How Schools Can Prevent Suicide

Few suicides or suicide attempts take place in schools. But the suicide of a student— even if it takes place off campus—will reverberate through a school, causing extreme emotional distress among students, staff, and parents; disrupting normal activities for weeks; and, in rare cases, provoking “copycat” suicides by emotionally vulnerable children. At the same time, schools represent an important opportunity for preventing these tragedies.

This publication explores how schools can prevent suicides as well as respond to suicides or suicide attempts that do occur. A companion publication Recognizing and Responding to the Warning Signs of Suicide: A Guide for Teachers and School Staff, discusses how teachers, counselors, and other personnel in schools can identify and help individual students who may be thinking about ending their own lives.

Suicide and Young People

Suicide is the third leading cause of death in the United States for young people between 10 and 19 years of age. Every year in this country, about 125,000 young people are treated in emergency rooms for injuries sustained during suicide attempts. And every year, about 4,000 young people take their own lives (CDC, 2004). Additional young people are treated by family doctors—or not treated at all—for selfinflicted injuries. A still larger group of young people exhibit signs that they are at-risk for suicide. A national study (CDC, 2003a) revealed that in the 12 months preceding the research

• almost 17 percent of high school students seriously considered suicide
• 16.5 percent of high school students made a plan for attempting suicide
• 8.5 percent of high school students attempted suicide one or more times

Suicide among children under the age of 14 is rare. Suicide by children under the age of 9 is extremely rare (CDC, 2003b).

Many young people who attempt suicide are afflicted by depression or other mood disorders or substance abuse (which itself can be related to depression). Other emotional problems linked to suicide include conduct disorders (especially aggressive behavior), borderline personality disorder, and high levels of hopelessness (Berman, Jobes, and Silverman, 2006). Suicide among younger children is related to depression and other serious psychiatric problems as well as feelings of “expendability”— an exaggerated sense of guilt for family problems combined with low self-esteem (Pfiefer, 2000). It is important to remember that although most young people who commit suicide are affected by mental disorders, only a relatively small proportion of young people troubled by such problems try to take their own lives.

The National Association of School Psychologists (NASP) summarized the school’s role as follows (Poland and Lieberman, 2003):

Detection/awareness

• All school personnel (including teachers, paraprofessionals, administrators, support staff, bus drivers, and cafeteria workers) who interact with students on a regular basis should know the warning signs of suicide and the importance of sharing their concerns about a student with an appropriate adult, such as the school counselor.

Parent notification

• School personnel who are aware that a student is considering suicide must contact the student’s parents or guardians. Ideally, this contact should be made face-to-face and should include recommendations to parents about how to decrease the risk of suicide by increasing supervision, removing lethal means, and finding appropriate mental health services for the young person. A confidential record of parent notifications should be kept.

Support for students at risk of suicide

• School personnel, including psychologists and counselors,should support students at risk of suicide with counseling, monitoring, and follow-up services.

Recognizing and Responding to the Warning Signs of Suicide among Young

People Suicide attempts rarely occur without some warning. Teachers and other professionals who see young people on a daily basis are in a unique position to distinguish "normal" adolescent behavior from hints that something is wrong. For more information on identifying and helping students who may be at risk, see Recognizing and Responding to the Warning Signs of Suicide: A Guide for Teachers and School Staff.

School-Based Suicide Prevention Programs

Schools can help prevent suicide by providing teachers and students with the mechanisms necessary to identify and respond to students who are at risk of suicide as well as of other self-destructive behaviors. The following are some important steps that schools can take to reduce the risk of suicide among their students:

Establish a school-based suicide prevention program

• School-based suicide prevention programs include efforts to screen students for mental health problems and provide educational activities that encourage young people to recognize and find help for emotional issues. These programs can be especially effective when implemented in the context of a comprehensive risk prevention or health promotion program.

Implement a suicide prevention gatekeeping program

• Suicide prevention gatekeeping programs train those who have regular contact with young people, such as teachers, to (1) recognize behavioral patterns and other warning signs that indicate that a young person may be at risk of suicide; (2) actively intervene, usually by talking with the young person in ways that explore the level of risk without increasing it; and, (3) ensure that young people at risk receive the necessary services.

Create a comprehensive school crisis preparation and response plan

• A crisis plan helps a school respond to any emergency, from a natural disaster to violence in the school community. Such a plan should include procedures for addressing students who try to harm themselves as well as those who are only contemplating it. It should also provide some guidance for the role of individual teachers in identifying and responding to potential suicidal or violent behavior in students, and how to respond when actual violence takes place.

Implement school-based mental health services

• The American Academy of Pediatrics Committee on School Health reported that “School-based [mental health] programs offer the promise of improving access to diagnosis of and treatment for the mental health problems of children and adolescents.” They offer a set of recommendations for mental health programs that may help reduce the rates of suicide and other problems among children (Committee on School Health, 2004).

Postvention

Postvention is a term used to describe prevention measures implemented after a crisis or traumatic event to reduce the risk to those who have witnessed or been affected by the tragedy. The suicide, or violent or unexpected death, of a student, teacher, or even a celebrity can result in an increased risk of suicide for other vulnerable young people. Although rare, a suicide in the community (or even a remote suicide that receives substantial press coverage) can contribute to an increased risk of suicide. Appropriately responding to a tragedy that may put students at risk is an essential part of any crisis or suicide prevention plan. Postvention includes grief counseling for students and staff; identification of students who may be put at risk by a traumatic incident, and support for those students; support for families; and working with the media to ensure that news coverage of such an event does not lead to additional suicides or emotional trauma.

Schools Can Help

It is not always possible to tell exactly what is troubling a student and where these troubles may lead. But indications that a young person is in emotional difficulty demand action. School staff cannot assume that a young person’s family will take positive steps to respond to these problems. Schools may be the last positive social connections for students from dysfunctional families. By acting on these warning signs, schools can help students become healthier, happier, and achieve academic success. And in some cases, action will save a life.

Information on Recognizing and Responding to Suicide Warning Signs:

For more information on how individual members of the school staff can identify and help students who may be at risk for suicide, see Recognizing and Responding to the Warning Signs of Suicide: A Guide for Teachers and School Staff.