Risk assessment training 2015

1. Risk assessment training 2015 September 2015 Crystal Walsh and Angie Calhoun

2. Guidelines for Obtaining and Conducting an In-School Risk Assessment and Follow Up(Based on the Suicide Prevention Guidelines 22.1-272.1 Code of Virginia 2003 Revision, please refer to the guidelines for full information) • Guidelines of Obtaining and Conducting an In-School Risk Assessment and Follow Up Reporting Concerns All licensed school professionals bear a responsibility to identify and report students at risk of suicide. Some school personnel, such as building administrators and teachers, do not by training and job responsibility possess the skills to professionally assess imminent danger with regard to suicidal ideation. The latter are expected to report any direct communication from a student that indicates a suicidal intent to licensed school professionals, who by training and job responsibility possess the skills to professionally assess imminent danger such as school guidance counselors. Details for making the report under various conditions (e.g. school counselor is on sick leave) should be included in each school division’s crisis management plan. Conduction and Assessment Licensed school professionals who by training and job-related duties are responsible for assessing imminent risk of danger related to suicidal ideation include school counselors, school nurses (Registered Nurses and Licensed Practical Nurses), school psychologists, and school social workers.   Making Contacts The school personnel identified above who are responsible for conducting this assessment are also responsible, subsequent to this assessment, for ensuring that a contact is made to parents or Department of Social Services (DSS) as deemed appropriate within the parameters of statue. Refer to attachment A. • Guidelines For Notifying Concerned Parties Identification of Available and Appropriate Community Services for Suicidal Children Each school division will develop and maintain a current local and state-level resource list of public and private assessment and treatment facilities appropriate for school age children. Refer to attachment B. Parent Notification Timelines and Procedures If a student is determined to be at imminent risk of suicide, then the licensed school professional who completed the assessment shall immediately call at least one of the student’s parents/guardians. When contacting the student’s parent or guardian, the licensed school professional should: *provide his or her name and position in the school *state that in his or her professional judgment the student is at imminent risk of suicide *assure the parent or guardian that the student is currently safe *state the legal requirement for the call citing the 22.1-272.1 of the Code of Virginia *ask the parent whether he or she is aware of the student’s mental state *ask the parent whether he or she wishes to obtain or has obtained mental health counseling for the student *provide names of community counseling resources if appropriate *offer to facilitate the referral, and *determine the parent’s intent to seek appropriate services for the student.

3. GuidelineS Continued….. Parents who opt for supportive interventions outside the professional mental health arena, such as religious-based interventions, should provide at a minimum a plan that will include a safety plan and an issues-based intervention procedure that will keep the child safe and will address the precipitant issues. The licensed school professional shall document the phone call or attempted phone call to the parent or guardian. The documentation shall include the time and date of the call, the parent’s or guardian’s response, and any required follow up. If the licensed school professional is unable to contact either parent or guardian by the end of the school day, then he or she shall follow the school’s crisis management plan for seeking treatment for a student without the parent’s authorization. (see attachment A) A student who is at imminent risk of suicide must remain under adult supervision until a parent or other authorized individual accepts responsibility for the student’s safety. Issues of Abuse and Neglect If a student indicates that parental abuse or neglect is the reason for contemplating suicide, parental contact should not be made. The licensed school professional should follow school guidelines to ensure that local social services agency is notified immediately in a manner consistent with school reporting guidelines. Department of Social Services Notification Timelines and Procedures If the licensed school professional suspects or has knowledge of abuse or neglect, he/she ensure that the Virginia Department of Social Services (1-800-552-7096) or Child Protective Services unit of the local department of social services is contacted in accordance with school reporting guidelines. Guidelines for Following Up an Intervention The licensed school professional who initiates the referral makes direct, personal contact (by telephone, letter and/or a visit, depending on family circumstances) with at least one custodial parent and/or guardian to help make an initial assessment of the child’s status and to invite the parent/guardian to attend a follow up meeting with the school’s student assistance team or its equivalent.   It is recommended that written confirmation of the meeting should be accompanied by the brochure entitled What Every Parent Should Know About Preventing Youth Suicide.

4. The purpose of the risk assessment interview form The purpose of this form is to help us as counselors and nurses to gather information to determine the level of risk to a threat that has been reported and for documentation purposes. This document is a work in progress. It is a combination of our old form along with the Department of Criminal Justice Services Threat Assessment forms. If you are using this form and want to change a part just let us know.

5. RISK ASSESSMENT INTERVIEW FORM • Part 1 • Threat Reported This is identifying information such has who is completing the form, source of the report, address, phone numbers, and parent information. • Information about the threat/concerning behaviors This is the date the threat occurred, where was the threat made, who reported the threat, and what was reported. Quote as closely as possible when documenting the threat.

6. RISK ASSESSMENT INTERVIEW FORM, Continued • Information on target/recipient(s) of threat This part documents whom the threat is against. Was the threat against another person or themselves. If the threat was against another person document the intended victim.

7. Findings of Interview • This next session is the student interview, witness interview, and threat recipient if applicable. • Student interview-page 12 has possible questions to ask to get the answers to the questions on the student interview. Also, there is the history and observation section. This section is to document the history of suicidal and threats against others. The observed behaviors is a checklist to complete of some of the behaviors you observed during the interview. • The witness interview is done if a person heard the student make a statement, etc. The threat recipient interview would be done if the student made a threat against another person and that person was aware of the threat.

8. Analysis of Findings • This is where you document your findings and how significant this risk is to the student or another person. • Questions one through twelve are to help you get to the determination of threat level.

9. Determination of threat level • High/Imminent Risk/Threat This is when based on the interviews and documentation you have there appears to pose a clear and immediate threat to self or another. For suicide this is when there is a plan or the person has the classic signs of suicide. What are some classic signs of suicide?????? For threats this is when there is an imminent risk that this student is going to harm someone else. • This is rare. We don’t have many of these a year. We have some but not many.

10. Determination of threat level • Moderate Risk We get this a lot!!! These are our students who are exhibiting potential to harm themselves or another in the future. These are our students that need intervention!! These are our students that talk about things in broad terms, no specific dates or times, or specific plans.

11. Determination of threat level • Low Risk This is when a student does not appear to pose a threat at all and the situation can be easily resolved. This is when students make a statement in the middle of class but truly they don’t mean it.

12. Basis for determination • Explanation of how you came to this determination.

13. Response High/Imminent Risk • Will need to have further evaluation by Mecklenburg Behavioral Health if risk to themselves. Can call Mecklenburg Behavioral Health to let them know you are sending someone. Also, you can call them back to see if the person went. • Contact parent/guardian for them to pick up the student. When parent arrives have them do the parent contract. Have the student do the student contract. • Make sure that student has supervision while at school until the parent/guardian picks them up. They can not go home at the end of the day if you can’t get a hold of the parent!!! • If it is a threat to someone else of course you would have notified the administer and the SRO. FOLLOW YOUR SCHOOLS CRISIS TEAM MANUAL. Administers have specific guidelines they follow when it is a threat to others. They often have to follow the chain of command and call central office to speak to their supervisor.

14. Response Moderate Risk • If threat against another consult with administrator. They may be the ones to contact the parent and SRO. • For threat to self, call the parent and let them know what has happened and what was said. You can discuss with them Mecklenburg Behavioral Health and/or outside counseling services. • The parent/guardian may or may not come to get the student, depends on the situation. If it is a harm to self talk to the parent about making sure someone is home when the student gets home. • Fill out parent and student contract. Low Risk • You don’t have to contact the parent/guardian but you can if needed. • Tell an administer so they can follow discipline procedures as needed. • See the threat is resolved. • Develop a behavior plan if needed. • May still do student contract if appropriate.

15. Documentation and Follow up • Documentation This is the place to document when you called the parent. Also, was the parent in agreement with your professional decision. • Follow up This is the place to document any follow up conversations with the parent or mental health, etc. If the child was at high risk and the parent did nothing to help the child and ignored the situation. According to guidelines you would have to call child protective services on them (I am honest with parents to let them know this but you don’t have to tell them you are calling).

16. Summary • This is the summary page that you complete and give a copy to an administer (if they would like one) and the parent. This is just indicating the risk estimation, basis of determination, and recommendations. If the parent comes in to get the child you can have them sign the document. Sometimes I have spoken to parents over the phone and then mailed it home to them.

17. Thank you for all that you do!!!!!!!! • Please don’t ever hesitate to call us if you have a question about a case and need help. Sometimes it helps just to have someone else to talk it over with. • Angie Calhoun acalhoun@mcpsweb.org • Crystal Walsh cwalsh@mcpsweb.org