This January, a WFIS member school messaged Ask Nancy about resources for student stress as a growing suicide risk factor.

Question:

Student stress as a risk factor of suicide is a big concern amongst our staff and community.  What resources are out there for training private school staff and providing us with clear information?

Nancy helped us learn:

In Washington State, suicide is the second leading cause of death for teens 15 to 19 years old.  Because school staff have daily contact with young people who may experience mental distress that could lead to suicidal behavior, educators need to be aware of how to identify and help young people experiencing feelings of stress or hopelessness.  This includes a referral to someone in the school who has been trained to assess suicide risk. Schools following best practices should include teacher training to recognize the warning signs, refer students to appropriate resources, and create reentry plans for students coming back to school after a crisis that coordinate with mental health treatment plans.

The first step is to adopt a plan to protect the health and well-being of all students by having procedures in place to prevent, assess the risk of, intervene in, and respond to students in crisis.
OSPI provides a comprehensive list of resources and links in their Emotional and Behavioral Distress Guide. OSPI pdf
The Society for the Prevention of Teen Suicide offers free online training that is appropriate for anyone working in the school setting seeking training on how to recognize warning signs and next steps for intervention.  Additionally, New York State Center for Mental Health offers this free online training video (Adobe Flash required).

Question:

What is the appropriate way to respond to warning signs that a student is extremely distressed?

From the OSPI website:

It takes time and courage to reach out to students on a personal level, but your interest can be a lifeline to a child in crisis.

    • Ask the Tough Questions: Do not be afraid to ask a student if they have considered suicide or other self-destructive acts. Research has shown that asking someone if they have contemplated self-harm or suicide will not increase that person’s risk. Rather, studies have shown that a person in mental distress is often relieved that someone cares enough to inquire about the person’s well- being. Your concern can counter the person’s sense of hopelessness and helplessness. However, you need to be prepared to ask some very specific and difficult questions in a manner that doesn’t judge or threaten the young person you are attempting to help. For example:
      1. Sometimes when people feel sad, they have thoughts of harming or killing themselves. Have you had such thoughts?
      2. I’ve noticed you are going through some rough times. Have you ever felt your life is a burden on others? Do you ever wish you could go to sleep and not wake up?
      3. Are you thinking about killing yourself?
    • Be Persistent: The person you are contacting may feel threatened by your concern. They may become upset or deny that they are having problems. Trust your instinct and be consistent and firm, and make sure that they get the help they need.
    • Be Prepared to Act: You need to know what to do if you believe a student is in danger of harming themselves. Know the school’s procedures from the crisis response plan for this situation and explain to the student the steps you will be taking.
    • Do Not Leave a Student at Imminent Risk of Suicide Alone: If you have any reason to suspect that a student may attempt suicide or otherwise engage in self-harm, you need to remain with the student (or see that the student is in a secure environment, supervised by caring adults) until professional help can be obtained.
    • Get Help When Needed: If you believe that the student is in imminent danger, you, or another member of the school staff, should call 911 or (800) 273-TALK (8255). Tell the dispatcher that you are concerned that the person with you “is a danger to themselves” or “cannot take care of themselves.” These key phrases will alert the dispatcher to locate immediate care for this person with the help of police. Do not hesitate to make this call if you suspect that someone may be a danger to him- or herself. It could save that person’s life.
    • Use Your School’s Support System: School districts have crisis plans for working with students who are experiencing emotional or behavioral distress Familiarize yourself with these plans and use them when appropriate.
    • Connect with Parents or Guardians: Do not promise confidentiality to anyone when it comes to issues regarding their safety. If a student opens up to you about their feelings, talk privately with them about putting the steps of the school’s crisis plan in place, and include them in the conversation. Follow the school’s communication plan for contacting parents or guardians when a student is at risk. If you believe that contacting the parents or guardian may further endanger the child (if, for example, you suspect physical or sexual abuse), contact the proper authorities. School staff are mandated reporters and are required to report suspected child abuse.