Published Online: October 23, 2012
Published in Print: October 24, 2012, as Schools Can Be the Difference in Preventing Suicide

Commentary

Schools Can Be the Difference in Preventing Suicide

As increasing attention has—rightly—been paid to the issue of school-related bullying, growing attention, too, has come to the relationship between bullying and suicide. We're doing more to address bullying with our nation's youths, but we're not yet doing enough to address the problem of child and adolescent suicide.

Millions of 10- to 24-year-olds will attempt suicide this year. According to the U.S. Centers for Disease Control and Prevention, suicide is the third-leading cause of death among young people in that age range.

Research from Yale University's school of medicine suggests that victims of bullying are between two and nine times more likely to consider suicide than nonvictims. Furthermore, according to the 2008 Washington state healthy youth survey, which involved nearly 200,000 students, nearly one-quarter of 10th graders reported a history of being bullied while half of 12th graders reported feeling sad and hopeless almost every day for the previous two weeks.

More than 45 states have passed legislation requiring bullying-prevention programs in schools serving grades K-12, but legislation requiring suicide prevention in schools has been enacted in only a few states. Yet, almost no problem confronting our nation's schools is more urgent than suicidal behavior in our children. In the past decade, more youths died by suicide than from the combination of cancer, birth defects, stroke, aids, pneumonia, chronic lung disease, and influenza.

"[Suicide] is an issue that must be addressed in the place that young people spend most of their time, at school."

Why should schools accept any responsibility for suicide prevention? According to the National Association of School Psychologists, the reality is that every five hours, a child or adolescent in the United States dies by suicide. This is an issue that must be addressed in the place that young people spend most of their time, at school.

According to a report released this year by the federal Substance Abuse and Mental Health Services Administration, providing a safe environment is part of a school's mission. Students' mental health affects academic performance, and the suicide of a student will significantly impact the school community. Some schools have even been sued following student deaths by suicide.

Some schools are accepting more responsibility for prevention; for example, last year Texas passed a state law requiring that every school include suicide prevention in its campus-improvement plan for the 2012-13 school year, and that schools identify a suicide-prevention liaison. The bill also required the Texas Education Agency to provide a list of recommended best-practice prevention and early-intervention initiatives in the public elementary, middle, and high school systems. The legislation also identified bullying victims as potentially being suicidal.

A three-tiered public-health model of prevention, intervention, and follow-up with the school community after a suicide is encouraged to decrease suicidal behavior among school-age youths. Suicide prevention starts with providing teachers and students with the skills necessary to identify and respond to individuals who are at risk for suicidal behavior. These include knowing warning signs such as: talking and/or writing about suicide and death, giving away prized possessions, exhibiting dramatic changes in behavior, and making out a will. A suicide-prevention gatekeeping program includes training all school faculty and staff members to recognize these warning signs and to work as a team with key personnel, such as counselors and administrators, to secure the needed services for suicidal students. Personnel such as school counselors, social workers, and psychologists need to be trained to conduct thorough suicide assessments, and procedures need to be developed that require parent notification when a student is believed to be suicidal.

Schools have been successfully sued by parents in the aftermath of a child's suicide when the school failed to provide appropriate supervision and to notify parents of the suicidal behavior. The only exception to parent notification is when the school believes that the parents are abusing the student; then, the school's first call would be to the local protective-services agency. Middle and high schools are strongly encouraged to investigate depression-screening programs. Two of these programs—Teen Screen and Signs of Suicide—are cited by the national nonprofit Suicide Prevention Resource Center as evidence-based resources. We also recommend that schools link with community resources for suicide prevention and provide educational forums to inform parents about the warning signs of suicide and sources of help in the community. Schools should also develop student-assistance programs to increase a feeling of school connectedness among students.

There are various levels of prevention, including "selected" prevention, which targets individuals deemed at risk for suicidal behavior, and "indicated" prevention, which focuses on those with a history of suicidal behavior. These strategies consist of identifying at-risk students, assessing risks for them, making appropriate referrals, and then following up at school.

In addition to multitiered prevention strategies, an effective suicide-prevention program should include "postvention" strategies, which include interventions with other students and school employees after a suicide. In 2011, the Suicide Prevention Resource Center released the Suicide Postvention Toolkit for SchoolsRequires Adobe Acrobat Reader, which answers almost every question school employees might have about what to do or what not to do following a suicide. Adolescents are the most likely age group to imitate suicidal behavior, and postvention provides a time to help students with their shock, grief, and confusion and to make sure that they all know how to get help for themselves or a friend.

It is also essential for schools to create some type of plan following a student's return to school after exhibiting suicidal behavior. The idea is to lessen the student's academic, social, and emotional burden; to offer support from school personnel; and to help in a smooth transition back to the classroom.

Suicide—which takes the lives of approximately 4,600 young Americans a year—is preventable. Our schools have an important opportunity for averting many of these tragic deaths. Let's begin with schools' developing a suicide-prevention task force that links with the community and recognizes that the prevention of youth suicide is everyone's responsibility.

Vol. 32, Issue 09, Pages 24-25

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