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                          Slide #13: Recommendations and Best Practices for Compliance

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                          Slide #13: Recommendations and Best Practices for Compliance

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As a school counselor, it is vital to be well-versed in the best practices for handling students expressing suicidal ideation and suicidal outcries. The following is a list of suggestions for prevention, intervention, and postvention strategies when encountering instances involving suicide.

Prevention Recommendations:

Regulary review district protocols and trainings, such as the C-SSRS, regarding how to handle students expressing suicidal ideation and/or suicidal outcries.

On an annual basis, train faculty and staff on recognizing suicide risk factors, signs, and symptoms. Keep careful records of those who have completed the training.

Implement guidance and small group lessons covering coping skills, emotional regulation, and bullying.

Intervention Recommendations:

Take every instance of suicidal ideation and/or outcry seriously. Follow the district protocol, C-SSRS, and contact the student's parent/guardian as soon as possible. Notify the school's administration of the situation. If questions arise, contact the District Director of Counseling for guidance.

Provide the student's parent/guardian with the district's vetted list of community resources.

Contact Child Protective Services if there are suspicions that the student is not receiving the appropriate support.

Postvention Recommendations:

Follow-up with the student's parent/guardian. Express your concern and support.

Meet with student upon his or her return to school in order to evaluate and offer support.

Continue to monitor student's behavior and emotional state.

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Website: National Institute of Mental Health - Suicide Prevention

This website provides a wealth of resources regarding mental health issues, including suicide. There are pages regarding statistics, brochures and fact sheets, legislative activities, and education/awareness information.

The section specifically titled "Suicide Prevention," provides information including:

signs and symptoms

risk factors

treatments and therapies

ongoing research

The website is an excellent source of information for counselors and offers resources that may be helpful for parents and community members regarding suicide prevention.

Link:
https://www.nimh.nih.gov/health/topics/suicide-prevention/
index.shtml#part_153180

National Institute of Mental Health. (n.d.). Suicide prevention. Retrieved July 20, 2019, from https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml#part_153180

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The American School Counselor Association's (ASCA) "Ethical Standards for School Counselors" is very clear when addressing the responsibilities of counselors when a student may cause harm to himself/herself or others.

Part C of Section A.9 declares that a counselor may not release a student who is a danger to himself/herself unless the student will receive the proper support. If the counselor determines that the parents may not provide the necessary resources, then it is imperative that the counselor emphasizes the need to seek help. The counselor will need to contact Child Protective Services (CPS) in the event that the need for outside support is ignored (ASCA, 2016). The top priority is protecting the safety and well-being of the student.

Link:
https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf

American School Counselor Association. (2016). ASCA ethical standards for school counselors. Retrieved July 21, 2019, from https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf

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Northside Independent School District. (2019). Student Welfare – Crisis Intervention, FFB (Legal)- Practices and Procedures. Retrieved from https://pol.tasb.org/Policy/

Download/184?filename=FFB(LEGAL).html&title=
STUDENT%20WELFARE&subtitle=CRISIS%20
INTERVENTION

Summary: The school district will develop procedures for providing notice to a parent or guardian in cases where a student is identified at risk of committing suicide. Parents must also be provided with counseling alternatives to consider when his or her child has been identified as needing suicide prevention.

Link:

https://pol.tasb.org/Policy/Download/184?filename=FFB(LEGAL).html&title=STUDENT%20WELFARE
&subtitle=CRISIS%20INTERVENTION

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School Safety and Mental Health Promotion Act, SB 11, 86th Leg. §8 (2019)

Source of Law: Statutory (State)

Summary: Suicide is added to the mental health curriculum. The local School Health Advisory Council (SHAC) must increase parental awareness of warning signs of suicide risks, behavioral health concerns, community mental health programs and services, and community suicide prevention services.

Link:

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=
86R&Bill=SB11

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Tex. Educ. Code § 33.006(1a) (1995) (amended 2017)

Source of Law: Statutory

Summary: The primary responsibilities of a counselor are outlined. Among these responsibilities is addressing the needs of students at risk for committing suicide. This includes suicide prevention measures, intervention, and postvention monitoring of at risk students. It is also the counselor's responsibility to be knowledgeable of district protocol for handling suicidal issues.

Link:

https://statutes.capitol.texas.gov/Docs/ED/htm/ED.33.htm

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

Source of Law: Administrative (State)

Summary: According to 19 TAC §153.1013, school districts are required to provide suicide prevention training to all employees. Records must be maintained detailing the name of each educator who participates in the training.

Link:

http://ritter.tea.state.tx.us/rules/tac/chapter153/ch153bb.
html

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Eisel v. Board of Educ. of Montgomery County [1991] Md. 376 324 (A.2nd), p.597.

Source of Law: Judicial

Summary: Eisel v. Board(1991) was a landmark case brought against school counselors regarding a student suicide. A student reported to the counselor that 13-year-old classmate, Nicole Eisel, had made statements about killing herself. The counselors questioned Eisel and determined that she was safe. They did not notify Eisel’s parents nor school officials. Three days later, Eisel committed suicide. This case led to many school districts implementing protocols for notifying parents when students express suicidal ideation.

Link:

https://1-next-westlawcom.easydb.angelo.edu/Link/Document
/FullText?findType=Y&serNum=1991177209&pubNum=162&
originatingDoc=I026b3297942911d9bdd1Cfdd544ca3a4&ref
Type=RP&originationContext=document&transitionType=
DocumentItem&contextData=(sc.Search)#co_pp_sp_162_456

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The article, "Student reports bullying to school counselor, threatens suicide; Parents not informed," relates the case of  14-year-old Lukas Swearingen. Swearingen, diagnosed with autism, bipolar depression, and mood disorder, had been under the care of mental health professionals and had an Individualized Education Plan (IEP) in place at school detailing his mental health concerns.

Early into the 2017-2018 school year, Swearingen was physically and verbally harassed in the school cafeteria. His parents came to school and the administration agreed that the incident should be classified as bullying. Other incidents of bullying included messages written on classroom whiteboards stating, "Go kill yoursef, Lukas." Despite his parents multiple requests for help from school officials, Lukas continued to be a target for harassment and bullying. According to his mother, this led Lukas to throw himself off a second-floor balcony in an attempt to kill himself. As a result, Swearingen suffered a traumatic brain injury with long-term effects.

It was later discovered that Swearingen revealed suicidal thoughts to the school counselor on multiple occasions, as evidenced in the counselor's notes. The counselor never contacted Swearingen's parents regarding his suicidal ideation. That, coupled with the persistent bullying and lack of administrative contact and support, led the Swearingens to sue the school district. They believe that the mandated requirements for screening for emotional trauma and district suicide protocols were not followed sufficiently. Their legal battle is just beginning, and they hope to protect other students from suffering a similar fate as their son.

Clancy, A. (2019, February 05). Student reports bullying to school counselor, threatens suicide; Parents not notified. Retrieved July 19, 2019, from https://www.kiro7.com/news/local/monday-at-5-student-reports-bullying-to-school-counselor-threatens-suicide-parents-not-notified/913225958

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The National Education Association's (NEA) article, "As Teen Suicide Rate Increases, States Look to Schools to Address Crisis," (2018) illustrates the gravity of student suicide and the role that schools must take in prevention. The article cites some staggering statistics when it comes to the increasing trend of youth and suicide.

The suicide rate of youths in the United states ages 10-17 has increased by 70% between 2006 - 2016.

Among young girls aged 15-17, the suicide rate doubled from 2007-2015. The rate among boys the same age increased by 30% during this time period.

Forty percent of LGBTQ youth in high school seriously consider committing suicide.

Youth are an increasingly vulnerable group when it comes to suicide due, in part, to untreated mental health conditions. Other risk factors include: family problems, academic pressure, bullying, and social media. Schools are on the front lines of tackling suicide risk factors, and states are passing laws mandating schools create and implement specific suicide prevention policies. The policies must address prevention, intervention, and postvention strategies developed by stakeholders such as community members, mental health professionals, and suicide prevention experts.

National Education Association. (2018, June 06). As teen suicide rate increases, states look to schools to address crisis. Retrieved July 17, 2019, from http://neatoday.org/2018/05/14/teen-suicide-prevention/

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Slide #3: Professional Association Resource

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Slide #3: Professional Association Resource

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The American School Counselor Association (ASCA) released their position on suicide prevention and awareness in 2018. Due to the alarming statistics involving the prevalence of death caused by suicide in young people and the significant rate of depression and feelings of hopelessness among young people, the need for intervention and assistance from school counselors is paramount. In order to maintain their professional, ethical, and moral obligations, counselors must maintain training in: recognizing signs of suicidal thoughts, training staff in recognizing signs of suicidal behavior, awareness of available resources, and understanding how to refer students to outside agencies. Adhering to these obligations should assist counselors in increasing awareness of suicide risks and in preventing students from self-harm.

American School Counselor Association. (2018). The school counselor and suicide prevention/awareness. Retrieved July 16, 2019, from https://www.schoolcounselor.org/asca/media/asca/PositionStatements/PS_Suicide.pdf

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Mrs. Patricia Johnston retired in June from a twenty-eight year career as a professional elementary school counselor. We spoke about the topic of a counselor's role, legal responsibilities, and best practices when responding to a student's suicidal ideation and/or outcry.

Is student suicidal ideation and/or outcry and understanding the related laws and best practices a relevant issue for counselors today?
Mrs. Johnston expressed that the number of incidents involving suicidal ideation and/or outcry at her campus has increased over the past few years. She believes that it is, in part, due to a lack of coping skills and the breakdown of a stable, family unit. This greatly affects the counseling profession since counselors are those who directly respond to students in crisis. It is imperative that counselors are well-versed in the requirements and legal ramifications of that response, both in terms of keeping the student safe as well as protecting themselves and the district from liability infractions.

What are best practices for counselors when dealing with suicidal ideation and/or a suicidal outcry?
According to Mrs. Johnston, the following are three best practices for counselors dealing with a student's suicidal ideation or outcry.

First and foremost, take every report seriously. Do not ever assume that a student is "being dramatic" or simply "seeking attention."

Follow the screening protocol prescribed by the district, C-SSRS, the Columbia Suicide Severity Rating Scale. This helps you to determine how serious and immediate the risk is to the student's safety. Make sure that you review the protocol periodically so that you are familiar with the steps and not completely caught off guard. The situation is stressful enough without worrying about the required steps to take.

Remember to follow-up with the student and family. This helps you determine whether the student has gotten the assistance necessary, lets the family know that you are concerned, and provides support if necessary to those involved.

What is an emerging issue that you see related to student suicidal ideation and/or outcry?
The impact of social media, cyberbullying, and their affect on suicide is an issue to watch. Students need to realize that their online actions can have far-reaching consequences. Counselors must be aware of legislation that addresses online activity and inform students appropriately. Counselors must also realize their potential liability in bullying situations that result in suicide.

(P. Johnston, personal communication, July 10, 2019)

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My professional perspective is working as an elementary school counselor at a public school in a large school district.  This Legal and Ethical Guide Padlet is a resource for school counselors preparing for the upcoming school year. It is meant to be a resource for how to remain in legal compliance while navigating situations involving suicidal ideation and outcries of students.

I chose this topic due to my experiences as a first year elementary counselor. Before becoming a counselor, I taught middle school for twenty years. My counseling practicum was also in the middle school setting. I understood that, sadly, suicide prevention and crisis response is an integral part of the middle school counselors' experience. Upon entering the world of elementary school counseling, however, I was shocked at the number of instances of suicidal ideation and outcries I encountered. My naiveté quickly gave way to a reality check, and the need for all levels of counselors to possess a strong understanding of the law, protocols, and best practices when it comes to assisting students and families facing the issue of suicide.