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The legal guide is titled "Working with Suicidal Students" and is intended for school counselors. As a future school counselor, it may be unavoidable to encounter cases of students at risk of suicide. This topic was selected to help prepare school counselors who may find themselves working with students in such situations. School counselors must know their role in such cases and what steps to take if they come across a student with suicidal tendencies. School counselors must be knowledgeable of the legal implications, laws, and policies that regulate their profession when working with cases of suicide risk. Additionally, adhering to policies, laws, and ethical standards is essential for school counselors to be effective in their role, protect students, and safeguard themselves from any liabilities.

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13. Recommendations for Best Practices and Compliance 

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13. Recommendations for Best Practices and Compliance 

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·         School counselors must learn to identify the signs of suicidal behavior and the appropriate steps to take when a student is at risk.

·         School counselors must understand their role in suicide prevention and intervention.

·         School counselors must follow Federal Laws prohibiting them from disclosing information about the student’s health or treatment.

·         School counselors must adhere to Texas Statutory law by following the established district's policies, practices, and procedures in cases of suicide risk.

·         School counselors must attend all mandated suicide prevention training.

·         School counselors must follow American School Counselors Association Ethical Standards and protect students from harm by notifying parents when a student presents signs of self-harm or suicide.

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3. Professional Association: American School Counselor Association

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3. Professional Association: American School Counselor Association

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The American School Counselor Association (2023) has created a webpage providing resources related to suicide prevention and response. The resources include a toolkit to gather suicide concern information from students, a guide to support students with suicidal ideation, multiple webinars related to suicide prevention, legal and ethical considerations, and articles on suicide assessments. This information is crucial for school districts, their counseling department, and school counselors: https://www.schoolcounselor.org/Publications-Research/Publications/Free-ASCA-Resources/Suicide-Prevention-and-Response.

In the webpage, the American School Counselor Association (2018) included a link containing important information about the school counselor’s role in the topic of suicide awareness and prevention: https://www.schoolcounselor.org/Standards-Positions/Position-Statements/ASCA-Position-Statements/The-School-Counselor-and-Suicide-Prevention-Awaren. School counselors must know their role and the protocols they should follow in case they encounter a student at risk of suicide.

References
American School Counselor Association. (2018). The school counselor and suicide prevention/awareness. American School Counselor Association. https://www.schoolcounselor.org/Standards-Positions/Position-Statements/ASCA-Position-Statements/The-School-Counselor-and-Suicide-Prevention-Awaren

American School Counselor Association. (2023). Suicide prevention and response ASCA resources. American School Counselor Association. https://www.schoolcounselor.org/Publications-Research/Publications/Free-ASCA-Resources/Suicide-Prevention-and-Response

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11. Ethical Principle Related to an Ethical Dilemma:  2014 ACA Code of Ethics Confidentiality and Limits of Confidentiality.

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11. Ethical Principle Related to an Ethical Dilemma:  2014 ACA Code of Ethics Confidentiality and Limits of Confidentiality.

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In the process of working with students who may be at risk of suicide, school counselors often face ethical dilemmas regarding confidentiality and its limits. While school counselors need to protect students’ confidentiality, there are limitations to confidentiality when working with students at risk of suicide. According to the American Counseling Association’s (2014) Code of Ethics A.2.e., school counselors must disclose and explain the limits of confidentiality to their clients before working with them. They must inform students about the information that can and cannot be kept confidential. If a student displays suicidal or self-harm behaviors, they should be assessed, and their parents or guardians should be notified immediately to ensure their safety and well-being. It is important to discuss the limits of confidentiality with students so that they can understand the situation and avoid damaging the student-counselor relationship.

Reference
American Counseling Association. (2014). 2014 ACA Code of Ethics. Retrieved from https://www.counseling.org/resources/aca-code-of-ethics.pdf

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12. Non-Law Source: Classroom Mental Health Website

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12. Non-Law Source: Classroom Mental Health Website

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The website Classroom Mental Health provides information to help educators identify signs of suicide in students. The resource describes the steps to take if a student presents signs of suicide. This information is important because it helps educators identify students at risk of suicide, clearly states the steps to take in these cases, and may help with suicide prevention and intervention. This website could serve as an informal guide in cases where the educator is not certain of what to do.

Reference
Classroom Mental Health. (2023). About suicide. Classroom Mental Health. https://classroommentalhealth.org/common-concerns/suicide/

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A statement about thoughts of suicide, or even the suspicion that a student is contemplating suicide, requires your immediate attention and action. This information is provided to assist you in in the event that a student expresses suicidal thoughts or engages in conduct that may be dangerous to him…

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5. News Article: "Preventing suicide among young children: 5 Takeaways for educators"

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5. News Article: "Preventing suicide among young children: 5 Takeaways for educators"

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In the article "Preventing suicide among young children: 5 Takeaways for educators", Gans (2022) explains the importance of addressing the mental health of young students and meeting their needs. This article is a summary of an Education Week online summit that focused on the need for mental health services in school. Some important facts for educators are:

·         Students under 10 years old can present suicidal ideation and thoughts of death. The article establishes that is important that educators and school counselors have appropriate conversations with students when they are emotional.

·         Signs of mental health issues are difficult to identify when students are young, and the signs of self-harm may be different in older students.

·         Younger students may experience different stressors or triggers as their stressors may be more related to their home environment.

·         School staff members must be trained in suicide prevention as students need supportive adults.

·         School counselors are needed as the number of students seeking mental health services has increased after the pandemic.

Reference
Gans, A. (2022). Preventing suicide among young children: 5 Takeaways for educators. Education Week. https://www.edweek.org/leadership/preventing-suicide-among-young-children-5-takeaways-for-educators/2022/04

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The national mental health crisis has impacted students of all ages, yet efforts to address at least one specific mental health issue affecting those of school age-suicide-have largely focused on high schoolers. The mental health issues of a schools' most vulnerable population, its youngest students, are often overlooked in this area.

Reporters and experts shined a much-needed spotlight on that group during an Education Week online summit last week broadly focused on the growing mental health needs of students and staff in the nation's schools.

Schools in 22 states are mandated to have suicide-prevention policies, according to the American Foundation for Suicide Prevention. These often entail annual staff trainings on suicide prevention and how to have suicide-related conversations with high school students. While suicide risk and ideation is higher in teenagers, data from the Adolescent Brain and Cognitive Development Study, the largest long-term study of brain development and child health in the country, show that over 8 percent of 9- and 10-year-olds had previously had suicidal thoughts, and more than 1 percent had attempted suicide, indicating that millions of younger students need these resources, too.

Here are five takeaways for educators from last week's online discussion:

Young kids can experience suicidal thoughts

Contrary to popular belief, kids under 10 are capable of wanting to die and can conceive of death or suicide.

"[Kids as young as 5] understand killing themselves better than the word suicide," said John Ackerman, a child clinical psychologist and the suicide prevention coordinator at the Center for Suicide Prevention and Research at Nationwide Children's Hospital. But they may not grasp the finality of death. "Often they know that they would be dead, but they don't understand the permanence of that in the same way. They don't understand that doesn't mean they're coming back or they're not having conversations with loved ones," he added.

That is why Ackerman said it is important that educators and those in the mental health field have developmentally appropriate conversations with young children when they feel deep emotional stress.

"Those conversations should be direct, concrete, and done in a way that's really compassionate and curious, rather than sort of born out of fear or anger or pushing them away and picking up a punishing approach," Ackerman said.

Signs of mental health struggles may be harder to recognize in young children

Part of the problem, said Ackerman, is that warning signs of serious mental health issues, suicide risk, and self-harm risk can look different in younger children than in older children.

Ackerman said younger kids often possess less-developed language skills and less experience in regulating more-intense emotions. They can communicate and manage stress and trauma in ways that look different than for students with more-developed skills.

"A lot of times they're left with intense feelings that they're not able to communicate, or potentially the parts of the brain that do a good job of helping manage and find out solutions on how to deal with those don't have as much practice," he said.

Younger children may have different stressors than adolescents

Younger children may also be triggered by different stressors than older kids, because they tend to spend more time with adults than older children do.

"Young kids are stuck in this very difficult spot of having the people that they turn to for safety also be a major source of stress," Ackerman said.

"A lot of things you see in terms of risk for self-harm is around family conflict and exposure to things like community violence, domestic violence, things that are more interpersonally related," he added. "And that can be very stressful for a young child who's reliant on caregivers and parents."

Supportive adults can help

Ackerman said having supportive adults in their lives significantly reduces a child's suicide risk by making them feel more valued and connected to their school, home environment, or extracurricular activity. "That may not feel like a suicide-prevention program, but [these outside activities] really do act in that way," Ackerman said.

Younger children may prefer to speak with adults in their lives who are not their teachers or counselors, he added. Other school staff including bus drivers, sports coaches, and cafeteria staffers can also benefit from mental health awareness and assisted suicide prevention training.

School psychologists and counselors are in short supply

The pandemic has stoked demand for school counselors and psychologists by students. Nine in 10 teachers and school and district leaders surveyed by the EdWeek Research Center said that the percentage of students seeking school-based mental health services in their communities has increased since the fall of 2019.

Millions of students across the K-12 spectrum are feeling the effects of these shortages. Nearly 2 in 5 districts, which represent 5.4 million students, didn't have any counselors during the first year of the pandemic, according to an Education Week analysis.

During the same period, only 8 percent of districts in the United States met the recommended ratio of 1 school psychologist to 500 students, and 14 percent of districts met the recommended ratio of 1 school counselor to 250 students, a federal study showed.

Despite the influx of federal money going to mental health resources through programs like the American Rescue Plan Act last year, Ackerman said that, as a country, the United States is "definitely far behind the curve" in its resources for young children.

"We shouldn't be this far behind, but we are," Ackerman said. "And so the only thing we can do now is invest in learning what we can do to address that gap."

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Preventing Suicide Among Young Children: 5 Takeaways for Educators

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It's a myth that young children are incapable of having suicidal thoughts, said experts at an online forum on mental health in schools.

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4. News Article: "Understanding educators’ role in addressing the rise in youth suicide"

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4. News Article: "Understanding educators’ role in addressing the rise in youth suicide"

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The article "Understanding educators' role in Addressing the rise in youth suicide" reports that suicide rates among students have increased, particularly among younger individuals, due to added stressors caused by the pandemic. The article also explains the importance that schools have in helping decrease suicidal behavior among students (K-1 Dive, 2022).

·         Stressors may increase suicide risk. One factor that may increase risk is the use of social media, this may be due to cyberbullying or the pressure the kids put on themselves when others do not react how they want to their posts.

·         Educators must pay attention to changes in student’s behavior as this may be an indicator that the student may need help. by identifying students who feel isolated.

·         Educators can make a difference by including activities that help increase protective factors and establishing good classroom management.

·         Schools can also use a universal screening to identify issues early.

Reference
K-12 Dive. (2022). Understanding educators’ role in addressing the rise in youth suicide. K-12 Dive. https://www.k12dive.com/spons/understanding-educators-role-in-addressing-the-rise-in-youth-suicide/630147/

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Understanding educators' role in addressing the rise in youth suicide

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Is your school or district prepared to identify students in need of additional mental health support and connect them with the care they need?

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2. Summary of Topic: Working with Suicidal Students

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2. Summary of Topic: Working with Suicidal Students

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According to the Centers for Disease and Prevention (2023), deaths by suicide increased by 2.6% from 2021 to 2022 and is one of the leading causes of death in the United States. One of the issues school counselors will face throughout their careers is working with students at risk of suicide. School counselors must be aware of the legal implications and policies that regulate the services they provide to students at risk of suicide. School counselors must be knowledgeable of resources available, and ethical principles and keep current with information for the best practices when working with suicidal students.

An emerging issue that school counselors must watch when working with students at risk of suicide is that they may find themselves in the ethical dilemma of not reporting the risk to parents because it may seem low. In some cases, students with suicidal ideations may deny these feelings and try to act as if everything is fine. This could be due to any reason, and school counselors must know that students have the freedom of speech to share or not what they think (U.S. Const. amend. Ⅰ). School counselors cannot force students to share their ideas or feelings, but they can still help them. In such situations, school counselors must follow the policies, procedures, and ethical standards related to suicidal behavior in students. Adhering to regulations and best practices can help protect students and ensure they receive the necessary help.

Reference
Centers for Disease Control and Prevention. (2023). Suicide data and statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/suicide/suicide-data-statistics.html

U.S. Const. amend. Ⅰ

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10. Administrative Law: ASCA Ethical Standards for School Counselors.

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10. Administrative Law: ASCA Ethical Standards for School Counselors.

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American School Counselors Association (2022) establishes in ASCA Ethical Standards for School Counselors A.9.a, that school counselors have a duty to protect students from harm, inform parents and administration when a student is at risk of harming themselves or others, and intervene on behalf of the student. ASCA Ethical Standard A.9.b establishes that school counselors must identify and recognize the signs of suicide risk, use a risk assessment, and report suicide risk to parents or guardians even if the risk is low. School counselors must work with the school administration to ensure that the student receives the support and services they need (American School Counselor Association, 2022). ASCA Ethical Standard A.13.f, establish that school counselors should not destroy student’s records or notes related to suicide in case it may be needed by a court of law (American School Counselor Association, 2022).

ASCA Ethical Standards ensure that:

·         School counselors are knowledgeable of and follow the policies and procedures related to suicidal risk

·         School counselors identify signs of suicidal behavior, assess the risk, and intervene on behalf of students at risk of suicide

·         School counselors protect their role from liability by maintaining records and following their district's policies and procedures.

Reference

American School Counselor Association. (2022). ASCA Ethical Standards for School Counselors. https://www.schoolcounselor.org/getmedia/44f30280-ffe8-4b41-9ad8-f15909c3d164/EthicalStandards.pdf

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9. Judicial Law: Eisel v. Board of Education of Montgomery County (1991).

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9. Judicial Law: Eisel v. Board of Education of Montgomery County (1991).

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In the case of Eisel v. Board of Education of Montgomery County (1991), a 13-year-old student (Nicol Eisel) made suicidal comments to friends in school. Eisel’s friends told their school counselor, who proceeded to tell Eisel’s counselor. When both counselors talked to Eisel, she denied the comments. The school counselors did not notify Eisel’s parents; soon after, the student and a friend committed suicide. The decision of Eisel v. Board of Education of Montgomery County (1991):

·         Determined that school counselors must intervene and notify parents of a student to attempt to prevent suicide

·         Recognized that schools are liable when a school counselor fails to intervene or notify parents to help prevent suicide.

Reference
Eisel v. Board of Education of Montgomery County, 597 A.2d 447 (1991). https://casetext.com/case/eisel-v-board-of-education

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8. State Administrative Law: Suicide Prevention Training.

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8. State Administrative Law: Suicide Prevention Training.

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The Texas Administrative Code establishes that school districts are required to offer suicide prevention training to educators (19 T.A.C. § 153.1013). School counselors have the ethical responsibility of attending all required suicide prevention training mandated by their district. This code ensures that:

·         School districts provide suicide prevention training to staff members

·         School counselors are keeping themselves updated with current information and techniques that can serve as a tool for suicide prevention and intervention.

Reference
Suicide Prevention Training, 19 Tex. Admin. Code § 153.1013. https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=T&app=9&p_dir=P&p_rloc=187943&p_tloc=14861&p_ploc=1&pg=4&p_tac=&ti=19&pt=2&ch=153&rl=1021

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7. Texas Statutory Law: Mental Health Promotion and Intervention, Substance Abuse Prevention and Intervention, and Suicide Prevention.

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7. Texas Statutory Law: Mental Health Promotion and Intervention, Substance Abuse Prevention and Intervention, and Suicide Prevention.

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The Texas Education Code (TEC), Mental Health Promotion and Intervention, Substance Abuse Prevention and Intervention, and Suicide Prevention establishes that school districts must have practices and procedures in place that include education, mental health promotion, prevention, and suicide intervention (Tex. Educ. Code § 38.351). This code ensures that:

·         Districts have practices and procedures in place related to suicide prevention

·         Schools are actively preventing suicide by educating and intervening for all students

·         School counselors follow the practices and procedures that their districts have in place to ensure they are following best practices related to suicide prevention and intervention.

Reference
Mental Health Promotion and Intervention, Substance Abuse Prevention and Intervention, and Suicide Prevention, Tex. Educ. Code § 38.351. https://statutes.capitol.texas.gov/SOTWDocs/ED/htm/ED.38.htm

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6. Federal Administrative Law: Under what conditions is prior consent required to disclose information?

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6. Federal Administrative Law: Under what conditions is prior consent required to disclose information?

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The Code of Federal Regulations protects the confidentiality of students at risk of suicide by establishing the requirement for signed parental consent before disclosing students’ information (34 C.F.R. § 99.30). This regulation establishes that school counselors must protect the student’s confidentiality by not providing information about the student’s mental health or the treatment they are receiving. This code:

·         Protects students’ confidentiality

·         Prohibits school counselors from disclosing any information related to the student’s mental health or treatment

·         Promotes awareness among school counselors of the legal requirements they need to adhere to after a student has been referred to receive mental health services.

Reference
Under what conditions is prior consent required to disclose information?, 34 C.F.R. § 99.30.  https://www.ecfr.gov/current/title-34/subtitle-A/part-99/subpart-D/section-99.30