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I will be speaking from the perspective of a school counselor over grades 6th-12th at a high school campus. The purpose of this padlet is for school personnel to be able to recognize the signs of suicide risk and to make appropriate referrals. Educators need regular training to help them build the skills and confidence to identify and assist vulnerable youth in seeking help. I chose this topic due to suicide rates being on the rise. For the past 10 years, children and teens have been taking their own lives at alarming rates.

UC Davis Health. (2021). Even before COVID-19 pandemic, youth suicide already at record high. https://health.ucdavis.edu/news/headlines/even-before-covid-19-pandemic-youth-suicide-already-at-record-high/2021/04

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American School Counselor Association (ASCA). (2020). The school counselor and suicide risk assessment.

https://www.schoolcounselor.org/Standards-Positions/Position-Statements/ASCA-Position-Statements/The-School-Counselor-and-Suicide-Risk-Assessment

This ASCA position statement is extremely informative because it gives a school counselor a step by step process of the school counselor's role if they were to be put in a position dealing with this topic. "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 becoming aware of a student considering suicide, school counselors assert their ethical and legal responsibility to report suspected suicide risk to parents/ guardians and the appropriate authorities" (ASCA, 2020).

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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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Johnson, S. (2022, April 25). Study: adolescents accounted for larger share of suicides in 2020. U.S News and World Report. https://www.usnews.com/news/health-news/articles/2022-04-25/study-shows-higher-share-of-adolescent-suicides-in-2020

The purpose of this article is to make readers aware of the increase in adolescent suicides since the COVID-19 pandemic. "In October, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association issued a joint declaration of a national emergency in child and adolescent mental health. The groups cited the pandemic’s impact and the struggle for racial justice, and noted intensified rates of childhood mental health concerns over the past decade" (U.S News, 2022).

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Rogers, K. (2022, April 25). Adolescent suicides increased in 5 US states during the pandemic. Why parents should be concerned. CNN Health. https://www.cnn.com/2022/04/25/health/teen-suicide-increase-pandemic-study-wellness/index.html

The purpose of this article is to inform readers about the rise of adolescent suicides. The article mentions common signs to be aware of if you think an adolescent is thinking about suicide.

"Changes in eating and sleeping habits"

Loss of interest in activities or school

"Neglecting one's personal appearance"

"Obsession with death and dying"

More complaints of physical ailments linked to emotional distress

"Problems focusing"

"Lack of response to praise"

"Verbal hints such as 'I won't be a problem much longer' or 'If anything happens to me, I want you to know...'"

Giving or throwing away cherished belongings

Cheeriness after a depressive episode (CNN Health, 2022).

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If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the National Suicide Prevention Lifeline at 800-273-8255 to connect with a trained counselor or visit the NSPL site.

(CNN)The mental health of Americans has suffered during the Covid-19 pandemic, and new research shows the damage wasn't limited to adults.

The number of suicides among adolescents between the ages of 10 and 19 increased in five states during the pandemic, according to research looking at 14 states published in the journal JAMA Pediatrics on Monday.

Data from Georgia, Indiana, New Jersey, Oklahoma, Virginia and California also showed an increase in the proportion of adolescent deaths by suicide relative to suicides by people of all ages, the authors found. Conversely, Montana had a decrease in adolescent suicides and the proportion of adolescent deaths by suicide during the pandemic, while Alaska had a decrease in proportion only, the research found.

"Suicide-risk screenings have yielded higher positive rates" during the pandemic than beforehand, the authors said. And in 2021, the American Academy of Pediatrics declared a state of emergency concerning children's and adolescents' mental health.

To measure the impact of this heightened risk, the researchers partnered with public health departments in 14 states and looked into death certificate data on more than 85,000 people who died by suicide. The authors compared two time periods: 2015 to 2019 and 2020, which is the pandemic year they analyzed.

The findings highlight the need to pay attention to any behaviors adolescents show that can signal suicidal thoughts, said Marie-Laure Charpignon, the first author of the study and a doctoral student in statistics at the Institute for Data, Systems and Society at the Massachusetts Institute of Technology. "We're all kind of blind within our own families or households," she added. Sometimes "we see what we want to see, or what we have the opportunity to see in the limited amount of time we have."

Factors behind adolescent suicide risk

Why certain states had an increased number of adolescent suicides is a "tricky question," and the answer could depend on many factors, Charpignon said.

Knowing whether the deaths of adolescents' caregivers during the pandemic influenced the increase in adolescent suicides requires further research with local health departments, Charpignon said. Whether virtual or hybrid school settings in these states during the pandemic could have negatively affected adolescents' mental health, and therefore their suicide risk, is also unknown, Charpignon said.

Having this geographical data could help public health experts reconsider where they allocate mental health services, she added.

This research isn't the first to look into adolescent suicidality in the United States during the pandemic. Emergency department visits for suspected suicide attempts among youth, especially girls, ages 12 to 17 started to increase in May 2020, according to a US Centers for Disease Control and Prevention study. The same study found that from February 21, 2021, to March 20 of the same year, visits increased by 50.6% among girls and 3.7% among boys in that age range, when compared with the same time period in 2019.

Peers and caregivers should watch for any negative changes in how adolescents express themselves or how often they communicate, Charpignon said. Concerned parents can talk with health professionals and their children's teachers, in case they have noticed any behavioral changes, she added.

Suicide risk factors also include mental or substance abuse problems or a family history of them; negative life events; family history of suicide; familial abuse of any type; household guns; impulsive behaviors; and exposure to others' suicidal behaviors, according to Johns Hopkins Medicine.

Other common warning signs -- which could also indicate depression -- according to Johns Hopkins Medicine, include the following:

"Changes in eating and sleeping habits"

Loss of interest in activities or school

"Neglecting one's personal appearance"

"Obsession with death and dying"

More complaints of physical ailments linked to emotional distress

"Problems focusing"

"Lack of response to praise"

"Verbal hints such as 'I won't be a problem much longer' or 'If anything happens to me, I want you to know...'"

Giving or throwing away cherished belongings

Cheeriness after a depressive episode

Expanded access to suicide risk assessments and grief counseling for coping with loss of caregivers could be helpful interventions for adolescents at risk for suicide, according to the study authors.

The researchers have recently examined adolescent suicides in all other states and plan to submit those findings for peer review April 25, Charpignon said. Further research that looks at racial and ethnic differences is also needed, the authors said, since "pandemic-period suicidality may be differentially affected by race and ethnicity."

CNN's Jacqueline Howard contributed to this story.

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Adolescent suicides increased in 5 US states during the pandemic. Why parents should be concerned

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Adolescent suicides have increased in several US states during the pandemic, new research has found. Peers and caregivers can watch for these signs and risk factors.

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State: Nguyen v. Massachusetts Institute of Technology, 2018
https://cases.justia.com/massachusetts/supreme-court/2018-sjc-12329.pdf?ts=1525781117

In this case, MIT was sued for not preventing the suicide of a student. While the court ruled that MIT was not liable for the student's death in this case, it did find that colleges have a duty to prevent suicides and can sued for failing to do so in future cases. In some circumstances the court also ruled that professors and others could be sued for failing to help prevent suicide.

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Grand Prairie Independent School District. (2022). Suicide prevention. https://www.gpisd.org/site/default.aspx?PageType=3&DomainID=12250&ModuleInstanceID=49167&ViewID=6446EE88-D30C-497E-9316-3F8874B3E108&RenderLoc=0&FlexDataID=47969&PageID=43250

At the beginning of each school year Grand Prairie ISD provides staff, students, and parents with suicide prevention training. This makes them aware of suicide recognition and even gives students a crisis text line and mental health 24 hour hotlines.

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According to the American School Counseling Association (ASCA) Ethical Standards for School Counseling under A.9.b, it states "Recognize the level of suicide risk (e.g., low, medium, high) is difficult to accurately quantify. If required to use a risk assessment, it must be completed with the realization that it is an information-gathering tool and only one element in the risk-assessment process. When reporting risk-assessment results to parents/guardians, school counselors do not negate the risk of harm to self even if the assessment reveals a low risk, as students may minimize risk to avoid further scrutiny and/or parental/guardian notification. The purpose of reporting any risk-assessment results to parents/guardians is to underscore the need for parents/guardians to act, not to report a judgment of risk" (ASCA, 2022).

American School Counselor Association (2022). ASCA Ethical standards for school counselors. https://www.schoolcounselor.org/About-School-Counseling/Ethical-Legal-Responsibilities/ASCA-Ethical-Standards-for-School-Counselors-(1)

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Personal Connection to the Legal and Ethical Standards

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Personal Connection to the Legal and Ethical Standards

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By reviewing the ASCA Ethical Standards for School Counselors it allowed me to understand the importance of the school counselor role. School counselors have an ethical obligation to protect their students and are in an ideal position to educate students and school personnel about the risks and warning signs of suicide. Ethical issues such as counselor competence, school responsibility, and community buy in are important considerations for educators. As a future school counselor, I want to be able to implement training in suicide recognition to all staff, and present guidance lessons for students. By doing this teachers and students are empowered by understanding suicide and equipped with the necessary tools to address it. Together, all of us can provide a support system to help our students find a safe place when they are troubled.

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Bulleted List of Recommendations/ Best Practices for Compliance

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Bulleted List of Recommendations/ Best Practices for Compliance

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Always follow the school crisis protocol steps

Immediately interview a student who made crisis outcry to identify crisis type and severity

Notify parents, guardians or child protective services and campus administration of crisis

Assist family or school personnel with crisis intervention (e.g., providing outside counseling referrals)

Submit a crisis report to administration for documentation purposes

Follow-up with the student within 48 hours after crisis intervention

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Federal: National Suicide Hotline Designation Act of 2020.
Citation: National Suicide Hotline Designation Act of 2020, Public law 116-172, 116th Congress. https://www.congress.gov/bill/116th-congress/senate-bill/2661/text

This act made it much easier to reach National Suicide Prevention and Mental Health Crisis Lifeline by adopting 988 as a new three digit number for easier and quicker access. In order for 988 to work, providers would have to make necessary infrastructure changes to support this service.

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State: Suicide Prevention Act 2021
Citation: Suicide Prevention Act 2021. 42 U.S.C 247b- 23. https://www.congress.gov/bill/117th-congress/house-bill/2955/text

This is a two grant bill which provided programs for preventing self harm and suicide. The Center for Disease Control and Prevention would be responsible for awarding grants to state and local health departments. These individual departments would expand monitoring of episodes of self-harm. The Substance Abuse and Mental Health Services Administration would be responsible for awarding grants to hospital emergency departments. They would develop programs to help prevent suicide of patients after they are discharged.

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State: Texas law: Texas Education Code- Staff Development
Citation: Tex. Education Code § 33.006 (a) and (b), http://www.sccenter.org/wp-content/uploads/2016/11/Texas_laws_suicide.pdf

This law specifies all the responsibilities of the school counselor in areas of academics, career, personal, and social abilities. It also includes the counselor's responsibility to special needs of students who may be at risk of committing suicide.

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In my interview with Staci Jenkins, the high school counselor for Christoval ISD we discussed just how important it was for schools to discuss suicide prevention with staff and students.

Suicide prevention is crucial to implement in schools because the alternative would be suicide recovery. Students typically seek out counselors to help them and provide clues to counselors of self harm. It is important to be able to provide suicide prevention for times like these.

In light of the recent spike in anxiety and mental health concerns, it has changed the way that every student is dealt with when they come to the counselor's office. Counselors have to make sure they are listening intently to any clues or messages that students give you about how they are feeling or doing. Counselors have to really make sure they are listening to make sure all students' needs are met.

Best practices:

Being informed about signs of suicidal thoughts

Being knowledgeable about resources available

Preparing students, staff, colleagues and parents to recognize warning symptoms for suicidal behavior

Transgender students and students with mental health concerns have become an emerging issues. Counselors have to be aware of how to best meet their needs, how to communicate with parents, and what they can disclose and not disclose. There is so much changing right now in this area and counselors need to conscious of student privacy. Mental illness and transgender students are emerging and definitely need support from school counselors.

(S.Jenkins, personal communications, July 14, 2022)

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https://stacijenkins.wixsite.com/mysite

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Frequent updates from Chrstoval HS Counselor, Staci Jenkins.