Suicide Prevention and Intervention: Texas Suicide Safer

Schools

Dr. Scott Poland, Co-Director Suicide and Violence Prevention

OfficeNova Southeastern University

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

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

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)

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

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

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)

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

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

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

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.

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

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

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

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

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

• Family cohesion and stability

• Coping and problem solving skills

• Positive self worth and impulse control

• Positive connections to school and extracurricular participation

• Successful academically

PROTECTIVE FACTORSWorld Health Organization

• 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

PROTECTIVE FACTORS

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

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

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

YOUTH SUICIDE:Resources

American Association of Suicidologywww.suicidology.org

American Foundation for Suicide Preventionwww.afsp.org

Suicide Prevention Resource Centerwww.sprc.org

• Success StorySuccess Story• More Information More Information

www.nova.edu/suicidepreventionwww.nova.edu/suicideprevention

• Suicide in schools by Erbacher, Suicide in schools by Erbacher, Singer & Poland (2015) RoutledgeSinger & Poland (2015) Routledge

• spoland@nova.eduspoland@nova.edu

Suicide Prevention Is Suicide Prevention Is Everyone’s ResponsibilityEveryone’s Responsibility