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The information in this presentation is from the perspective of a school counselor, and is designed to educate current and prospective school counselors about legal and ethical issues related to suicidal students. I chose this topic because it is crucial that school counselors are aware of the policies related to this issue. Failure to follow procedures could result in the severe harm, or possibly death, of a student.

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Angelica Perez is the head counselor of Dr. John Folks Middle School in San Antonio, Texas. She has been a counselor for over fifteen years, and she feels passionately about supporting suicidal students.

According to Perez (personal communication, May 3, 2022), working with suicidal students is one of the most important roles of the school counselor. The purpose of a comprehensive school counseling program is to provide intervention to prevent students from reaching the point where they want to take their own life. However, even in schools with the strongest programs, there will still be students who reach this point. These students are in crisis, and if counselors do not respond immediately and appropriately, the consequences could be devastating.

When asked about best practices for working with suicidal students, Perez (personal communication, May 3, 2022) explained:

If a staff member notifies a counselor that a student is at risk for suicide, the counselor needs to meet with that student before they go home that day. If this is not able to happen, a counselor can notify local authorities to conduct a well-check at the student's home.

Parents and guardians must always be notified if there is a concern about their child potentially committing suicide, even if the risk seems low. Counselors could face legal action if they fail to notify parents and something happens to the student.

Parents should be provided with a list of resources to get help for their child. This list must include at least three places, and counselors cannot suggest one place over another.

When asked about an emerging issue, Perez (personal communication, May 3, 2022) mentioned the effects of the Covid-19 pandemic. She said that since the pandemic hit, counselors in our district have seen an increase in responsive services and suicidal outcries. Students have lost loved ones, been isolated from friends and family, and are falling behind in school. Local mental health facilities have been bombarded and currently have wait lists that are several months long, which can be dangerous to students needing immediate help. While this is an immediate effect of the pandemic, Perez said that it will be interesting to observe the long-term effects and how they will influence the role of the counselor.

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The American School Counselor Association (2020) outlines the role of a school counselor when responding to suicidal outcries. It provides information about notifying parents, following district protocol, completing risk assessments, keeping the student safe until the parents arrive, and the process for referring students to outside agencies.

American School Counselor Association. (2020). The school counselor and suicide risk assessment. https://schoolcounselor.org/Standards-Positions/Position-Statements/ASCA-Position-Statements/The-School-Counselor-and-Suicide-Risk-Assessment

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The School Counselor and Suicide Risk Assessment

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School counselors support best practice in suicide prevention to reduce suicide risk in children and adolescents and are part of a collaborative team who respond when students are identified as at-risk for suicide. When students are identified or are in crisis, school counselors support them by providing parents/guardians with appropriate information and referrals.

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Marraccini (2021) describes the impact the COVID-19 pandemic has had on student suicide rates. Specific information in the article includes:

Although reports show an increase of suicidal idealization during the pandemic, the actual number of committed suicides has not seen an increase.

Many media outlets are sharing false information about suicide rates related to the pandemic, and schools must be sure to base all interventions on actual research.

The article provides several research-based techniques that schools can use to support students' mental health while distance learning.

Marraccini, M. (2021, March 31). What we know about suicide during the pandemic (and what we don't). Education Week. https://www.edweek.org/leadership/opinion-what-we-know-about-suicide-during-the-pandemic-and-what-we-dont/2021/03

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We don't yet understand the effects of remote learning on student mental health. As parents, educators, mental-health professionals, and researchers, we must distinguish among projections of risk (what we think might happen), current practice (what is actually happening), and our next steps (what we think should happen next). It is not a foregone conclusion that remote learning will have overall negative effects. This story is still being written.

During the COVID-19 pandemic, a number of risks associated with suicide may be elevated-including social isolation, barriers to care, access to lethal means, and personal and economic loss. Over the past year, there have been numerous reports related to suicide risk, including some heartbreaking incidents of death. School communities must recognize warning signs for suicide, provide preventative services, and link kids to care.

These efforts must be rooted in what we know to be true about suicide. First and foremost, this means focusing on how suicide is preventable and how suicide-related thoughts and behaviors are treatable. This also means acknowledging the complexity of suicide, which relates to multiple factors (environmental, biological, and psychological risk) and cannot be attributed to any single factor.

A recent article published by the American Medical Association indicates that, while real-time data about suicide are not available in many regions, emerging data in several countries do not yet provide any evidence that overall deaths as a result of suicide have increased since COVID-19 first appeared. Estimates by the Centers for Disease Control and Prevention from last summer do suggest an increase in suicidal ideation among young adults, signifying the potential for increased distress in this age group and underscoring the importance of connecting individuals to care. Suicidal ideation, however, is not a strong predictor of suicidal behavior or death due to suicide, and multiple evidence-based treatments are available for individuals with risk for suicide.

Although there are reports that suggest increased proportions of emergency-department visits for mental-health treatment or suicide-related behaviors in youth during the pandemic, this increase appears to be the result of a lower frequency of emergency-department visits overall. In fact, the actual numbers of visits for mental-health crises appear comparable to prior years. Until more data become available, it remains unclear if there have been changes in severity and intensity of mental-health crises. However, because seeking help is associated with suicide prevention, the rise in emergency-department visits could also reflect an ongoing commitment by caregivers toward treating serious mental-health concerns.
Schools play an important role in identifying risk for suicide, linking young people to care, providing comprehensive suicide-prevention programs, and facilitating social connections among youth. Schools also harbor known risk factors for suicide, including negative social interactions, bullying, and academic stressors. Thus, whether remote learning increases or decreases, suicide risk likely varies from child to child.

Only 8% of students identified "interacting with teachers/school employees" as an activity that helped them maintain a positive state of mind in school during the pandemic.

As a school psychology researcher and professor, I study how schools can play a key role in suicide prevention. With the shift to remote learning, I have focused on understanding how schools can best continue to enhance suicide prevention in youth. I have also been closely following how the media has covered suicide prevention in the context of remote learning. Many reports convey messages that reflect negative outcomes as though they are final and unchangeable. Critically, there have been multiple, unfounded claims that rates of suicide are increasing or linked to remote learning. This is deeply concerning as it paints a false picture of a situation that remains uncertain.

Over the past few months, my colleagues and I have been surveying and speaking with school support professionals who are employing creative strategies to support suicide-prevention efforts and continue to connect with kids. I am hopeful about the potential for these remarkable professionals to have a positive effect on our youth. Some of these strategies, which are based on findings from my own research funded by several federal and private sponsors and other existing research, include:

Prioritizing connections with and between students. Allot nonacademic time for students, for example, asking students to answer fun discussion questions in smaller breakout rooms.

Integrating social and emotional learning into student and professional-development curricula.

Using multiple methods for reaching out to students. Consider emailing, calling, texting, video conferencing, and conducting home visits.

Offering counseling services, with a protocol for ensuring parents are available for sessions.

Providing information and resources to students and families, including suicide-prevention hotlines, crisis text lines, and community-based resources.

Learning about the warning signs and risk factors for suicide and how to connect students to care.

Establishing clear protocols for in-school and community-based referrals, virtual risk assessments, adapted safety planning, and emergency services such as mobile crisis.

Checking in with students, families, and colleagues regularly to identify ways to improve these approaches over time.

Practicing self-care and staying connected with your colleagues.

The shift to distance learning will have consequences, but we must continue to distinguish among reports of what can happen, what is happening, and what should happen. We need to tackle ongoing concerns of inequity and psychological distress, while being careful not to assume the worst. If we remain open to the possibility of multiple effects from remote learning, we won't miss opportunities to reinforce and celebrate the successes of our children, even in the midst of a pandemic.

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What We Know About Suicide During the Pandemic (and What We Don't) (Opinion)

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We don't yet understand the effects of remote learning on student mental health. As parents, educators, mental-health professionals, and researchers, we must distinguish among projections of risk (what we think might happen), current practice (what is actually happening), and our next steps (what we think should happen next).

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Merod (2022) states that the California Department of Education is among several states to mandate including mental health in their state standards. Specific information in the article includes:

The standards must be included by January 2023 and be part of the curriculum by January 2024.

The focus of the curriculum will be on the signs and symptoms of various mental health disorders, as well as how to seek help.

The goal of the standards/ curriculum is to reduce the stigma of mental health disorders and encourage students to seek help before their struggles become a crisis.

Taking these steps will work to prevent students from attempting suicide and seek help instead.

Merod, A. (2022, February 2). Mental health curriculum mandates seek to destigmatize getting help. K-12 Dive. https://www.k12dive.com/news/mental-health-curriculum-mandates-seek-to-destigmatize-getting-help/618199/

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Mental health curriculum mandates seek to destigmatize getting help

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California is the latest to add a mental health curriculum requirement in K-12 to help address the ongoing youth mental health crisis.

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The 14th Amendment states that no citizen shall be deprived of the right to life, liberty, or property.

Additionally, the Amendment states that all individuals are allowed equal protection under this amendment, which includes those in public schools.

In working to support suicidal students, school counselors are protecting students' right to life.

U.S. Const. amend. XIV.

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The 14th Amendment of the U.S. Constitution

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SECTION. 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

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Rogers v. Christina School District, 2013 

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Rogers v. Christina School District, 2013 

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A school counselor met with a suicidal student for four hours before sending him back to class. She determined that he was no longer suicidal.

The counselor notified officials of the meeting, but failed to notify the student's guardians. The student committed suicide when he went home.

Though the suicide happened off campus, the court decided that the school was responsible for the death due to failure to notify the student's guardians.

Rogers v. Christina School District, 2013

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The Texas Department of Health and Safety must provide an annual list of suicide prevention programs for schools to choose from.

Programs must include training for all school staff that interact regularly with students.

The purpose of the programs are to help staff to recognize students at risk for suicide as well as the process for intervention and referral.

Tex. Health and Safety Code § 161.325

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Texas Constitution and Statutes - Statutes By Date

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All Texas school districts and open-enrollment charter schools must provide suicide prevention training as part of their new employee orientation.

Districts must maintain proper documentation regarding which employees have received training.

Suicide Prevention Training, 19 Tex. Admin. Code § 153.1013

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(a) All school districts and open-enrollment charter schools shall provide suicide prevention training as required by the Texas Education Code (TEC), §21.451(d), to all new school district and open-enrollment charter school educators as a part of new employee orientation during the 2016-2017 school year. (b) Each subsequent school year, school districts and open-enrollment charter schools shall provide suicide prevention training as required by the TEC, §21.451(d), to all new school district and open-enrollment charter school educators as a part of new employee orientation. (c) All school districts and open-enrollment charter schools shall provide suicide prevention training as required by the TEC, §21.451(d), to all currently employed school district and open-enrollment charter school educators on or by September 30, 2016. (d) Suicide prevention training that is required by the TEC, §21.451(d), and was provided to existing educators by a school district or open-enrollment charter school on or after September 1, 2013, may be used to meet the requirements of this section if the training program is on the recommended best practice-based list maintained by the Department of State Health Services (DSHS), in coordination with the Texas Education Agency (TEA), or is an online program that meets the TEA guidelines for independent review. (e) In accordance with the Health and Safety Code, §161.325, school districts shall maintain records that include the name of each educator who participated in the suicide prevention training. (f) Open-enrollment charter schools are encouraged to maintain suicide prevention training records that include the name of each educator who participated in the suicide prevention training.

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(a) All school districts and open-enrollment charter schools shall provide suicide prevention training as required by the Texas Education Code (TEC), §21.451(d), to all new school district and open-enrollment charter school educators as a part of new employee orientation during the 2016-2017 school year.

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Northside Independent School District Handbook

All staff will receive training in identifying and referring students with mental health concerns. If there are concerns of potential suicide, school counselors should administer the Columbia Suicide Severity Rating Scale (C-SSRS) to determine the best course of action to help the student (Northside Independent School District, 2021).

Northside Independent School District. (2021). 2021-2022 secondary student-parent handbook. https://www.nisd.net/sites/default/files/documents/2021-22-nisd-secondary-student-parent-handbook_0.pdf

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ASCA Ethical Codes for School Counselors

Standard A.9.c. states that if a counselor suspects a student is at risk for harming themselves or others, they should not be released from the office until they have been given the proper support. In severe cases when parents/guardians refuse to get help for their child, counselors should call Child Protective Services (American School Counselor Association, 2016).

American School Counselor Association. (2016). ASCA ethical standards for school counselors. https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf

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The laws and ethical codes related to suicidal students have helped me greatly throughout my own educational journey. While I never contemplated suicide, I struggled greatly after my father passed away when I was in high school. Because of the systems the district had in place, my teachers were able to see that I was struggling, refer me to the counselor, and the counselor was able to provide me with the support that I needed.

As a future school counselor, my passion is ensuring the emotional well-being of all students. The laws and ethical codes related to suicide provide me with a clear outline as to how I should do that, from educating students and staff to working with parents and authorities. I now feel much more confident in helping these students in my future role.

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If a student is considered at risk for self-harm or suicide, even if the risk seems low, parents and guardians must be notified. Counselors should not downplay the risk of suicide when speaking to parents.

The primary role of the counselor is to keep suicidal students safe until they are released to their parents. When the parents arrive, they must be provided with a list of resources and strongly encouraged to seek outside support for their child.

If parents refuse to get the necessary help for their child, and they are neglecting their child's mental health, counselors should contact Child Protective Services.

All schools should include mental health programs and curriculum as a preventative measure. These programs will inform students of the risk factors associated with suicide, how to get help, and how to identify classmates that may be struggling.

All school staff that interact regularly with students must be trained in identifying students that may be at risk for suicide as well as the process for referring them to the counselor.

School counselors may use screening tools if mandated by their district, but it is the counselor's role to advocate for the proper and ethical use of such tools.

Prior to talking with students, counselors must gain informed consent. Students must be aware that their parents/ guardians will be notified if the counselor believes they are at risk for harming themselves or others.