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The perspective that will be taken is that of a high school counselor. This legal guide may be used by campus faculty and staff as a resource for suicide prevention and response.

Suicide prevention and response was the topic selected due to the fact that this is a growing problem in schools, but often educators are unsure of how to identify the risks of or respond to the issue.

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My interview was with Mrs. Alicia Walton, a Student Support Counselor with Stephenville Independent School District (including Stephenville High School).

Summary: During the interview, Mrs. Walton stated that suicide prevention and response is both impactful and important to the field of school counseling because it is currently the second leading cause of death for high school-aged students. She also explained that students tend to develop strong bonds with staff and students, and therefore, are more likely to disclose their thoughts in a school setting. She went on to report that schools are required to provide suicide prevention lessons to grades 6-12 and that SISD places the National Suicide Hotline on all student bus tags for these grades as well. She then discussed the steps to follow when a student reports suicidal thoughts. First, that parents are always notified and encouraged to seek medical attention for their child. If a student reports having a plan, a local agency is notified and a counselor is sent to campus to assess the student and make recommendations to the parents. If care is not provided by the parents, Child Protective Services (CPS) is called. Mrs. Walton stated that she recently attended an online PESI training that was very beneficial, and to stay current on the topic, she reads journal articles, watches the news and attends conferences (A. Walton, personal communication, February 25, 2022).

Best Practices:
1. Prevention - students should be provided with information that teaches them how to recognize the signs of suicide and how to get help (A. Walton, personal communication, February 25, 2022).
2. Training for Faculty/Staff - school faculty/staff also need information on recognizing the signs of suicide and ways to help. Teachers need to know what question to ask a suicidal student, be aware of not leaving the student alone, and to immediately report the situation to a counselor or administrator (A. Walton, personal communication, February 25, 2022).
3. Provide Resources to and Follow Up with the Student and Parents: assure that the parents are provided with appropriate resources and assure that the student receives the help they need (A. Walton, personal communication, February 25, 2022).

Emerging Issue: An emerging issue surrounding suicide is mental health. There are more students now who struggle with anxiety and depression than ever before. Mrs. Walton said that when she became a counselor in 2004 there were 1-2 students a year who had suicidal thoughts, and now it is 1-2 a week. There is potential need for Licensed Professional Counselors (LPC) to be on school campuses to assist school counselors with the caseloads (A. Walton, personal communication, February 25, 2022).

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The article, Recognize and Address, in the American School Counselor Association (ASCA) School Counselor Magazine, by Louise Diamond (2021), discusses how school counselors can assist students engaging in risky behaviors.

Diamond (2021), discusses the importance of being watchful over students and the activities/behaviors to be aware of as warning signs. She talks about recognizing the warning signs for suicidal ideation and the role of the school counselor when dealing with students who may be at risk of harming themselves. She ends the article with explaining how essential school counselors are in attending to the mental health needs of students.

Link:
https://www.schoolcounselor.org/Magazines/November-December-2021/Recognize-and-Address

Citation:
Diamond, L. (2021). Recognize and address. American School Counselor Association. https://www.schoolcounselor.org/Magazines/November-December-2021/Recognize-and-Address

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In the article, "Suicide Assessments: The Medical Profession Affirms School Counselors' Truth," by Carolyn Stone, the subject of suicide assessments and school counselors is discussed. The article:
* recognizes what school counselors have been taught and known for years, that they are not qualified to determine the suicidal risk level of students by using in-school assessments (Stone, 2021).
*  implies how this is not only dangerous, but unethical. "-school counselors should never be required to predict if a student is safe from suicide based on an in-school assessment" (Stone, 2021, p. 1).
* discusses how despite this, there continues to be school districts who require counselors to classify a student's suicide risk as low, medium, or high based on assessments (Stone, 2021).
* emphasizes the importance of school counselors informing those who may be requiring this of them of their limitations as counselors and to remain within their ethical responsibility (Stone, 2021).
* encourages counselors to be upfront and honest with  parents about the lack of reliability with self-reports and steering away from labeling students as "low risk" (Stone, 2021).

Link:
https://www.schoolcounselor.org/Magazines/July-August-2021/Suicide-Assessments-The-Medical-Professional-Affir

Citation:
Stone, Carolyn (2021, July 1). Suicide assessments: The medical profession affirms school counselors' truth. ASCA School Counselor. https://www.schoolcounselor.org/Magazines/July-August-2021/Suicide-Assessments-The-Medical-Professional-Affir?sso=d6dcf268-e445-4b80-b130-c82d615089e2

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In the article, “Suicide and Child Abuse Reporting,” the author first presents a scenario in which a counselor fails to notify a student’s parents, even though it has been reported by a teacher and peer that the student has written and spoken about suicide. After speaking to the student, the counselor determines he is “low-risk.” The counselor used their own judgment and the student took his life.
Stone’s article goes on to discuss:
*how counselors and educators are required by law to report child abuse, using no discretion, but are not with suicidal ideation (Stone, 2018).
*that in her opinion, counselors and educators should be required to report suicidal ideation. “Reporting suicidal ideation to parents is as much a legal/ethical imperative as that of reporting suspected child abuse to authorities” (Stone, 2018, p. 1).
*that when it comes to suicide, judgment or inclination by the counselor is unacceptable and dangerous (Stone, 2018).
*that using and relying on self-reporting when it comes to assessing suicidal risk is unsafe and unreliable (Stone, 2018).
*how counselors should always notify parents if suicide is even a suspicion or remote possibility, because it is better to be safe than sorry (Stone, 2018).

Link:
https://www.schoolcounselor.org/Magazines/July-August-2018/Suicide-and-Child-Abuse-Reporting

Citation:
Stone, C. (2018). Suicide and child abuse reporting. American School Counselor Association. https://www.schoolcounselor.org/Magazines/July-August-2018/Suicide-and-Child-Abuse-Reporting

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Federal Constitutional Law:
Suicide Prevention Act:
*This bill requires the Department of Health and Human Services (HHS) to establish two grant programs to prevent self-harm and suicide(Suicide Prevention Act, 2020).
*HHS must award grants to state, local, and tribal health departments to expand surveillance of self-harm. As a condition of receiving this funding, recipients must agree to share data on suicide and self-harm with the Centers for Disease Control and Prevention (Suicide Prevention Act, 2020).
*HHS must award grants to hospital emergency departments for programs to prevent suicide attempts among patients after discharge, including programs for screening patients for self-harm and suicide and providing short-term preventive services, as appropriate. In addition, HHS must develop standards of practice for such screenings (Suicide Prevention Act, 2020).

Link: https://www.congress.gov/bill/116th-congress/house-bill/5619

Citation:
H.R. 5619 - 116th Congress (2019-2020) : Suicide Prevention Act. (2020, September 21). https://www.congress.gov/bill/116th-congress/house-bill/5619

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Federal Statutory Law:
National Suicide Hotline Designation Act of 2020:
*This bill requires the Federal Communications Commission (FCC) to designate 9-8-8 as the universal telephone number for a national suicide prevention and mental health crisis hotline (National Suicide Hotline Designation Act of 2020, 2020).
*A state may impose and collect a fee for providing 9-8-8 related services. However, this fee must be held in a designated account to be spent only in support of 9-8-8 services, and the FCC must submit an annual report on state administration of these fees  (National Suicide Hotline Designation Act of 2020, 2020).
*The Department of Health and Human Services (HHS) and the Department of Veterans Affairs must jointly report on how to make the use of 9-8-8 operational and effective across the country, and HHS must develop a strategy to provide access to competent, specialized services for high-risk populations such as lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth; minorities; and rural individuals  (National Suicide Hotline Designation Act of 2020, 2020).

Link:
https://www.congress.gov/bill/116th-congress/senate-bill/2661

Citation:
S. 2661 - 116th Congress (2019-2020): National Suicide Hotline Designation Act of 2020. (2020, October 17). https://www.congress.gov/bill/116th-congress/senate-bill/2661

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State Administrative Law:
Texas Suicide Prevention Policy:
*State law requires districts to adopt suicide prevention policies (Texas Suicide Prevention Policy, 2011).
*Texas Statutes Education Code 11.252 District-Level Planning and Decision-Making:

(a) Each school district shall have a district improvement plan that is developed, evaluated, and revised annually, in accordance with district policy, by the superintendent with the assistance of the district-level committee established under Section 11.251 (Texas Suicide Prevention Policy, 2011).
*The district improvement plan must include provisions for: (3) strategies for improvement of student performance that include: (B) evidence-based practices that address the needs of students for special programs, including: (i) suicide prevention programs, in accordance with Subchapter G, Chapter 38, which include a parental or guardian notification procedure (Texas Suicide Prevention Policy, 2011).

Link:
https://statepolicies.nasbe.org/health/categories/counseling-psychological-and-social-services/suicide-prevention-policy/texas

Citation:
Texas Suicide Prevention Policy, Tex. Education Code §11.252 (a)(3)(B). (2011). https://statepolicies.nasbe.org/health/categories/counseling-psychological-and-social-services/suicide-prevention-policy/texas

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Federal Judicial Law:
Eisel v. Montgomery County Board of Education: landmark case that was the first suicide case brought against school counselors.
* a 13-year-old female student died in an apparent murder-suicide pact with another student. Her father sued the school district and two of its school counselors, arguing that their special relationship with his daughter imposed a duty on them to report her suicidal ideations to him and his wife (Stone & Zirkel, 2012).
*The trial court dismissed the father’s lawsuit. On appeal, however, Maryland’s highest court sent it back to the lower court for a trial. The appellate court listed foreseeability of harm as the leading factor in determining whether school employees had a duty to warn the student’s parents (Stone & Zirkel, 2012).
*Ultimately, the jury in the lower court determined that the school counselors were not liable for the student’s death. However, the Eisel case provided some critical principles (Stone & Zirkel, 2012).
*Eisel v. Montgomery County Board of Education court case (1991) led to a duty owed to try and intervene to prevent a student’s suicide. Eisel strengthened school counselors’ legal obligation to students by satisfying for the first time the primary element of negligence, declaring school counselors have a special relationship with students and owe a duty to try to act when placed on notice that a student is possibly suicidal (Stone, 2013).

Link:
https://case-law.vlex.com/vid/597-2d-447-md-617556811

Citation:
Eisel v. Montgomery County Board of Education, 597 A.2d447 (Md. 1991). https://case-law.vlex.com/vid/597-2d-447-md-617556811

Stone, C. (2013). Suicide: Err on the side of caution. American School Counselor Association. https://www.schoolcounselor.org/Magazines/September-October-2013/Suicide-Err-on-the-Side-of-Caution

Stone, C. & Zirkel, P. (2012). Student suicide: Legal and ethical implications. American School Counselor Association. https://www.schoolcounselor.org/Magazines/May-June-2012/Student-Suicide-Legal-and-Ethical-Implications

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The Stephenville Independent School District Secondary Handbook (2021-2022) includes a mental health support policy that encompasses suicide prevention, intervention, and postvention.
The handbook also contains a Parental Rights Section that discusses how the district has procedures for the district's mental health liason notifying parents with an intervention recommendation for students who have been identified as at risk of attempting suicide.
Additionally, the handbook incorporates a plan for staff on notifying the mental health liason with regards to students who may need intervention (Stephenville Independent School District, 2021-2022).

Link:
https://4.files.edl.io/b989/09/02/21/154335-76877e3f-0458-4ba2-b84b-ff66f4ec0705.pdf

Citation:
Stephenville Independent School District. (2021-2022). Secondary Handbook. Retreived from https://4.files.edl.io/b989/09/02/21/154335-76877e3f-0458-4ba2-b84b-ff66f4ec0705.pdf

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The American School Counselor Association (ASCA) Ethical Standards for School Counselors addresses the ethical responsibility of a counselor for suicide response. Reading in part, A.9. a. Serious and Foreseeable Harm to Self and Others, states that school counselors: Inform parents/guardians and/or appropriate authorities when a student poses a serious and foreseeable risk of harm to self or others. The consequence of the risk of not giving parents/guardians a chance to intervene on behalf of their child is too great. Even if the danger appears relatively remote, parents should be notified (American School Counselor Association, 2016). This ethical standard demonstrates the importance and responsibility of a school counselor. A counselor should avoid using discretion with the topic of suicidal risk, and always inform the parents.

The ASCA Ethical Standards for School Counselors serve as a set of guidelines and outlines what school counselors do and do not do in their jobs. In regards to using assessments to determine a student's level of suicide risk, these standards set expectations and are meant to prevent behaviors that may cause harm to other people. ASCA Standard A.9.b. Serious and Forseeable Harm to Self and Others, states: Use risk assessments with caution. If risk assessments are used by the school counselor, an intervention plan should be developed and in place prior to this practice. When reporting risk-assessment results to parents, school counselors do not negate the risk of harm even if the assessment reveals a low risk as students may minimize risk to avoid further scrutiny and/or parental notification. School counselors report risk assessment results to parents to underscore the need to act on behalf of a child at risk; this is not intended to assure parents their child isn’t at risk, which is something a school counselor cannot know with certainty (American School Counselor Association, 2016). This ethical standard also signifies the significant duty of a school counselor when identifying the level of suicide risk of a student. A school counselor's response to parents should never lessen the seriousness of  suicide.

Link:
https://mail.google.com/mail/u/7/?zx=o5fatdtgvjx3#inbox/FMfcgxwLtkcHWbNqkMMNWHBrTcmXrSGW

Citation:
American School Counselor Association. (2016). ASCA Ethical Standards for School Counselors (1984, revised 1992, 1998, 2004, and 2010, 2016). https://www.schoolcounselor.org/getmedia/f041cbd0-7004-47a5-ba01-3a5d657c6743/Ethical-Standards.pdf

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As a future school counselor, there is now a better understanding of suicide prevention and response and how the law applies to this topic. I have learned the danger of using discretion or self-assessments in determining suicidal risk, and that ethically, it is the duty of the counselor to avoid using these means. In addition, there is now an awareness that reporting suicidal ideation is not mandated by law for school counselors, but school districts have faced law suits, so it is best to err on the side of caution and to always contact parents.

As a school counselor it should never be the use of my own judgment in determining the degree of suicidal ideation of a student. Parents should absolutely be notified and the counselor should never minimize the topic of suicide when speaking with a parent. It was a surprise to learn that reporting suicidal ideation is not required by law for school counselors, but it is my personal opinion that it should be.

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The following are best practices/recommendations obtained while researching Suicide Prevention and Response as it pertains to high school counselors:

Best Practices:

*Prevention - students should be provided with information that teaches them how to recognize the signs of suicide and how to get help (A. Walton, personal communication, February 25, 2022).

*Training for Faculty/Staff - school faculty/staff also need to be provided with information on recognizing the signs of suicide and ways to help (A. Walton, personal communication, February 25, 2022).

*Resources/Follow-Up - parents should be provided with appropriate resources and a counselor follow-up should take place to assure the student receives the help they need (A. Walton, personal communication, February 25, 2022).

Recommendations:

*School counselors should not use judgment or inclination when determining the suicidal risk of a student (Stone, 2018). A counselor basing a student's level of suicide using their own perception is unsafe.

*School counselors should not rely on self-assessments when determining the suicidal risk of a student (Stone, 2018). Suicide assessments are not dependable and counselors should not make decisions based on their results.

*School counselors should always notify parents if suicide is even a suspicion or remote possibility (Stone, 2018). It is the ethical duty of a counselor to report the suicidal ideation of  a student to the parents.

Citation:

Stone, C. (2018). Suicide and child abuse reporting. American School Counselor Association. https://www.schoolcounselor.org/Magazines/July-August-2018/Suicide-and-Child-Abuse-Reporting