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As a middle school teacher and a future school counselor educating school staff on the roles that we each play in preventing teen suicide is a topic that demands more attention. In the last 20 years, teen suicide has increased by 30% and is the 2nd leading cause of death behind unintentional accidents like an auto accident (American Foundation for Suicide Prevention website, 2019). After Netflix released 13 Reasons Why, a story about a high school student that committed suicide due to betrayal and bullying, a spotlight on suicide prevention in schools was ignited across the country. This Legal Guide Padlet, for the staff at Davila Middle School, will be used as a reference guide for staff, administrators, and counselors to ensure student safety by making ethical and legal decisions when dealing with suicidal students. I chose this topic because of the many factors that are played in preventing teen suicide and the often dismissal by adults when teens express their feelings on bullying, anxiety, stress, and depression. The middle and high school years are full of changes and students need the support and guidance of caring adults that are there to provide help when needed.

Reference:
American School Counselor Association. (2019). Retrieved from https://www.schoolcounselor.org/asca/media/asca/PositionStatements/2018PublicComment/Suicide-DRAFT.pdf

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2: Interview with Heidi Regusa, Lead Counselor at Davila Middle School

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2: Interview with Heidi Regusa, Lead Counselor at Davila Middle School

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I interviewed Heidi Regusa, the lead counselor at Davila Middle School in Bryan to discuss school policies on working with suicidal students. Regusa has been in education for twelve years with eight years teaching high school business classes and 5 years as a counselor to 7th and 8th-grade students. She expressed that the most important aspect of working with not only students expressing suicidal thoughts but all students, is to listen carefully when students are talking. Listen to the conversations that are taking place in the hallways, during lunch, at dismissal, and especially one on one. Regusa shared that in moments of extreme stress, sudden loss, or disappointment is when she most likely encounters students with thoughts of self-harm. It was discussed in our interview that the likelihood of these thoughts coming to fruition is rare but it is important to treat every occurrence with extreme caution. Junior high students often express "extreme thoughts but ignoring or dismissing them as being overdramatic can end negatively," said Regusa. When questioned about best practices, Regusa expressed that however minimal the threat she administers the P.L.A.I.D.P.A.L.S. risk assessment, contacts parents, and monitors the student after. When Regusa contacts the parents she explains the situation and recommends to parents that it is vital for them to take the thoughts seriously. She will ask the parents if they would like to know about some resources that are available and shares the information with them. Her main concern at the moment is that more students are reporting suicidal tendencies through hear-say. This concerns her because when the accused student is called in for a discussion the student will not admit to the thoughts. All in all, Regusa suggests that all suicidal thoughts need to be treated the same to ensure the safety of the student. Currently, Regusa in the process of completing a guidance lesson on how students should respond when a friend is expressing suicidal thoughts and the proper procedures to access help. She would like for students to understand the seriousness of their words and how important it is for everyone to be good listeners.

Reference:
Regusa, Heidi (2019, September 24). Personal interview.

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Arthur L. Davila Middle School serves 6-8th grade students and is part of Bryan Independent School District.

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3: The ASCA District Model Policy of Suicide Prevention

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3: The ASCA District Model Policy of Suicide Prevention

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The American School Counselor Association provides a comprehensive guidebook that offers best practices for K-12 schools to use when designing a personalized suicide prevention program tailored to students' specific needs.  The guidebook lays out specific criteria to follow for suicide intervention, prevention, and postvention concerning ethical and legal policy. This resource is written in common language so that districts can alter the language used to best fit local and district policy, while also remaining in compliance with laws and ethics. Because it is impossible to predict when a crisis will occur, having an ASCA Suicide Prevention Plan prepared is necessary when working with teens (American School Counselor Association website, 2019).

Reference:
American School Counselor Association. (2019). Retrieved from https://www.schoolcounselor.org/asca/media/asca/home/ModelPolicySuicidePrevention.pdf

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4: Current News: Teen Suicide Rates At An All Time High 

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4: Current News: Teen Suicide Rates At An All Time High 

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The article discusses how suicide rates over the last 20 years are at an all-time high for ages 15-19. While the article points out that suicides rarely happen at school, the reason for them occurring is often due to events happening during the school day or with schoolmates. Some of the reasons teens contemplate suicide are:

Cyberbullying

Stress and anxiety of school work

Testing

Substance abuse

Family problems

Depression

School counselors are well equipped to help recognize these symptoms and provide help. However, teachers must also know how to recognize risks and warning signs of suicidal ideation for an extra layer of protection and support (Haper, 2019).

Reference:
Harper, A. (2019, June 21). Report: Adolescent suicide rate hits 20-year high. Retrieved from https://www.educationdive.com/news/report-adolescent-suicide-rate-hits-20-year-high/557262/.

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Dive Brief:

Recent research published in the Journal of the American Medical Association indicates the suicide rate for teens ages 15 to 19 is at its highest point in 20 years, and that suicide is now the second-leading cause of death for that age group, Education Week reports.

The report, based on statistics from the Centers for Disease Control's Underlying Cause of Death database, reveals the increase has mainly occurred between 2007 and 2017, reaching a rate of 11.8 suicides per 100,000 in 2017, with males more than three times more likely than females to commit suicide.

The rise in the suicide rate is attributed to increased use of social media, anxiety and depression, though the report suggests more research is needed.

Dive Insight:

Though student suicides rarely happen at school, teen suicides are often related to events occurring there or with schoolmates. According to an article published in Psychology Today, student suicide rates increase during the school year.

Cyberbullying via social media is among the main causes of suicide because negative comments can now spread so widely and thoughtlessly, and increased access to cell phones makes the problem worse. The stress and anxiety of schoolwork and testing can also contribute to the problem. Stress and depression aren't limited to secondary school students, either - they can affect elementary students, as well.

Once a student suicide or a tragedy such as a school shooting occurs, the entire student body is impacted. Suicides can occur in clusters, making it more important that schools are prepared to deal with these events by providing mental health support and using toolkits designed to help students deal with these issues. As recent school tragedies suggest, mental health support can be a school safety issue, as well.

Other factors such as family problems, substance abuse issues, and depression can also affect teen suicide rates. But schools are well-positioned to provide support for these concerns if they have the counselors available. While a 250-to-1 ratio is recommended to provide adequate support, the caseload is often much higher in many states, with Arizona peaking at 905-to-1 - and funds aren't always available to help lower the numbers.

Training teachers to identify potential problems can provide additional support. Principals have a number of options, also including community partnerships, to help students gain access to the mental health resources they need, and making sure students know how to find them is often the biggest part of the battle.

Other broader preventative strategies include incorporating social emotional learning and specific programs such as Sources of Strength that allow schools to deal more openly with topics like depression and thoughts of suicide. Strengthening peer relationships and student relationships with staff members is another pro-active measure. While some states are stepping up to strengthen suicide prevention programs in schools, it's important that schools create policies and look for strategies that can be the most effective for their situations.

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Report: Adolescent suicide rate hits 20-year high

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Recent research published in the Journal of the American Medical Association indicates the suicide rate for teens ages 15 to 19 is at its highest point in 20 years, and that suicide is now the second-leading cause of death for that age group, Education Week reports.

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5: Current News: Student Commits Suicide After University Violates Title IX. 

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5: Current News: Student Commits Suicide After University Violates Title IX. 

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A lawsuit was filed against William Paterson University by a mother whose daughter committed suicide after the University mishandled a rape claim. Once the University was found to have violated Title IX by not investigating and reporting the rape claim immediately to authorities; it looked into ways to prevent the situation from happening again. The article reports that the most effective ways to prevent campus tragedy are:

Provide institutional systems of counseling

Promote a culture of empathy

Provide training on how to identify the warning signs of suicide

The article suggests that if you suspect someone you know has suicidal thoughts that it is important to ask them about it. People suffering from suicidal ideation are often relieved to reveal their pain so they do not have to suffer alone (Carter, 2016).

Reference:
Carter, J. (2016, September 15). Following a lawsuit over a campus suicide, experts talk prevention. Retrieved from https://www.educationdive.com/news/following-a-lawsuit-over-a-campus-suicide-experts-talk-prevention/426362/.

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Dive Brief:

A mother of a former William Paterson University student has filed a lawsuit against the university, alleging its mishandling of a rape claim filed by her daughter led to her suicide in 2015.

In an interview with Education Dive, Drs. Laurie Berdahl and Brian D. Johnson described institutional systems of counseling service, a culture of empathy, and training on how to identify warning signs of suicide as the most effective ways to prevent campus tragedy.

"Contrary to common belief, asking someone [if they're considering suicide] can't put the idea into their heads, and suicidal people are often relieved when they are asked because then their problems are out in the open and they have people to talk to," the husband-and-wife pair told Education Dive via email.

Dive Insight:
Berdahl and Johnson said, "Educational institutions greatly benefit their staff and students by having on-site counseling services and protocols for emergency mental health triage. Facilitating a culture of caring, where other students are encouraged to reach out to others in distress, and providing resources such 24-hour help lines are also vital."

Along with the ramifications suicide can have on institutional morale, recruitment and public relations, institutions should take stock in using their space and platform as an example of how communities can embrace concepts of mental health wellness and treatment. In most communities, campuses are the most diverse, population concentrated areas of affluence and innovation for miles. Mental health awareness and sharing the importance of the same is an ideal way for colleges to use student activism, research and a social bully pulpit to deliver messages about the importance of this area of well being.

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Following a lawsuit over a campus suicide, experts talk prevention

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A mother of a former William Paterson University student has filed a lawsuit against the university, alleging its mishandling of a rape claim filed by her daughter led to her suicide in 2015. In an interview with Education Dive, Drs. Laurie Berdahl and Brian D.

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6: •	Family Educational Rights and Privacy Act of 1974 -- Statutory & Administrative Law

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6: •	Family Educational Rights and Privacy Act of 1974 -- Statutory & Administrative Law

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The Family Educational Rights and Privacy Act (FERPA) requires parents to give consent for officials to disclose personally identifiable information from a student’s education records (20 U.S.C. § 1232g; 34 CFR Part 99). When a student is suicidal there is a general exception to this consent rule due to the health and safety of the student. This provision allows schools to disclose personal information to appropriate parties if knowledge of that information is deemed necessary to keep the student safe (Palmon, Damme, & Peterson, 2015).

References:
Family Educational Rights and Privacy Act of 1974, 20 U.S.C. § 1232g (1974).
Palmon, S., Damme, A., & Peterson, R. (2015, December). Suicide Prevention- Policy Q&A. Retrieved from https://k12engagement.unl.edu/suicide-prevention-policies.

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7: Tex. Education Code § 33.006 -- Statutory Law                                              

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7: Tex. Education Code § 33.006 -- Statutory Law                                              

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The Texas Education Code states that it is the responsibility of the school counselor is to guide students to fully develop their academic, career, personal, and social abilities. Also, this law requires counselors to develop, implement, and evaluate a school guidance program that serves all students and addresses the special needs of students who are at risk of dropping out of school, becoming substance abusers, participating in gang activity or committing suicide (Tex. Educ. Code § 33.006).

References:
Tex. Education Code § 33.006 (2013)

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EDUCATION CODE CHAPTER 33. SERVICE PROGRAMS AND EXTRACURRICULAR ACTIVITIES

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(b) A school district with 500 or more students enrolled in elementary school grades shall employ a school counselor certified under the rules of the State Board for Educator Certification for each elementary school in the district. A school district shall employ at least one school counselor for every 500 elementary school students in the district.

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8: Eisel v. Board of Education -- Judicial Law

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8: Eisel v. Board of Education -- Judicial Law

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In Eisel v. Board of Education of Montgomery County (1981), the father of a 13-year-old girl sued the school district and two of the counselors after his daughter died in a murder-suicide pact with another student.  The father believed that it was the duty of the counselors to inform him and his wife of his daughter’s suicidal thoughts. The court dismissed the father’s lawsuit and appeals were filed to Maryland’s Supreme Court where the case was sent back down for trial. Even though in the end the counselors were not found liable, this landmark case stated that “the consequence of the risk is so great that even a relatively remote possibility of suicide may be enough to establish duty” (Eisel vs. Board of Education of Montgomery County, 1991). It is the obligation of the counselors to protect the student’s safety at school and give the parents enough notice for them to have a chance to protect their children. When working with minor’s it is important to note that the ASCA Ethical Standards for School Counselors states that parents must always be notified of a potentially suicidal child with very few exceptions (Stone, Zirkel, 2012).

References:
Eisel v. Board of Education 324 Md. 376 (Md. 1991)
Stone, C., & Zirkel, P. (2012, May 1). Student suicide: legal and ethical implications. Retrieved

from https://www.schoolcounselor.org/magazine/blogs/may-june-2012/student-suicide-legal-and-ethical-implications

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The Jason Flatt Act (2015), requires that suicide prevention training be given to employees each year a part of new employee orientation to all new school district or charter school employees and to existing school district or charter school employees. The training must be one of the best practices recommended by the Department of State Health Services. This Act also includes staff development trainings on how to prevent, identify, respond, and report incidents of bullying. Jonathan Childers, was a 15-year-old from Fairfield ISD that took his own life and this Act was passed in honor of him (Professional Development Series: Texas, n.d.).

References:
Professional Development Series: Texas. (n.d.). Retrieved from http://jasonfoundation.com/get-

involved/educator-youth-worker-coach/professional-development-series/texas/

Tex. Education Code § 21.451 (2017)

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(b-1) A superintendent or director of a school district, district of innovation, open-enrollment charter school, regional education service center, or shared services arrangement shall complete an investigation of an educator that involves evidence that the educator may have engaged in misconduct described by Subsection (b)(2)(A) or (A-1), despite the educator's resignation from employment before completion of the investigation.

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Bryan Independent School District includes the use of P.L.A.I.D.P.A.L.S. when assessing suicidal students. This information is strictly used by the school counselor or qualified individual that has been trained on working with suicidal students. The information from .P.L.A.I.D.P.A.L.S. will give the evaluator key knowledge on the number of risk factors associated with the individual and be used to notify the parent/guardian about the seriousness of the situation. All students undergoing this evaluation are considered high risk.

P.L.A.I.D.P.A.L.S.

P: Plane

Do they have a plan on how they will carry out the suicide?

L: Lethality

Is the plan lethal? If the plan is carried out will death occur?

A: Availability

Does the student have the means to carry out the plan? Or access?

I: Illness

Has the student been diagnosed with a physical or mental illness?

D: Depression

Does the students suffer from chronic or specific incident(s) of depression?

P: Previous Attempts

Has the student previously attempted self-harm? How many times? How recent did they occur?

A: Alone

Is the student currently alone? Are they going to be alone? Do they have a support system?

L: Loss

Has the student suffered a loss? This can be in the form of losing a job, the ending of a relationship, death of a relative, or loss of self-esteem.

S: Substance Abuse (or use)

Does the students abuse drugs, alcohol, medicine? Is the use current or chronic?

References:
Assessing the Risk of Suicide. (n.d.). Retrieved from https://ucc.nd.edu/self-help/depression-suicide/helping-someone-in-a-suicidal-crisis/assessing-the-risk-of-suicide/.

Bryan ISD, Children First. Always. (n.d.). Retrieved from https://www.bryanisd.org/apps/pages/index.jsp?uREC_ID=539034&type=d&pREC_ID=572553.

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The American School Counselors Association identifies in the Code of Ethics Section B.5.b that school counselors working with minors have the legal responsibility to inform parents about the role of the counselor and the confidential nature of the counseling relationship. This code also includes that counselors should establish appropriate and collaborative relationships with the parents and inform them whenever their child's welfare might be in danger, including suicidal thoughts (ASCA, 2016).

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

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The National Suicide Prevention Lifeline website provides valuable information on suicide prevention. Links are provided on how to reach out for help, learn about prevention, and ways to get involved in the mission to prevent suicide. The national suicide prevention hotline at      1-800-273-8255 provides 24/4 free, confidential support for people in distress or needing guidance on how to help someone else through a difficult time (National Suicide Prevention Lifeline, n.d.).

References:
National Suicide Prevention Lifeline. (n.d.). Retrieved from https://suicidepreventionlifeline.org/.

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The 988 Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States. We're committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices, and building awareness.

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Skip to main content We can all help prevent suicide. The 988 Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States. 988 ¡Los servicios de texto y chat de 988 Lifeline ya están disponibles en español!

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13: Recommendations for Preventing Teen Suicide

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13: Recommendations for Preventing Teen Suicide

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When students are having suicidal thoughts and are at risk of harming themselves, a collaborative effort by all needs to take place before a tragedy occurs. The following are recommendations of best practices to use when trying to prevent teen suicide:

Counselors:

It is the responsibility of the school counselor to be informed about suicidal thoughts, be knowledgeable about resources available and notify parents/guardians when suicide is possible; whether the information came from a self-report or hearsay. Never quantify the situation by assigning a student a “low risk” , all suicidal thoughts are to be treated with an immediate response. Counselors should prepare staff and parents on how to recognize warning signs of suicidal behavior and refer students who demonstrate signs of suicidal thoughts to local resources (American School Counselor Association, 2019).

Teachers:

The day-to-day contact that teachers have with students is crucial in suicide prevention. Teachers should observe students’ behavior and act immediately when a student displays a risk of self-harm. Teachers need to work diligently to have a positive classroom environment that promotes connectedness and belonging; always intervene if a student is being outcasted or uncomfortable. Teachers need to know the warning signs of suicide and report to a school counselor immediately if there is ever any doubt about a child’s safety (Suicide Prevention Resource Center, 2019) .

Administrators:

Administrators have the legal and ethical responsibility to communicate clear policies and procedures for what needs to occur to prevent and respond to suicide. A crisis team needs to be appointed that has clearly defined roles and responsibilities. It is also the responsibility of the school administrators to promote a positive and supportive school environment that encourages students to take active roles in their social and emotional health (School Crisis Center, 2017) .

Parents:

Parents play a crucial part in preventing suicide. Parents should be aware of the changes that their teen is expressing either through words, clothing, mood, or participation in events. Parents need to listen to their teens when they are talking and more importantly when they are not; what is the underlying message they are trying to say. Acknowledge their anxiety or depression by not letting it snowball to a point of danger and always seek professional help if a teen is expressing and suicidal thoughts ("10 Things Parents Can Do", n.d.).

Students:

Teens can help each other prevent suicide by knowing the warning signs and by openly talking with one another about their feelings. It is important to never make a deal with a friend that you won’t tell anyone about their suicidal thoughts, always seek help. Most importantly tell an adult right away; do not wait; better safe than sorry! ("Save a Friend", 2015).

School:

The school should promote emotional well-being and a positive environment. A school-wide policy on how to identify students at risk of committing suicide needs to be in place and always diligently monitor these students throughout the school year. If suicide was to occur the school crisis team needs to be trained on how to respond and help students with grief. (School Crisis Center, 2017).

References:
10 Things Parents Can Do to Prevent Suicide. (n.d.). Retrieved from https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Ten-Things-Parents-Can-Do-to-Prevent-Suicide.aspx.

American School Counselor Association (2019). Retrieved from https://www.schoolcounselor.org/.

Save a Friend: Tips for Teens to Prevent Suicide. (2015). Retrieved from https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/mental-health-resources/preventing-youth-suicide/save-a-friend-tips-for-teens-to-prevent-suicide.

School Crisis Center (2017). Retrieved by https://www.schoolcrisiscenter.org/wp-content/uploads/2018/02/guidelines-death-by-suicide.pdf

Suicide Prevention Resource Center (2019). Retrieved from https://www.sprc.org/sites/default/files/resource-program/V13_HS%20teachers.pdf