Suicide Prevention
Copy of Bubbl.us - IS STUDENT AT RISK FINAL.pdfThe purpose of the Suicide Risk Referral Protocol is to prevent and intervene with concerns of self-harm and/or suicidal ideations and support the families of those students. According to ASCA, “suicide is the third leading cause of death among young people from ages 10-19, it is important that schools have policies and procedures in place to prevent, assess the risk of, intervene in, and respond to youth suicidal behavior.”
Definitions
At-risk: A student who is defined as high risk for suicide is one who has made a suicide attempt, has the intent to die by suicide, or has displayed a significant change in behavior suggesting the onset or deterioration of a mental health condition. The student may have thought about suicide including potential means of death and may have a plan. In addition, the student may exhibit feelings of isolation, hopelessness, helplessness, and the inability to tolerate any more pain. This situation would necessitate a referral, as documented in the following procedures.
Mental health: A state of mental and emotional being that can impact choices and actions that affect wellness. Mental health problems include mental and substance use disorders.
Postvention: Suicide postvention is a crisis intervention strategy designed to reduce the risk of suicide and suicide contagion, provide the support needed to help survivors cope with a suicide death, address the social stigma associated with suicide, and disseminate factual information after the suicide death of a member of the school community.
Risk assessment: An evaluation of a student who may be at risk for suicide, conducted by the appropriate school staff (e.g., school psychologist, school counselor, or school social worker). This assessment is designed to elicit information regarding the student’s intent to die by suicide, previous history of suicide attempts, presence of a suicide plan and its level of lethality and availability, presence of support systems, and level of hopelessness and helplessness, mental status, and other relevant risk factors.
Risk factors for suicide: Characteristics or conditions that increase the chance that a person may try to take his or her life. Suicide risk tends to be highest when someone has several risk factors at the same time. Risk factors may encompass biological psychological and / or social factors in the individual, family, and environment.
Self-harm: Behavior that is self-directed and deliberately results in injury or the potential for injury to oneself. Can be categorized as either non-suicidal or suicidal. Although self-harm often lacks suicidal intent, youth who engage in self-harm are more likely to attempt suicide.
Suicide: Death caused by self-directed injurious behavior with any intent to die as a result of the behavior. Note: the coroners or medical examiner's office must first confirm that the death was a suicide before any school official may state this as the cause of death.
Suicide attempt: Self-injurious behavior for which there is evidence that the person had at least some intent to kill himself or herself. A suicide attempt may result in death, injuries, or no injuries. A mixture of ambivalent feelings such as wish to die and desire to live as a common experience with most suicide attempts. Therefore, ambivalence is not a sign of a less serious or less dangerous suicide attempt.
Suicidal behavior: Suicide attempts, intentional injury to self associated with at least some level of intent, developing a plan or strategy for suicide, gathering the means for a suicide plan, or any other overt action or thought indicating intent to end one's life.
Suicide contagion: The process by which suicidal behavior or a suicide influences an increase in the suicidal behaviors of others. Guilt, identification, and modeling are each thought to play a role in contagion. Although rare, suicide contagion can result in a cluster of suicides.
Suicidal ideation: Thinking about, considering, or planning for self injurious behavior which may result in death. A desire to be dead without a plan or intent to end one's life is still considered suicidal ideation and should be taken seriously.
Risk Factors
Major depression (feeling down in a way that impacts your daily life) or bipolar disorder (severe
mood swings)
Problems with alcohol or drugs
Unusual thoughts and behavior or confusion about reality
Personality traits that create a pattern of intense, unstable relationships or trouble with the law
Impulsivity and aggression, especially along with a mental disorder
Previous suicide attempt or family history of a suicide attempt or mental disorder
Serious medical condition and/or pain
Students at Elevated Risk
Youth living with mental and/or substance use disorders
Youth who engage in self-harm or have attempted suicide
Youth in out-of-home settings
American Indian/Alaska Native (AI/AN) youth
LGBTQ (lesbian, gay, bisexual, transgender, or questioning) youth
Youth bereaved by suicide
Youth living with medical conditions and disabilities
Signs and Symptoms of Suicide
The behaviors listed below are common signs that someone is thinking about suicide. This list is not exhaustive:
Talking about wanting to die or wanting to kill themselves
Talking about feeling empty, hopeless, or having no reason to live
Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun
Talking about great guilt or shame
Talking about feeling trapped or feeling that there are no solutions
Feeling unbearable pain (emotional pain or physical pain)
Talking about being a burden to others
Using alcohol or drugs more often
Acting anxious or agitated
Withdrawing from family and friends
Changing eating and/or sleeping habits
Showing rage or talking about seeking revenge
Taking great risks that could lead to death, such as driving extremely fast
Talking or thinking about death often
Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
Giving away important possessions
Saying goodbye to friends and family
Putting affairs in order, making a will
It is important to note that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress, not a harmless bid for attention, and should not be ignored.
Mandatory Reporting
You should be honest and upfront with your students that while you encourage them to express themselves and will keep their secrets safe, there are certain things that you are obligated to report. Explain to your students that you are a mandated reporter, and what that means. This helps build trust between you and your students, and it also gives students an easy and non-threatening way to inform an adult they are in danger.
Mandated reporters defined: Gen. Stat. § 7B - 301
All persons who have cause to suspect that any juvenile is abused, neglected, or dependent, or has died as the result of maltreatment, shall report.
Reasonable suspicion: Standards for Making a Report Gen. Stat. § 7B -301
A report is required when a reporter has cause to suspect that any juvenile is abused, neglected, or dependent, or has died as the result of maltreatment.
It is ALWAYS better to err on the side of caution when it comes to protecting a student. If you’re wrong and you look into the issue more, then there is no harm done. However, if you’re right and you decide not to look into the issue, it could be lethal to the student. A referral to a family for mental health services that goes unaddressed MAY be reportable under the category of neglect, but only after a referral has been made and documented. Always consult with your grade-level counselor as needed.