about the reality of teen self-destructive behavior, and sensitize them about their own friends' signs, about the reality of their own well-being. We teach them to deal with depression in themselves and their friends," she said.

The last step is to train a team from the school to learn how to conduct similar programs on a continuing basis. Professionals from the mental-health centers remain as consultants.

Community-School Linkages

"This all falls under the first major goal of getting the information out," Ms. Ryerson said. "The second major goal is to build links between the school and community mental-health services." She noted that too often suicide-prevention programs in schools are limited to one school or one district.

"This is very inefficient," she said. "It is much more efficient to work through the mental-health system, where you are getting information from experts used to dealing with suicidal kids. We think this is the critical part overlooked by most school-based programs."

Ms. Ryerson said she would advise any school official thinking of starting a suicide-prevention program first to contact a local community mental-health center or a group of professionals involved in the field. She is helping set up a program similar to Bergen County's in Putnam County, N.Y.

The New Jersey legislature is also considering a bill that would appro-priate $150,000 for three model community-based suicide-prevention programs, as well as create a state-wide council on youth suicide.

Fairfax County Response

The Fairfax County, Va., school district began its own suicide program three years ago in response to 20 adolescent suicides in one year. Myra Herbert, coordinator of school social-work services for the school system, said officials decided to make a concerted effort to reach teachers, parents, and students.

Under the program, all school psychologists, social workers, and counselors are trained to deal with potential suicide victims and know where to refer such students, if necessary.

The program also invites parents to attend special pta meetings with mental-health professionals to discuss adolescents' stress-related problems. The program has been expanded this year to include what is called a "student-stress program" because of the stigma still attached to the word "suicide," Ms. Herbert said.

Teachers identify students who appear to have difficulty coping with one or more of the factors common to many suicide victims. They then attend seminars led by school counselors.

Ms. Herbert said that since the program started, the number of suicides in the county has declined; three students took their own lives in the 1983-84 year.

"There is nothing more difficult to evaluate than a prevention program," she said. "But the factors in the community have remained the same, and the suicide rate for this county is the reverse of the national trend."

I don't think it's a question of whether schools should deal with the problem or not," Ms. Herbert added.

"Schools are dealing with the problems regardless. With a greater mobility rate, schools become a base for students who don't have any other system of support."

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