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Five Considerations for Developing Suicide Prevention Supports in the Schools
Posted by: Paula McCall on
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We know that suicide rates continue to rise, but where do we even begin in implementing a comprehensive model that includes suicide prevention, assessment, and postvention? It can all feel very overwhelming but here are five key points to assist:
- Broaden the view of prevention. Suicide prevention includes risk assessment, education, and postvention response. While this can seem overwhelming, it means that we can target any aspect and it will naturally begin to flow to other areas. Training on suicide prevention for students and staff naturally leads to increases in suicide risk assessment referrals. Effective suicide risk assessments naturally translate into preventive support plans. Compassionate and supportive postvention response is one of the most powerful forms of suicide prevention in a grieving community. If suicide prevention efforts are new to your school, identify one element with which to start, and the others will begin aligning as well.
- Assess suicide risk for understanding, not prediction. It is impossible to predict suicidal actions at any point in the future, as ideation can fluctuate dramatically over short periods of time. Effective suicide risk assessment is focused not on prediction but on understanding the student’s story and where they are in the moment. Effective suicide risk assessment includes exploration of risk factors, warning signs, and current ideation as well as protective factors, coping skills, and underlying resiliency. We need to find out what is going well in their lives, where they feel connected, and what they care about. Time taken to conduct a thorough student interview translates directly into the development of a realistic and meaningful support plan for that student. Assessment becomes prevention.
- Incorporate understanding of the baseline. Many people experience some level of ongoing suicidal ideation, such as having thoughts about suicide when stressors increase or experiencing fleeting thoughts at certain points in the day. It is important to not overreact when we hear this but rather explore how it is experienced by that individual. We can empower students with the language to express their baseline, as well as any changes in it, and we can refer back to the baseline when reassessing students who often end up in our offices. The value in recognizing when a change in the baseline has occurred, and developing a safe space to share that recognition, can be lifesaving.
- Implement compassion and care in postvention. All deaths should be handled in the same way, and these procedures should be outlined by the district before a loss occurs. Providing compassion and care to a grieving population means recognizing that every individual is potentially affected and hurt, that those affected need to grieve, and that the school provides a critical place for support and healing. Postvention should never include schoolwide announcements about the loss, as this does not allow adults to be present with all students and recognize those who are in need of support. The school should never shut down attempts by students to grieve, as this communicates to them that their feelings do not matter. A school also should never shut down classes in order to host a memorial or funeral, as this disrupts the valuable sense of routine and predictability that people in crisis need. This is what schools need to do:
- Provide small group and classroom discussions to dispel rumors, validate feelings, and focus on coping.
- Check on students with higher risk—not only the closest friends of the person who has died. Higher risk after a suicide loss expands to acquaintances and to students who have been struggling themselves, even if they did not know the person who died.
- Allow an on-campus memorial site with parameters. For example, items may be picked up at the end of every school day and kept in a designated location until after the services, at which time students and staff deliver them to the family.
- Allow students and staff to attend services if they occur during school hours. Encourage participation in community vigils and gatherings. Although not hosting the events, the school can still be present at them to show support and grieve with the community.
- Recognize that some suicide prevention is simple. While suicide itself is very complex, there are ways to incorporate suicide prevention into already existing models. Open house, curriculum, and athlete nights already bring in many parents; inclusion of a 5-minute reminder of suicide warning signs and how to get support can be easy to fit in, while also normalizing the conversation. Education to all staff about using students’ names and pronouns and its ability to halve suicide risk in our LGBT+ youth can impact action, and schools may instruct substitutes to check attendance by last name rather than first name to further reduce this suicide risk factor. In addition, an automatic system can be put in place in which parents are given concrete information about suicide warning signs and crisis lines whenever there has been a discipline or mental health referral. Suicide prevention does not always have to be elaborate; it can be embedded where conversations already occur.