Suicide Response and Prevention in School Settings

1. Suicide Response and Prevention in School Settings Office of School & Adolescent Health School Mental Health Advocates Amanda Askin, Region 5 Delia Mendoza, Region 4 Rubina Syed, Region 3 Twila Fundark, Region 1

2. Workshop FocusWhy do we respond a certain way? • Workshop will define postvention • Provide rationale for response • Include roles in a school coordinated response

3. Facing the Facts Nationally • On average,1 young person kills themselves every 2 hours & 53 minutes. • Suicide is the10th ranking cause of death in U.S. & 3rd for young people after accidents & homicide. Suicide State Data Page, 2009 American Association of Suicidology

4. NM Suicide Rates • New Mexico ranks 6th in the nation per suicide death rate, 18.7 per 100,000. • Second leading cause of death for youth aged 15-24 in New Mexico. • 2005-2009, 352 suicide deaths of youth in New Mexico. NM Bureau of Vital Records & Health Statistics, NMDOH American Association of Suicidology, State Date Page, 2009

5. When schools cease to attend to suicide prevention programs, the facts surrounding suicide fail to be communicated to faculty, staff and students. If this happens, a true understanding about adolescent suicide becomes clouded by false myths and presumptuous ideas, which surround the topic of suicide and act as a barrier for suicide prevention programs. Florida Mental Health Institute 2003

6. Why do we respond a certain way? Rationale for response • Reduce the risk of those who have witnessed or been affected by the tragedy • Reduce the onset and degree of mental health problems subsequent to a school crisis • Assist staff and students with the grieving process • Assist school in returning to its normal routine and educational pursuits

7. What is Postvention? • A term first coined by Shneidman (1981), the American Association of Suicidology (1998) defines suicide postvention as “the provision of crisis intervention, support and assistance for those affected by a completed suicide”.

8. SCHOOL SUICIDE POSTVENTION PLAN Every school should have a suicide protocol plan as mandated by the Safe School Plan. Components should include: • Identification of key players • District policy • Action Plan • Available resources within the school and community • Lines of communication

9. Safe School Plan • Guidance Document from Public Education Department (PED), 2008 for Safe Schools Planning • 6.12.6 NMAC School District Wellness Policy • National Incident Management Systems (NIMS) and Incident Command Structure (ICS)

10. Unified Command Structure (ICS) Emergency Operations Center Director- School Incident Commander Public Information (PIO), Safety Officer, Mental Health Officer & Liaison Officer Planning Operations Logistics Finance Security/ Safety (SRO) Facilities (building Engineer) Student Care (crisis team) Supplies & Equipment (Secretary) Emergency Medical (nurse) Staff &Comm. volunteer Translation (Liaison) Communication

11. Student Care/Mental Health (within the ICS) • Determines extent and nature of services needed • Works with district from team and/or community resources • Mobilizes mental health resource personnel • Establishes and coordinates group and individual counseling • Identifies resources to manage grief and healing process • Coordinates debriefings and services • Prepares for memorial services and long term support needed • Maintains records of services provided • Oversees training and supervision of all counseling staff • Make sure meaningful, appropriate and timely follow up services are provided • Provides mental health referral or support for students, teachers, and families National Association of School Psychologist, 2006

12. Crisis Response

13. Why respond? • To return the school community to its normal routine as soon as possible. • To decrease the negative impact on school attendance and learning. • To normalize crisis reactions and reduce possible long-term effects.

14. Postvention=Preventioncontinuum PREVENTION RESPONSE (POSTVENTION) INTERVENTION PRPREVENT What can be done to reduce the probability of a suicide? What processes are used to lessen the stress reactions to a suicide or attempt? What efforts are applied during the immediacy of a suicide? Early Identification & Referral Programs/Projects Curriculum oriented Student based Adult dependent Policies & Procedures Safe Schools Plan Situation Stabilization Facts, Feelings, and Action Crisis Teams School District Community/Regional

15. The Goals for Responding • Provide support • Create a safe environment • Educate on prevention and awareness • Make resource information available • Mitigate potential adverse affects

16. Levels of Response • School-Limited to school settings & school-based personnel. No outside assistance is needed • District-These are events where support and involvement is required from school district personnel or members of the District Crisis Team. • Community/Regional-These include large-scale events during which coordination of services from the school district and local community response agencies is warranted.

17. Roles in a Coordinated School Response • School Administration/leadership • Crisis Teams • Community Mental Health Resources

18. School Administration Responsibilities • Verify the death of a student • Contact the family • Convene the school based crisis response team • Inform other schools/staff where siblings attend • Schedule after school de-briefing sessions for school staff • Provide information about the death and funeral arrangements to parents/guardians along with resource listing and warning signs. Wisconsin Components of School-Based Suicide Prevention, Intervention, Postvention Model

19. School Admin. con’t. • Implement an enhanced attendance system to track students leaving school premises only with parental permission and documentation for safety purposes. • Select one person as spoke person to the media….have a script ready. • Have school staff be visible • Provide secretaries with a script, when calls or concerned people coming to the school have inquiries. • Stress the importance of self care for self and staff Wisconsin Components of School-Based Suicide Prevention, Intervention, Postvention Model

20. Crisis Response Team con’t • Safe rooms/counseling support for students • Assess and determine if additional support is needed. • Assist school admin. in their role when following guidelines -notification (announcement/letters, etc) -classroom support -update resource list • Conduct daily debriefing with staff during postvention Wisconsin Components of School-Based Suicide Prevention, Intervention,

21. Send Clear Messages • Expressing grief is important and reactions are normal • No secrets especially if crisis is related to suicide • Support is available, it is okay to ask for help. • Share information as it becomes available like funeral services or additional resources, etc.

22. SUICIDE CONTAGION IS REAL “Suicide contagion” or “copycat” suicides is the behavior that leads to clusters of suicides. • What is a suicide cluster? A group of suicides or suicide attempts, or both, that occur close together in time and space. • Who is at risk? Teenagers and young adults. • Why? They model the behaviors of their peers and the tendency to act impulsively.

23. Community Mental Health role/functions • Crisis team members • Receive referrals on site • Follow up care and coordination with school crisis team/staff • Support crisis team/staff in debriefing/grief counseling • Resource for parents and families • Prevention/awareness trainings

24. Self Care • Support is important for crisis response team, too. • Neighboring districts, community mental health agencies and grief group support. • Qualified outside help for debriefing and provide support to crisis team and staff.

25. Coordinated School and Community Response • Prevent Suicide Contagion. • Work collaboratively with other individuals and entities utilizing identified safe school plan. • Student Mobility. • Community Cohesiveness. • Schools and larger community.

26. State Resources • Nancy Kirkpatrick, Youth Suicide Prevention Coordinator, nancy.kirkpatrick@state.nm.us • Statewide Agora Crisis Line 1-866-HELP-1-NM or (435-7166) • Southern New Mexico Crisis Line: 866-314-6841 or (575) 646-CALL (575-646-2255) • www.nmsuicideprevention.org

27. National Resources for Crisis Response/Planning • National Suicide Prevention Lifeline-a free, 24-hour hotline available to anyone in suicidal crisis or emotional distress. 1 (800) 273-TALK http://www.suicidepreventionlifeline.org/ • Hopeline Network -1 (800) SUICIDE (784-2433) • Native Youth Crisis Line:  1-877-209-1266 • Lesbian/Gay/Trans/Questioning Youth: The Trevor Line:  1-866-4-U-Trevor (866-488-7386) • www.sprc.org (Suicide Prevention Resource Center) • American Association of Suicidology www.suicidology.org • American Foundation for Suicide Prevention www.afsp.org • Sibling Survivors of Suicidehttp://www.siblingsurvivors.com/index.htm •  A toolkit for schools, it can be found at this website: http://www.afsp.org/files/Surviving/toolkit.pdf. 

28. National Resources for Crisis Response/Planning, cont. • Wisconsin School Based Health Model : http://www.mhawisconsin.org/content/schoolbasedmodel.asp • Recommendations for Media Reporting on Suicidewww.reportingonsuicide.org • Poynter Reporting on Suicide http://www.poynter.org/uncategorized/18183/reporting-on-suicide/ • Covering Teen Suicide: One Paper’s Decision http://www.poynter.org/uncategorized/36012/covering-teen-suicide-one-papers-decision/ • Suicide Prevention Action Network USA: http://www.spanusa.org/ • www.jasonfoundation.com • Friends and Families of Suicide • www.compassionatefriends.org • www.thelink.org/ • www.survivorsofsuicide.com/