Suicide is a reality in U.S. public schools. Prevalence data indicate that one suicide every 5 years and about 170 suicidal behaviors annually take place at a typical high school. Unfortunately, many of the latter will not come to the attention of school staff and may eventually lead to off-campus suicides. However, when school staff do become aware of a student’s suicidal behavior, diligent school psychologists and counselors, in partnership with other school personnel and community-based professionals, can do something about it.
The goals of suicide intervention are ensuring student safety, assessing and responding to suicide risk, determining needed services, and ensuring appropriate care. Accordingly, both general staff procedures and specific risk assessment and referral procedures should be adhered to. Risk assessment and referral are performed by a designated reporter – typically a school psychologist or counselor. General staff have an essential role to play before the designated reporter is notified. These procedures should be followed whenever a teacher or other staff member suspects a student is at risk for suicide:
- Stay with the student. A suicidal student should never be left alone. A staff member should maintain constant visual contact with the student until help is obtained. This is true regardless of whether the student has made a direct or indirect threat. Until a suicide risk assessment is conducted, every student who appears to have suicidal ideation should be viewed as being at risk for a suicidal behavior.
- Do not allow the student to leave the school. A student who has threatened suicide should not be allowed to leave school until the designated reporter has conducted a risk assessment and adequate supervision has been ensured. If a student does attempt to leave, staff members should ask the student to stay but should not do anything that puts themselves, or other students or staff members, in danger. If the student will not stay when requested, the police should be called.
- Do not promise confidentiality. All staff members have a legal and ethical responsibility not to honor confidentiality when a student is threatening harm to self or others. No matter how much a student implores, a suicide plan must not be kept secret. It is better to have the student angry and alive than dead because a confidence was maintained.
- Determine if the student will relinquish the means. If the student has the means to attempt suicide readily accessible, staff members should request that the student relinquish the means. They should not force the student or put themselves or others in danger. If a student refuses to voluntarily relinquish the means of a threatened suicide, the police should be called.
- Take the student to a prearranged, nonthreatening room away from other students. There should be a phone in the room, and again, a staff member must stay with the student.
- Notify the designated reporter. A designated reporter must be accessible and able to quickly respond to a suicide threat throughout the school day.
- Notify the principal. The principal should be made aware of any suicidal ideation or behavior. Given the high stakes and the principal’s responsibilities for the school, it is essential that the principal be aware that a student is being assessed for suicide risk.
- Inform the student of the actions taken before he or she is interviewed by the designated reporter. It’s important for the student to know that help has been called and what will happen next. The student should be told that their parents or guardians will be contacted. If the student is resistant to this idea, that information should be relayed to the designated reporter. If it is suspected that a student’s resistance to parental contact is a consequence of abuse, a referral to child protective services must be made. Though staff members cannot promise that parents will not be informed of the suicidal threats, it would be appropriate to let a suicidal student know his or her concerns have been heard and are understood.
Student suicidal ideation and behavior are inevitable. Therefore, schools must establish and adhere to specific intervention protocols as suggested above. In a previous post, https://www.videntpartners.com/blog/2023/youth-suicide-prevention-and-competent-school-community, I presented strategies for suicide prevention. A forthcoming post will discuss recommendations for postvention, which is the school’s response when suicide or attempted suicide occurs. It is my hope that readers will be stimulated to seek further education on this topic and be better prepared for suicidal crises.