School Prevention with School Age Students Practice Brief

 Published September 2016

Dr. Paul F. Granello, The Ohio State University
Dr. Gerald A. Juhnke, University of Texas, San Antonio
Dr. Darcy H. Granello, The Ohio State University


Suicide  is a significant public  health  problem  for school age children  and adolescents (Granello  & Granello,  2007). For youth  ages 10 to 14 years  old, suicide  is the third leading  cause of death and the second leading  cause of death for persons 15 to 34 years of age (CDC, 2015). Of youth  ages 10 to 24 who died in 2013, nearly  17 percent died as a result of suicide (Heron, 2016). Hispanic  youth appear to experience greater  suicide risk than their Black or Caucasian counterparts. For example, more  than 11 percent  of Hispanic  9th through  12th  graders  reported  attempting suicide  at least one time in 2015; 4 percent  of these Hispanic  youth  suicide attempters required  medical  attention (CDC,  2015). Schools  are a natural  place  for suicide  prevention programming to occur (Granello & Granello,  2015). Concomitantly, for youth  with  immediate suicidal  intent  or for those returning to school after serious suicidal  intent  or attempt  suicide risk assessment and postvention programs within  schools can provide  prosocial  help seeking  skills to students (Granello  & Granello,  2015).

ASSESSMENT & INTERVENTION STRATEGIES

Elementary Age Students: While suicide specific programs  may not be appropriate for very young children, positive mental  health  programming should begin  as early  as possible  with  young  children. Examples may  include  exercises in identification of emotions,  expressing emotions,  working with safely  expressing negative emotions,  loneliness  prevention, and communication skills.  Identification of early  onset risk factors for suicide such as learning disabilities, cognitive problems,  impulse control difficulties,  ADHD, mood disorders, and family violence are important so that children may be referred to appropriate services both within  the school and also the community.

Middle School Students: In addition  to the preventative types  of mental  health  programming that  a counselor  can provide  elementary age  students,  middle  school  students  are old enough  for direct suicide specific prevention programs. Such programs  should focus on de-stigmatizing help seeking behaviors. A central theme of how to “get help for oneself or get help for a friend” can prove useful. It is important to provide  local and national  suicide hotline information to middle school children. The National  Suicide Prevention Lifeline is available 24/7 at 1-800-273-TALK (8255).

Children  should  learn  the difference  between  normal  feelings  of sadness  that  we  all  experience from time to time and clinical  depression  which  is a diagnosable illness for which  they should seek help. Lastly,  it may be useful to identify  “safe” adults who are open to having conversations about mental  health in the school. Some research  has indicated that “one shot” programs  (school assemblies) are not effective  but rather a several  lesson intervention delivered to a small group such as a health class is more desirable.

High School Students: High  school  aged  students  should  all receive  mandatory suicide  prevention education as suicide is now the second leading  cause of death for young  people. The loss of a high school student by suicide can affect an entire school. Assessment can include mental health screenings in the school for depression  and anxiety disorders which  underlie  many  suicides.

Proper training of all school personnel  concerning how to talk to a suicidal  student and how to refer that student for further help is essential.  All school personnel  should be trained as suicide gate keepers. Further,  student  leaders  and peers may  also be trained  as gate  keepers.  Gate keeper  training entails having the individual learn to engage with an individual that they may suspect is suicidal  in an empathic  manner, and knowing how to get that person help if needed. The national  Suicide Prevention  Resource Center (SPRC) has a best practices resource list available to see what commercial and/or  free programs  have been vetted  for use with differing  age groups (http://www.sprc.org).

A special  note is important concerning postvention programming (i.e., what  to do in the school following a suicide)  because  it is very  important to try and prevent  subsequent related  suicides  or contagion. Much of the proper programming for postvention is counter intuitive such as not having locker memorials  at school. Rather  it is better to make increased  counseling services available for those in need. The American Foundation  for Suicide Prevention (http://www.afsp.org)  has created a video program with educational guide that may be used with high school students.


INTERNET RESOURCES
•     School-based Prevention Guide – http://theguide.fmhi.usf.edu/: This is a fantastic  resource, with FREE checklists,  programs, and resources for schools!
•     American Association of Suicidology – http://www.suicidology.org: For up-to-date information, professional conferences, and suicide research
•     Suicide Prevention Resource  Center – http://www.sprc.org: For resources,  magnets, posters, fact sheets, and other information
•     American Foundation  for Suicide Prevention – http://www.afsp.org: Research, education about suicide and mood disorders,  policy  promotion
•     Suicide Prevention Advocacy Network  – http://www.spanusa.org: National  hotline, public policy


REFERENCES

Centers  for Disease Control  and Prevention (2015). Suicide: Facts at a Glance 2015. Retrieved from http://www.cdc.gov/ ViolencePrevention/pdf/Suicide-DataSheet-a.pdf

Granello,  D. H., & Granello,  P. F. (2015, June). Suicide prevention in school settings.  In D. Bird (Ed.), Every life matters: Suicide and self-harm  prevention conference. Paper presented  at Every Life Matters,  Cairns,  Queensland, Australia. Dr. Edward  Koch Foundation.

Granello,  D. H., & Granello,  P. F. (2007). Suicide: An essential guide for helping professionals and educators. Boston, MA: Allyn  & Bacon.

Heron, M. (2016). National  Vital  Statistics  Report,  Deaths:  Leading  Causes  for 2013. Retrieved from http://www.cdc. gov/nchs/data/nvsr/nvsr65/nvsr65_02.pdf