Suicide Prevention Plan
Suicide Prevention, Intervention, and Postvention
Definitions of terms
Prevention:
Suicide Prevention is the intentional steps that your school takes to create a school culture that encourages positive coping skills, reaching our for help with mental health, and talking about suicide in a safe and healthy way.
Prevention Includes:
- Mental health education for students
- Suicide prevention training for faculty and staff
- Mental health awareness campaigns
Intervention:
Suicide/Crisis Intervention is the intentional steps that your school and its staff take in the event of a student mental health crisis.
Intervention Includes:
- Safety planning
- Parental involvement
- Suicide risk assessments
- Emergency services
Postvention:
Suicide Postvention is the intentional steps that your school and its staff take in the event of a suicide in the school community. Best practices in postvention are designed to reduce the rate of suicide contagion.
Postvention Includes:
- Communication with students and parents
- Promoting healing in your community
- Communication with the media
Suicidal Behavior Risk and Protective Factors
A combination of situations could lead someone to consider suicide. Risk factors increase the possibility of suicide, but they might not be direct causes. Individual characteristics and things we can do in communities that may help protect people from suicidal thoughts and behavior.
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- Family history of suicide
- Depression, or substance use
- Previous suicide attempts
- Untreated depression, anxiety, or
- Incomplete comprehension of death (if a child doesn’t understand the consequences of their actions, they may be more likely to take deadly risks)
- Self-harm such as repetitively picking wounds, sticking pins into skin, biting fingernails to cause bleeding or pain, self-hitting other mental illness
- Learning difficulties or lack of success in school (child may believe they are a failure)
- Exposure to physical, emotional, or sexual trauma
- Unstable home environment resulting from situations such as divorce, frequent moves, or multiple caregivers (child may blame themselves for their circumstances)
- Negative school experiences such as bullying
- Significant recent losses such as the death of a parent, close friend, or pet
- Access to means of suicide such as firearms or prescription drugs
- LGBTQ+, Native-American, Alaskan Native, Male
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- Engaged in effective health and/or mental health care
- Positive problem-solving skills
- Positive coping skills
- Restricted access to means to kill self
- Reasonably safe and stable living environment
- Willing to access support/help positive self-esteem
- Resiliency
- High frustration tolerance
- Cultural and/or religious beliefs that discourage suicide
- Does well in school
- Sense of purpose and future orientation
- School climate/positive connection
- Strong sense of self-worth or self-esteem
- Responsibilities/duties to others (pets, younger siblings, friends, etc.)
- Connectedness
- Family
- Peers
- School
- Trusted adults
- Community
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National Suicide Prevention Hotline: 988
Willamette Education Service District
Mid-Valley Suicide Prevention Coalition
Suicide Prevention Resource Center
American Foundation for Suicide Prevention
Suicide Rapid Response: SRR@linesforlife.org
Warning Signs for Suicide
Keep in mind that warning signs do not necessarily mean the person is suicidal. Many warning signs of suicide are similar to the signs of depression or anxiety. Mental health struggles can be risk factors for suicide, but are not the cause. Usually these signs last for a period of two weeks or longer, but many youth behave impulsively and may choose suicide as a quick solution to their problems, especially if they have access to firearms or other lethal means.
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- Someone who has already taken action to kill themselves
- Someone threatening to hurt or kill themselves
- Someone looking for ways to kill themselves – seeking access to pills, weapons, or other means
- Someone talking, joking, or writing about death, dying, or suicide.
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- Excessive somatic complaints
- Anxiety/worry
- Sleep problems/nightmares
- Constant fidgeting/movement
- Expression in writing or art
- Withdrawal
- Crying spells
- Increased anger, frustration, temper tantrums
- Becoming less verbal
- Attempting self-harm such as cutting skin or rubbing objects repeatedly to break skin
- Marked decline in school work and absenteeism
- Bullying/being bullied/cyberbullying
- Harassment
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- Feeling like a burden
- Being isolated
- Increased anxiety
- Feeling trapped or in unbearable pain
- Increased substance use
- Looking for a way to access lethal means
- Increased anger or rage
- Extreme mood swings
- Expressing hopelessness
- Sleeping too little or too much
- Talking or posting about wanting to die
- Making plans for suicide
- Bullying/being bullied/cyberbullying
- Harassment/Sexual harassment
- Dating violence
Confidentiality
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School Employees – with the exception of nurses, psychologists, and some members of our school-based mental health team who are bound by HIPAA – follow the laws of the Family Education Rights and Privacy Act of 1974, commonly known as FERPA.
There are situations when confidentiality must NOT BE MAINTAINED; if at any time a student has shared information that indicates the student is at imminent risk of harm/danger to self or others, that information MUST be shared. The details regarding the student can be discussed with those who need to intervene to keep the student safe. This is in compliance with the spirit of FERPA and HIPAA known as “minimum necessary disclosure.”
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The school suicide prevention contact person can say something like, “I know that this is scary for you, and I care, but this is too big for me to handle alone.” If the student still doesn't want to tell their parent/guardian, the staff suicide prevention person can address the fear by asking, “What is your biggest fear?” Processing fears with the student may be helpful in reducing anxiety and helping the student to gain confidence to tell the parent/guardian. Staff may offer to call the parents with the student present to hear the conversation or allow the student to tell their parent/guardian themselves in the presence of the school staff person.
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- Designated school staff will make every attempt to inform a student's parent or guardian if there is any reason to believe a student is a risk of suicide.
- Parents/guardians need to know about a student's suicidal ideation unless a result of parental abuse or neglect is possible. The school suicide prevention contact person is in the best position to make that determination. School staff will let the student know that other people need to be involved to ensure everything possible is being done to keep them safe.
Quick Notes: What Schools Need to KNow
- School staff are frequently considered the first line of contact with potentially suicidal students.
- In the Central School District, we believe that Mental Health is everyone's job. However, that does not mean that most school personnel are expected or qualified to provide in-depth assessment or counseling necessary for treating a suicidal student. It does mean that all staff in the Central School District should be trained and equipped to recognize warning signs that students may be at risk and take reasonable and prudent actions to help at-risk students, such as making appropriate referrals, and securing outside assistance when needed.
- All school personnel need to know that protocols exist to refer at-risk students to trained professionals so that the burden of responsibility does not rest solely with the individual “on the scene.”
- Research has shown talking about suicide, or asking someone if they are feeling suicidal, will not put the idea in their head or cause them to kill themselves.
- School personnel, parents/guardians, and students need to be confident that help is available when they raise concerns regarding suicidal behavior. Students often know, but do not tell adults, about suicidal peers. Having supports in place may lessen this reluctance to speak up when students are concerned about a peer.
- Advanced planning is critical to providing an effective crisis response. Internal and external resources must be in place to address student issues and to normalize the learning environment for everyone.
School-based suicide intervention process
Any employee who reasonably believes that a student is at risk of suicide shall report such belief to the designated staff member and/or administrator as soon as possible, but no later than the end of the school day. This step is not considered complete until confirmation that the information has been received by designated staff or administrator.
If imminent danger exists (an attempt has been made or student has access to lethal means and a plan), activate protective response: CALL 911
Every attempt will be made to ensure that the student is under continuous adult supervision during this time.
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Every attempt will continue to be made to ensure that the student is under continuous adult supervision during this time. This will be ensured by a designated staff member.
If the assessment is being conducted virtually or by phone, designated school staff will make every attempt to inform the student’s parent/guardian of the situation, unless doing so could result in further harm to the student. Emergency services will be contacted immediately if an imminent threat and/or a known attempt is made.
Designated staff person interviews student using Level 1 Risk Assessment Form (see appendix).
Designates staff person will work with student to complete Safety Plan (see appendix).
Designated staff person contacts parents to inform and to obtain further information.
Designated staff person determines need for Level 2 suicide Risk Assessment based on level of
concern.Designated staff person consults with another trained screener or assessor prior to making a decision to not proceed to a Level 2 Suicide Risk Assessment.
Designated staff person informs administrator of assessment results.
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If a referral for a Suicide Risk Assessment Level 2 is determined, after a Level 1 is completed, staff will reach out to the Polk County Crisis Team for addition support. Level 2 requires parent permission, unless student is 14 or older. If parent is unavailable or unwilling to consent and the risk of self-harm per assessment is high, the school team calls crisis team or law enforcement.
Assessor interviews student, collects collateral information from other pertinent sources and makes risk determination.
Assessor determines need for immediate intervention. (e.g. in-home or out-of-home respite, hospitalization, etc.)
Assessor shares concerns and recommendations with school team and parent.
School Administrator will notify District Suicide Prevention Coordinator of Level 2 Assessment need.
Suicide Postvention Protocol
Schools must be prepared to act and provide postvention support and action in the event of a suicide attempt or completed suicide. Suicide Postvention has been defined as “the provision of crisis intervention, support, and assistance for those affected by a suicide” (American Association of Suicidology). Postvention strategies after a suicide attempt or completion is very important. Schools should be aware that youth and others associated with the event are vulnerable to suicide contagion or, in other words, at increased risk for suicide. Families and communities can be especially sensitive after a suicide event. The school’s primary responsibility in these cases is to respond to the suicide attempt or completion in a manner which appropriately supports students and the school community impacted. This includes having a system in place to work with the multitude of groups that may eventually be involved, such as students, staff and faculty, parents/guardians,
community, media, law enforcement, etc.
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- Support the grieving process.
- Prevent suicide contagion.
- Re-establish healthy school climate.
- Provide long-term surveillanceIntegrate and strengthen protective factors (i.e., community, positive coping skills, resiliency, etc).
First Step:
In the event of a suicide death, the superintendent will contact the WESD Crisis Response Team directly or through the district’s Polk County School-Based Mental Health team lead. The crisis response team shall meet with district personnel and help to develop a postvention plan. The Superintendent will also notify Polk County Behavioral Health.
Themes of Responsible Postvention
- Grief is normal
- Help is available
- Youth and young adults are resilient
- Healthy coping skills can be learned
- Suicide loss survivors are not responsible for the death
- Suicide is preventable
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- Do not glorify or romanticize the suicide or the victim.
- Treat it sensitively when speaking about the event, particularly with the media. Do not provide excessive details, or describe the event as courageous or rational.
- Address all deaths in a similar manner. For example, having one approach for a student who dies in a car accident and a different approach for a student who dies by suicide reinforces the stigma surrounding suicide.
- Address loss, avoiding school disruption as best as possible.
- Research and identify the resources available in your community.
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District/Building administrators, with crisis response support if needed
- Verify the suicide attempt or completion.
- Estimate level of response resources required.
- Determine what and how information is to be shared (DO NOT release information in a large assembly or over the intercom).
- Mobilize the Crisis Response Team.
- Inform faculty and staff.
- Identify at-risk students and staff (see “risk identification strategies”).
- Refresh faculty and staff on prevention protocols and be responsive to signs of risk.
- Be aware that persons may still be affected months after the event.
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What is Safe Reporting?
The way that media outlets, reporters, and others can safely share news that someone has died by suicide. Safe Reporting can help reduce the risk of suicide contagion and/or cluster incidences in a community. Examples of safe reporting practices include not sharing the means of death, avoiding sensationalizing the death, and including resources for community members to get help if needed.
- Help is available
- Prevention (warning signs, risk factors)
- Survivors are not responsible for the death
- Mental illness etiology
- Normalize anger and a wide range of complex emotional responses
- Stress alternatives
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After A Suicide: A Toolkit for Schools
Suicide Prevention Resource Center
American Foundation for Suicide Prevention
Suicide Rapid Response: SRR@linesforlife.org
Key Terms
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Requires Oregon School Districts to develop comprehensive district Student Suicide Prevention Plans.
These Plans are to include procedural planning, equity and racial equity-centered supports, and a staff training process that explicitly addresses when and how students and families are referred to appropriate mental health and crisis services.
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The Health Insurance Portability and Accountability Act of 1996 is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.
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The Family Educational Rights and Privacy Act is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education.
FERPA gives parents certain rights with respect to their children's education records.
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An evidence-Based gatekeeper training for suicide prevention. QPR teaches people how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help. Gatekeepers can be anyone, but include parents, friends, neighbors, teachers, ministers, doctors, nurses, office supervisors, squad leaders, foremen, police officers, advisors, caseworkers, firefighters, and many others who are strategically positioned to recognize and refer someone at risk of suicide.
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An in-depth, two-day workshop that prepares individuals to provide suicide first aid intervention using LivingWorks’ evidence-based Pathway for Assisting Life (PAL) model. It teaches participants to recognize when someone may have thoughts of suicide and work with them to create a plan that will support their immediate safety.
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Directs Oregon Health Authority to develop plan for communication among local mental health authorities and systems to improve notifications and information-sharing when death suspected to be suicide involves individual 24 years of age or younger.
