Embedded Files
Ritu Roy (she/her)
Special Projects Manager for Prevention Services
Suicide Prevention Plan and Procedures (Click Here)
Email: roy_r@4j.lane.edu
Work cell: 541-393-7715
Suicide Intervention Flowchart
Suicide Intervention Flowchart
Level 1: Suicide Risk Screener (in school)
Level 2: Suicide Risk Assessment (referral out of school)
School Plan Process
Documentation Expectations
Steps for the 4J Screening and Documentation Process:
Steps for the 4J Screening and Documentation Process:
A student is referred to you or you have determined the need for a mental health screening of a student.
Complete a C-SSRS screening using the guidance provided.
File the C-SSRS in the student's working file in the school counselor's office.
Contact the primary caregiver and/or DHS to communicate the screening results. Gather information using the primary caregiver interview guide (if needed) to include in your assessment.
Complete the Dataport District Documentation EVERY TIME you do a C-SSRS screening regardless of risk level. This includes scheduling follow up check ins at a minimum of 14 days and 30 days after the initial screening.
Complete the Mental Health Alert form and have it filed in the student's Cumulative folder.
Step One: Screen Student of Concern
C-SSRS Scoring.pdfC-SSRS Flowchart
C-SSRS Flowchart
(4J Process)
C-SSRS-Screener-recent-with-triage-colors-2018.docxC-SSRS Screener English
C-SSRS Screener English
(Counselor File - Make a Copy)
Spanish C-SSRS Screener-recent-2021.docxC-SSRS Screener Spanish
C-SSRS Screener Spanish
(Archivo del Consejero - Hacer una Copia)
C-SSRS Child Screener
C-SSRS Child Screener
(Ages 6-11)
Community-Card-Teens.pdfC-SSRS Card for Teens
C-SSRS Card for Teens
(Resource)
Step Two: Contact Primary Caregiver and/or DHS
"Talking to your Child about their Suicide Concerns" Resource Guide
"Talking to your Child about their Suicide Concerns" Resource Guide
Resource Guide and Script for Parents / Families to talk to their elementary aged child about their suicide experiences. This was created to support caregivers as most resources are designed for older aged youth.
Community-Card-Parents-2020-1.pdfC-SSRS Card for Parents
C-SSRS Card for Parents
CSSR-S Screener Checklist for Parents and Families to conduct with their children to ask about suicide experiences.
Step Three: Complete District Documentation in Dataport and Cumulative File
(Confidential Screening Documentation)
Instruction Guide:
In the top right corner click on the "Suicide Intervention" tab.
Click on the "Create New Suicide Intervention Report" button.
Step 1: Input the School and Student Name / ID into the pop-up if it does not auto populate.
Step 2: In filling out the form, please ensure you do the following:
Under the SRA Team, the person filling out the report should put their name as the first entry, followed by the Building Admin team (Principal and Support Staff as applicable).
Step 3: Required files to upload:
Always attach a Safety Plan created and if there isn't one, please note why there is not one.
Attach Reentry Plan if applicable.
If you don't yet have these, "Save and Email" the form for now, noting that you can edit the form at a later date to upload the relevant files.
Step 5: Click "Save and Email" to complete documentation. Note: "Save Draft" is inconsistently saving.
Creating an Account & Log-In Details:
Follow these directions if this is your first time logging into Dataport:
Click re-set password (this will prompt you to set up your new account)
Once you have your password set up, return to the login screen.
Make sure you enter your username as your name WITHOUT @4j.lane.edu
You will then be able to complete your documentation.
SS Record(s) on File Cum FormSUMMER DOCUMENTATION
SUMMER DOCUMENTATION
(Confidential Screening Documentation)
Confidential Screening Documentation:
Fill out the copy of confidential screening documentation.
Keep all related records in a confidential folder with the building administrator.
Notify district administrators for summer programs.
Turn in confidential folders to district administrators for summer programs at the end of the session.
Resources
Safety & Re-Entry Plans
Safety & Re-Entry Plans
4J Safety and Re-Entry Plan - All Levels (required upload to Dataport)
Click on the above link to make a copy of the safety plan to use in your school.
4J x Youth SAVE Safety Plan (MS and HS students) - English
4J x Youth SAVE Safety Plan (MS and HS students) - Spanish
Click on the above link to make a copy of the safety plan to share with students to make their plan.
Young Kids Safety Plan (Lane County)
Click on the above link to make a copy of the safety plan to fill out together with student and caregiver.
Provider Safety Plan (Youth SAVE)
Click on the above link to make a copy of the safety plan to use for your records at school.
988 Suicide &
Crisis Lifeline
988 Suicide &
Crisis Lifeline
Call / Text / Chat | 988 988lifeline.org
The 988 Lifeline is available 24/7/365. Your conversations are free and confidential.
YouthLine ~ Lines for Life
YouthLine ~ Lines for Life
CALL: 877-968-8491
TEXT: ‘teen2teen’ to 839863
CHAT: Online
EMAIL: teen2teen@linesforlife.org
Youth peer support available daily
from 4-10pm PST.
(adults are available by phone at all other times!)
Youth Resources: theyouthline.org/resources
Lane County Youth Crisis Response Line
Lane County Youth Crisis Response Line
Youth or caregivers in Lane County can call 24-hours a day, 365 days a year:
1-888-989-9990
riverviewgrowth.org/crisisresponse
Firearms and Suicide.pdfFirearms and Suicide
Firearms and Suicide
Safe Storage - All 4J school buildings have lock-boxes and corresponding locks for families to use.
For further details in English and Spanish including how to securely store firearms, conversation starters and further trainings, please check: https://safefirearmstorage.com/
Training & Supplemental Information
Please click on the Columbia Lighthouse Project image to access the full list of training options and tools to learn how to implement the C-SSRS.
The Online Module Training is an interactive way to learn how to implement the C-SSRS in different situations via lecture, slides, question prompts, role-plays and tips for various scenarios.
These are demonstration videos briefly illustrating essential aspects of the Safety Planning Intervention which break-down:
Understanding Warning Signs & Risky Behaviors
Affirming Coping Skills & Strategies
Inviting In Trusted Humans / Building a Support Network
Reducing Access to Lethal Means & Unsafe Environments
Follow-Up on Safety Plan
Role-of-HS-MH-Providers in SI P&R.pdfRecommended Student At-Risk & School Re-Entry Plan Guidelines.pdf
Click on image for more information
Sources of Strength
Sources of Strength
A best practice youth suicide prevention project designed to harness the power of peer social networks to change unhealthy norms and culture, ultimately preventing suicide, bullying, and substance abuse. The mission of Sources of Strength is to prevent suicide by increasing help seeking behaviors and promoting connections between peers and caring adults. Sources of Strength moves beyond a singular focus on risk factors by utilizing an upstream approach for youth suicide prevention. This upstream model strengthens multiple sources of support (protective factors) around young individuals so that when times get hard they have strengths to rely on.
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