Suicide Prevention and Intervention: Texas Suicide Safer Schools

1. Suicide Prevention and Intervention: Texas Suicide Safer SchoolsDr. Scott Poland, Co-Director Suicide and Violence Prevention OfficeNova Southeastern University

2. Challenges/Recommendations • Schools accepting more responsibility (1910 Vienna conference) • Community and state agencies and schools working together • Schools knowing and utilizing community and state resources • Increasing physicians engagement and screening • Schools increasing mental health services • Postvention assistance provided longer and including more students

3. Many Texas Accomplishments • Zero Suicide Statewide Emphasis • All 37 mental health authorities have a suicide prevention liaison www.txcouncil.com • Texas has over 30 suicide prevention coalitions www.texassuicidprevention.org • Collaboration of State Dept. of Health, Mental Health America of Texas and TEA www.dshs.state.tx.us

4. Facts to Dispel Most Common Suicide Myths • Suicide rarely occurs on a whim or without warning • Suicide is not inherited or destined • Talking about suicide will not plant the idea • There is a relationship between bullying and suicide • There is a relationship between suicide and self injury (NSSI)

5. World Health Organization: What Works? • Reduce lethal means available to suicidal individuals • Interrupt the development of suicidal behaviors as a result of profound life stressors • Increase education about the warning signs of suicide especially for physicians

6. Center for Disease Control Recommendations • Improve school and community partnerships • Build community receptivity and capacity for competent response to suicidal youth • Increase availability of mental health services for youth • Increase their connections to other persons, families, schools and the community

7. 2013 National YRBS Results Surveyed 15,000 H.S students and in the last year 17.0% considered suicide (increase from 2011) 13.6% made a suicide plan (increase) 8.0% made an attempt (increase)

8. 2013 Texas YRBS Results Surveyed 3181Texas H.S students and in the last year 16.7% considered suicide 15.6% made a suicide plan (increase) 10.1% made an attempt

9. Texas Suicide Safer Schools Project • Surveyed Texas school personnel and leaders in state agencies • Reviewed the Texas legislative requirements for schools and suicide prevention • Identified Texas resources • Made recommendations for prevention/intervention and postvention

10. Texas 84th Legislature • Texas school districts must include suicide prevention in the campus improvement plan • New employees required to receive suicide prevention training and TEA will determine training schedule for existing employees • Texas State Department of Health Services & Texas Education Agency will send out a list of best practices programs annually • TX Education Codes emphasizes the role of the school counselor in suicide prevention

11. Bullying and Suicide • Children who have been bullied have reported a variety of behavioral, emotional and social problems. • Suicide is a leading cause of mortality in children and adolescents. • Studies reported positive associations between all bullying types and suicidal risks.

12. SPRC Brief: Suicide and Bullying Both victims and perpetrators are at higher risk than peers and a strong association exists between bullying and suicide Personal characteristics such as internalizing problems; low self-esteem; and low assertiveness increase the risk of being bullied and these factors are also associated with risk for suicide It is difficult to control all the risk factors to determine if being bullied was a proximal cause to a youth suicide

13. Best Practices • Schools are encouraged to form a suicide prevention task force to develop policies and procedures and to obtain assistance from the local mental health authority • The task force will be the most effective when community mental health, law enforcement, medical personnel, survivor groups and clergy are represented • Schools need to have bullying and suicide prevention programs

14. Best Practices for Schools • Annual awareness training for all staff • Suicide lethality assessment training for key staff • Policies for parent notification and supervision • Implement depression screening (SOS) and peer intervention programs • Provide prevention information for parents about suicide and teen depression on district website and provide presentations for parents • Link with community partners and state services • Develop referral procedures for community services, monitoring and follow up at school

15. Assessment and Notification • Assessment training not part of university training or credentialing (AAS Task Force) • Three critical assessment questions must be asked • Essential to develop a safety plan with the student • Parent notification (one exception) • Utilize emergency notification forms

16. GLBTQ Issues Higher rates for youth not due to identity but unique complications “nothing inherently suicidal about same sex orientation” Studies have found 2 to 3 times more attempts External factors: conflict, harassment, abuse rejection, lack of support Advocacy for GLBTQ population in school often met with resistance Strongest protective factor is parental acceptance

17. PROTECTIVE FACTORS World Health Organization • Family cohesion and stability • Coping and problem solving skills • Positive self worth and impulse control • Positive connections to school and extracurricular participation • Successful academically

18. PROTECTIVE FACTORS • Good relationships with other youth • Seeks adult help when needed • Lack of access to suicidal means • Access to mental health care • Religiosity • School environment that encourages help seeking and promotes health

19. Contagion/Clusters • Suicide attempts by friends and family do trigger suicidal thoughts especially for middle school students and those students with preexisting risk factors • Guide to determine who is most at risk? • Effect can last to up to six years especially for girls who are more likely to have not just thoughts but make attempts • School postvention efforts after a suicide are short term and focus on too few students

20. Postvention The journey begins and ends with prevention and no single agency or entity can stop a suicide cluster as it takes the entire community working together! After a suicide: Toolkit for schools www.sprc.org Texas coming together to care toolkit www.texassuicideprevention.org

21. TEXAS SUICIDE PREVENTION: Website is maintained by Mental Health of America Texas with input from the Texas Suicide Prevention Council and the Texas Department of State Health Services www.texassuicideprevention.org

22. YOUTH SUICIDE:Resources American Association of Suicidology www.suicidology.org American Foundation for Suicide Prevention www.afsp.org Suicide Prevention Resource Center www.sprc.org

23. Success Story More Information www.nova.edu/suicideprevention Suicide in schools by Erbacher, Singer & Poland (2015) Routledge spoland@nova.edu Suicide Prevention Is Everyone’s Responsibility