Suicide has been in the news this week — with designer Kate Spade and chef Anthony Bourdain taking their own lives, and new data showing that suicide rates in 49 states rose between 1999 and 2016. Adding to the horror: More than half of the suicides in 27 states were committed by people with no diagnosed mental health condition.
Suicide is the 10th-leading cause of death in the United States and the second-leading cause among people ages 15 to 34. There were twice as many suicides in this country in 2016 — nearly 45,000 — as homicides.
Schools can and should play a big role in fostering discussion with young people about the subject, experts say, and should train personnel in suicide prevention as well as how to handle a crisis after a student’s suicide.
To help with that, a group of organizations published a “Model School District Policy on Suicide Prevention: Model Language, Commentary, and Resources” (which you can see in full below). The program was created by the American Foundation for Suicide Prevention with the American School Counselor Association, the National Association of School Psychologists and the Trevor Project, which provides crisis intervention and suicide prevention services to LGBTQ youth.
And a resource titled “After a Suicide: A Toolkit for Schools,” which was issued this year by the foundation and the Suicide Prevention Resource Center, provides guidance to school personnel on how to help students deal with the tragedy, work with the community and the media, and memorialize the student who died without contributing to emotional trauma or suicide risk among other students. (You can see it in full below.)
There are two key tasks for schools in preventing suicide among young people: identifying students at risk and referring them to a professional for assessment and evaluation, the foundation says. But most states do not require annual training.
There are now 11 states — Alaska, Delaware, Georgia, Kansas, Kentucky, Louisiana, Maryland, Nebraska, North Dakota, Tennessee and Texas — that mandate annual suicide prevention training for school personnel, the foundation said. The required training is usually no more than two hours a year.
Washington D.C., plus 17 states — Arkansas, Connecticut, Illinois, Indiana, Maine, Massachusetts, Mississippi, New Jersey, Ohio, Pennsylvania, South Carolina, South Dakota, Utah, Virginia, Washington, West Virginia and Wyoming — mandate some training in suicide prevention for school personnel but do not say it must be done every year.
Fourteen states — Alabama, Arizona, California, Colorado, Florida, Michigan, Minnesota, Missouri, Montana, Nevada, New York, Oklahoma, Rhode Island and Wisconsin — have laws that encourage suicide prevention training for school personnel but don’t require it, the foundation said.
So how should schools approach the subject with students?
Thea Gallagher, clinical psychologist at the University of Pennsylvania’s Center for the Treatment and Study of Anxiety, wrote the following for the American Foundation for Suicide Prevention:
I value bringing awareness about mental health issues to the public. We know that talking about suicide and suicide prevention in productive ways is very important for both the individuals suffering from suicidal ideation, and the people who so desperately want to help them. Suicide can affect everyone. The good news is, there is room for all of us to get involved with suicide prevention.
School-based interventions that involve students, faculty and parents are one way we can promote and implement suicide prevention efforts. This work can begin with school administrators, but can easily extend to students and parents, as well.
So how do we start talking about suicide in our schools? And what are productive ways in which to do this?
One way is to create small groups for students to discuss difficult issues like mental health problems, family difficulties, interpersonal challenges and painful emotions. This is especially important as it is more likely that a student will report something to another student rather than to an adult. Helping establish relationships between students and faculty can also serve as a preventive measure with regard to suicidal ideation, violence, bullying, etc. Preventive measures should include promoting help-seeking, emotional well-being and networks of social support and “connectedness” among students, faculty and parents. After-school clubs and relationship-building activities are also ways to connect students to each other and provide alternatives to negative behaviors and isolation.
How do we implement preventive interventions?
It’s important to enhance resilience and life skills among children and adolescents. Sponsoring mindfulness and stress reduction workshops can help individuals take control in managing their mental health. Providing information about self-help tools, coping and emotion regulation, and connecting students to apps they can use on their phones that assist in building these skills can help in the management of life stress and mental health challenges. Incorporating lessons about empathy, forgiveness and behavior management into curriculums can help expand one’s insight and understanding. Other helpful interventions include showing kids how to reach out, encouraging them to do so, making care available and ensuring that a suicide hotline number is easily accessible. Teaching bullying prevention is also important, as it is linked to a variety of mental health issues, not just suicide.
What else can we do?
Identify students at risk! This includes prior attempts, misuse of drugs, family history of suicide, chronic illness or disability, and lack of access to mental health care. School-based screening programs that protect student identity while identifying the presence of suicidal ideation and risk factors can also help with suicide prevention. These screenings should include parents, school personnel and students in this process in a collaborative way. Screening should be done with efforts to educate and reach out to students regarding suicide in order to empower individuals to be aware of their own mental health as well as signs of people suffering around them.
Making concerted efforts to reach LGBTQ groups in schools is also critical, as stress from discrimination is a known risk factor for LGBTQ youth. It is important to educate students, parents and faculty as to the warning signs of suicide. These include but are not limited to suicide notes or plans, making final arrangements, preoccupation with death, changes in behaviors, thoughts and/or feelings.
How do we manage death by suicide?
In the event that someone dies of suicide in the school, plans for the presence of extra mental health counselors, grief groups, etc., should be established so that students and parents and faculty can talk, healthily process their feelings and support each other.
So what do we do now?
Start the conversation! The point is that social support and connection are key factors that buffer against suicide. In school and out, we should all strive to find more ways to communicate and connect about our own struggles and personal challenges . . . even when it is hard or uncomfortable.
Here’s what a model school district policy on suicide prevention looks like, according to the program:
Protecting the health and well-being of all students is of utmost importance to the school district. The school board has adopted a suicide prevention policy which will help to protect all students through the following steps:
1. Students will learn about recognizing and responding to warning signs of suicide in friends, using coping skills, using support systems and seeking help for themselves and friends. This will occur in all health classes.
2. Each school will designate a suicide prevention coordinator to serve as a point of contact for students in crisis and to refer students to appropriate resources.
3. When a student is identified as being at risk, they will be assessed by a school-employed mental health professional who will work with the student and help connect them to appropriate local resources.
4. Students will have access to national resources that they can contact for additional support, such as:
• The National Suicide Prevention Lifeline – 800-273-8255 (TALK), suicidepreventionlifeline.org
• The Trevor Lifeline – 866-488-7386, thetrevorproject.org
5. All students will be expected to help create a school culture of respect and support in which students feel comfortable seeking help for themselves or friends. Students are encouraged to tell any staff member if they, or a friend, are feeling suicidal or in need of help.
6. Students should also know that because of the life-or-death nature of these matters, confidentiality or privacy concerns are secondary to seeking help for students in crisis.