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Anabel Stiles is a school counselor at Richard E. Cavazos Elementary school in Killeen ISD. She has worked for the district for 26 years, as a teacher, librarian, and now as an elementary school counselor.

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The interview focused on the procedures and protocols to be implemented when working with a suicidal student. Mrs. Stiles explained that she has worked with two students who expressed a desire to self-harm. The first student was a fourth-grader who threatened to kill himself and the second student was a kindergartener who talked about killing herself so she could go to heaven. In both cases, Mrs. Stiles explained that she followed KISD student suicide/self-harm protocol which clearly states the counselor's role in this case.
a. Isolate students from peers if possible
b. Talk with students and assess the seriousness of the threat.
c. Ask directly if the student has entertained thoughts of suicide.
d. Do not leave students alone.
e. Contact parent/guardian
f. Ask the student to sign a "contract for safety" and if he or she refuses document refusal.
g. Provide paent/guardian
h. Work with the parents/guardians, students, administrators, and teachers to develop and document a plan to monitor the student.
i. Notify Campus Administrator and document report in school and the Director of Elementary Guidance Services.

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Constitutional Law-The Fourteenth Amendment to the Constitution

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Constitutional Law-The Fourteenth Amendment to the Constitution

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https://www.law.cornell.edu/wex/fourteenth_amendment_0

The Privacy Rights Clause of the Fourteenth Amendment- U.S. Const. amend. XIV. The United States Supreme Court established limits to the privacy clause in Washington v. Glucksberg, 521 U.S. 702 (1997) The supreme court ruled that assisted suicide was not right given to Americans under substantive due process. This case makes it difficult to argue
that a person who attempts to commit suicide has the right to do so.
Washington v. Glucksberg, 521 U.S. 702 (1997),  .

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https://www.pbminc.com/blog/2021/08/texas-2021-%E2%80%93-texas-legislation-passes-house-bill-279-focus-children%E2%80%99s-mental-health#:~:text=One%20of%20those%20bills%20focused,printed%20on%20their%20ID%20cards.

is Texas helping us to accomplish this?

During the 2021 Texas Legislative Session, Legislation passed a series of bills in support of children’s mental health. One of those bills focused on suicide prevention. On June 14, 2021, Legislature passed the Texas 2021 – House Bill 279 which requires all Texas students 6th grade & up to have suicide prevention information printed on their ID cards.
Texas Education Code Chapter 38, ex. Education Code.§.38.0591 allows for the school districts to partner with local mental health agencies.

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As the school year begins, we are especially thankful to all the educators that are working fearlessly to address the toll this past year has taken on their students. We are here to support these superheroes as they try to bring back a sense of normalcy to their classrooms.
What do we hope for our school systems, teachers and students in 2021/2022? How is Texas helping us to accomplish this?
To create a positive school atmosphere and community that support the health and well-being of teachers and students. We want teachers to feel valued, appreciated and supported. We want students to feel safe and comfortable within their schools so they are ready to engage and learn.
How PBM can support you and your students?
During the 2021 Texas Legislative Session, Legislation passed a series of bills in support of children's mental health. One of those bills focused on suicide prevention. On June 14, 2021, Legislature passed the Texas 2021 - House Bill 279 which requires all Texas students 6th grade & up to have suicide prevention information printed on their ID cards.
Learn More
We have the ID system that ensures that you will have the proper suicide prevention information on ID cards. We can help you print ID badges for your students and guide you through out the entire process. Having the proper tools to support this bill and students will foster a greater well-being for everyone.

Contact us today for additional information or request a demo with one of our ID experts.

More information on Texas 2021 - House Bill 279
More information on other bills passed in support of Children's Mental Health Policy.

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Texas 2021 - Texas Legislation passes House Bill 279 to focus on children's mental health

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As the school year begins, we are especially thankful to all the educators that are working fearlessly to address the toll this past year has taken on their students. We are here to support these superheroes as they try to bring back a sense of normalcy to their classrooms. What do we hope for our school systems, teachers and students in 2021/2022?

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Understanding that suicide is now the second leading cause of death for children between the age of 10-19 should urge counselors to become familiar with how to best help suicidal students. Chances are more likely now than ever, that suicidal students will be a part of the majority of school environments.
1. Understand the duties of a school counselor when dealing with suicidal students. ASCA Ethical Standards for School Counselor (2016), A.9 Serious and Foreseeable Harm to Self and Others, clearly states the responsibilities of a school counselor when dealing with a suicidal student.
2. Be prepared as a school counselor to present parents and guardians with a list of the district's approved services during the first conversation informing them that their child's talked of suicide. This would allow parents and guardians to seek immediate help for their child and not worry about how or who to take their child to for help.  ASCA Ethical Standards for School Counselor (2016), A.6.a explains that being prepared to present a list of resources to give to parents is a school counselor's duty.
3. School counselors need to understand the laws in their state. They need to know if their state has qualified immunity laws and if it does, what actions by the school counselor could disqualify them for protection under the law.
4. School counselors should know any and all constitutional law, judicial law, statutory law, or administrative law that outlines a school counselor's responsibility when working with a suicidal student.
5. Know the school's protocol in advance of dealing with a suicidal student. Trying to read up on how to respond when you are dealing with a suicidal student is both unprofessional and dangerous.
6. Understand the district's protocols and become familiar with the suicidal assessment your district uses to determine a student's level of risk to commit suicide.
7. Understand the State laws that govern how a school counselor should respond to a suicidal child. Understand what actions or inactions could render you liable when working with a suicidal child in your state.
8. School counselors need to guarantee their actions do not lead to the injury or death of any student. They do not want their actions to be a proximate cause of a student's death. If school counselors follow these best practices suggestions they are more likely to not be in breach of duty when working with a suicidal student.

Reference
ASCA Ethical Standards for School Counselors (2016). ASCA Ethical Standards for School Counselors - American School Counselor Association (ASCA)

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ASCA Ethical Standards for School Counselors (2016), A.9. Serious and Foreseeable Harm to Self and Others outlines how school counselors should respond when dealing with a suicidal student. A.9. c. requires that school counselors should not release a study who is deemed to be a danger to themselves or others until they are confident that the study has the necessary support from parents or guardians.

A.9.c. Do not release a student who is a danger to self or others until the student has the proper and necessary support. If parents will not provide proper support, the school counselor takes necessary steps to underscore to parents/guardians the necessity to seek help and at times may include a report to child protective services.

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1. Know the school's protocol in advance of dealing with a suicidal student. Trying to read up on how to respond when you are dealing with a suicidal student is both unprofessional and dangerous.
2. Understand the district's protocols and become familiar with the suicidal assessment your district uses. KISD uses the Columbia-Suicide Severity Rating Scale to determine if a student is in imminent danger of self-harm.
3. Understand the laws that govern how a school counselor should respond to a suicidal student in your state. Understand what actions or inactions could render you liable in this situation.
4. Follow the steps outlined in ASCA Ethical Standards for School Counselors (2016). A.9 Serious and Foreseeable Harm to Self and Others.

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Current Issue:  https://kappanonline.org/student-suicide-school-liability-underwood/     

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Current Issue:  https://kappanonline.org/student-suicide-school-liability-underwood/     

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There is a case in the Ohio court system involving a student who expressed thoughts of suicide. The school counselor was informed about the student's threat of suicide. The first time it was brought to her attention, the school counselor informed his parents, talk to the student, and recommended that he sees a medical professional.  His father sought medical help for the child. The school counselor was notified that the student continued to make suicidal threats. This time the school counselor did nothing. The student followed through with his threat and commit suicide. The school and the school counselors were both being sued by his father for negligence. However, the trial court found that the school counselor was negligent and would stand trial. They also determined that the school was protected under the state's qualified immunity laws. The school counselors appeal the decision to the Ohio Courts of Appeals. They sided with the trial court and found that the school counselor acted with a conscious disregard to a known or obvious risk of harm. Ohio Courts of Appeals found that the school was not liable but upheld the case against the school counselors in the Baab v. Medina City School Board of Education (Ohio Ct. App. 2019).

The results of this case should be proof that schools counselors should follow the school, district, state laws, and procedures when working with students who may be suicidal.

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I am taking the perspective of a school counselor at Richard E. Cavazos Elementary school. It is a title l school in Killeen ISD.  School counselors should be committed to the emotional, academic, and mental well-being of all students.

I chose this topic because there has been a disturbing trend that shows an increase in suicide among teenagers across America. According to America's Health Ranking, (2022) suicide is the second leading cause of death amongst children between the age of 10-24.  I am hoping that together the staff members here at Cavazos Elementary would work together to help our current students develop healthy ways to deal with life stressors.

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Amerca's Health Ranking. (2022). Teen suicide. retrieved from https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/teen_suicide/state/ALL

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https://kappanonline.org/student-suicide-school-liability-underwood/
ASCA Ethical Standards for School Counselors (2016). ASCA Ethical Standards for School Counselors - American School Counselor Association (ASCA)

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https://www.counseling.org/news/aca-blogs/aca-counseling-corner/aca-counseling-corner-blog/2019/03/04/we-can-do-something-about-teen-suicide

This article highlights some disturbing facts about the teen suicide rate in America. Suicide has become the second leading cause of death amongst teens and young adults between the age of 10-24. Disturbingly if the data for death resulting from heart disease, cancer, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease were combined, they will result in less death per year than teen suicide.

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Many parents are, unfortunately, not aware of how common the problem of teen suicide is. In America, it's estimated there is an average of more than 3,000 suicide attempts every day by young people in grades 9 to 12. Suicide is the second leading cause of death among young people ages 10 to 24, killing more teens and young adults than cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza and chronic lung disease combined.

Studies have found that four out of five teens who attempt suicide have given clear warning signs, yet too often such signs are ignored or simply not noticed or recognized.

Life today can seem overwhelming for many adolescents. Young people are confronted with physical and hormonal changes, school grade anxieties, being socially accepted and making life decisions about college or employment choices. Other factors, such as a parental divorce, a seriously ill relative or even moving to a new home can bring added levels of stress and anxiety. Being bullied, whether in person or online, will also contribute to the negative feelings a teen may be experiencing.

Teens affected by such factors are often suffering from depression and suicide may simply seem the easiest way to escape the blackness they are feeling. Depression is a mental health issue that doesn't cure itself, but it does have a number of signs that can help a parent spot a teen in trouble.

Teens suffering from depression will often exhibit changes in eating and sleeping habits. They often are withdrawn, losing interest in friends and family, and no longer participating in favorite activities. Their school work may be suffering, they may have difficulty concentrating, and may not pay much attention to their personal hygiene and appearance.

In some cases the teen may verbalize feelings of wanting to die or simply outright threaten suicide. The warnings given may be more subtle, like saying "I won't be a problem much longer." Any such references to death or suicide are clear cries for help and shouldn't be ignored.

Depression, whether in a teen or adult, is a mental health problem that can be treated. Any signs that a teen may be considering suicide should call for immediate action. Talk to your family physician or a professional counselor. There's also information and help from the National Suicide Prevention hotline at 1-800-273-8255. Acting early can help save a young life.

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Many parents are, unfortunately, not aware of how common the problem of teen suicide is. In America, it's estimated there is an average of more than 3,000 suicide attempts every day by young people in grades 9 to 12.

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American Counseling Association. (2022). https://www.counseling.org/news/aca-blogs/aca-counseling-corner/aca-counseling-corner-blog/2019/03/04/we-can-do-something-about-teen-suicide

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https://www.edweek.org/leadership/teen-suicides-rising-sharply-federal-data-show/2019/10

The leading cause of death for children between the age of 10-19 years old,
1. accidents.
2. suicide
3. homicide
This shocking revelation is one of the focuses of author Arianna Prothero as explained in an October 2019 article in Education Week. Prothero also highlights that over a ten-year period, (2007-2017), teen suicide has increased by 76 percent. One of the contributing factors that Prothero (2019), attributed to the sharp increase is growing mental health problems in teens. She interviewed Professor Steph Brock a school psychology program coordinator at California State University. He stated that 9 out of 10 people who died from suicide also struggled with mental health issues. Disturbingly the types of mental health issues and the severity of the mental health issues are showing a sharp uptick as well.

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Teen suicide rates have increased dramatically in the past decade, according to a report released on Thursday by the U.S. Centers for Disease Control and Prevention.

Suicide rates for teens between the ages of 15 and 19 increased by 76 percent between 2007 and 2017. And the suicide rate for 10- to 14-year-olds nearly tripled over that same time period, according to CDC's data.

It's a sharp reversal from the previous period-2000 to 2007-when the suicide rate had been stable for the 15-to-19 age group and had even declined for 10- to 14-year-olds.
If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741
While still relatively rare, suicide is now the second leading cause of death among 10- to 19-year-olds. Accidents are the leading cause of death, while homicides rank third.

But the impact of a single suicide can have far reaching, negative effects for the friends, family, and classmates, said Stephen Brock, a professor and school psychology program coordinator at California State University, Sacramento.

"In a given five-year period, for your typically sized high school in the United States, you wouldn't expect more than one suicide death," he said. "It has been argued that the larger problem from a public health perspective, it's not the prevention of suicide, it is rather dealing with those left behind by a suicide."

Increasing suicide rates are part of an alarming trend of rising mental health issues among school children.

"It's not so much that there's large increases in mental illness, but the type and the severity of mental illness has gone up," said Brock, who formerly served as a president of the National Association of School Psychologists. "In particular we have seen pretty significant increases in girls needing to be hospitalized because of depression."

Nine out of 10 people who die by suicide, he said, suffer from a mental illness.

Schools often struggle with limited resources and expertise to deal with the wide range of mental-health needs that teens and younger children are now experiencing.

Still, experts say teachers, principals, coaches, and other school staff members are critical players in preventing suicide by recognizing students who may be at risk for harming themselves, by connecting those students with resources and support, and by building relationships throughout the school so that students have multiple people to turn to if they need help.

It's unclear why mental health issues are increasing among children and youth, though researchers are exploring a number of explanations, including the rise of smartphone and social media use, as well as the prevalence of bullying.
Related stories:

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Teen Suicides Rising Sharply, Federal Data Show

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Teen suicide rates have increased dramatically in the past decade, according to a report released on Thursday by the U.S. Centers for Disease Control and Prevention. Suicide rates for teens between the ages of 15 and 19 increased by 76 percent between 2007 and 2017.

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https://www.insidehighered.com/news/2022/02/03/multiple-suicides-leave-wpi-reeling
In the February 3rd, issue of Inside Higher ED. Josh Moody wrote an article depicting seven students' death at Worcester Polytechnic Institute (WPI), (2022). He states that student mental health issues, which were already a concern across America, got incredibly worse over the pandemic. The seven deaths at WPI occurred over an eight-month span. Three of the seven deaths are confirmed suicides, the others are under investigation. Prior to these confirmed suicides, WPI had two suicides in 15 years. In an attempt to address students' concerns and mental health issues, WPI launched its Mental Health and Well-being Taskforce which is made up of 35 students, faculty, and staff.  The task force is hoping to identify student mental health needs, triggers, as well as to provide mental health services.

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Seven student deaths in the last eight months have left the Worcester Polytechnic Institute community grief-stricken. Compounding that tragedy is the fact that at least three of those lives were lost to suicide; two deaths are under investigation, according to the university.

"Certainly any loss of a student is devastating," said WPI president Laurie Leshin.

Three deaths by suicide in the span of a year is staggering for a campus that has seen two student suicides over the past 15 years. Now WPI-which has a total enrollment of around 7,000-is mourning but also looking for a way forward, working to identify student mental health needs and provide services as these tragedies reverberate across campus and beyond, with students nationwide facing mental health challenges exacerbated by the COVID-19 pandemic.

"We have been working very closely with families, with the students who are closest colleagues with the students we've lost, to make sure that they are receiving personal and extensive support," Leshin said. "And then we are looking more broadly at our community's well-being and working to understand where the issues are and how to address them."

What's Happening at WPI

Students describe a somber, almost eerie feeling on the Massachusetts campus, where grief hangs heavy in the air. Some point to the striving culture, the constant grind, the academic pressure at WPI as a source of distress-an issue that a report from the university also identified as significant.

Jack Baker, a senior engineering major, said he has had his own experiences with despair, attempting to end his own life multiple times. Even after one attempt landed him in a psychiatric hospital, he continued his schoolwork there, which he believes is a testament to the WPI culture.

"I think it comes from the WPI mind-set," Baker said. "I believe it is an unhealthy frame of mind that students have-it almost feels like a competition. It seems like if you aren't struggling, you aren't working hard enough. I believe that's where most of these problems are stemming from."

In response to the recent suicides, WPI launched a 35-member Mental Health and Well-Being Task Force comprised of students, faculty and staff. The task force released a report in January; based on student surveys, listening sessions and town halls, and various other inputs, the group identified a number of stressors for both undergraduate and graduate students at WPI.

Students cited academic pressure as a significant challenge, with 82 percent of undergraduates and 65 percent of graduate students reporting "too much academic pressure."

"WPI is a culture of systemic overwork: individuals feel pressure to do more and more," according to the report, which goes on to note that students-particularly those who are new to the college-often experience "significant academic pressure in our introductory courses and struggle to manage workload and pace and find appropriate assistance."

Both undergraduates and graduate students named lack of self-care and balance as another challenge; additionally, graduate students reported that the lack of social connections affected their mental health.

Among the other findings, both groups reported issues such as a lack of resilience, uncertainty about where to find mental health and well-being resources, and inadequate communication about the availability of such services. "Pandemic burnout" also had a moderate impact on undergraduate students' mental health and well-being, according to the report.

Addressing the Challenges

In addition to identifying the stressors, the report makes a series of wide-ranging recommendations, including teaching academic success skills and self-care to newly enrolled students, better identifying students who are struggling with coursework, and modifying policies and practices in an effort to relieve academic stress. The report also recommends increasing the role faculty members play in dealing with student mental health issues.

While the recommendations above offer only a snapshot of what is in the 28-page task-force report, Leshin says it all comes down to two things: community building and skill building.

"Community building is all about building that circle of support, that circle of friends, making sure that everyone has a sense of belonging on our campus," Leshin said, adding that despite WPI's best efforts, it has proven difficult to keep students connected during the pandemic. She hopes the easing of COVID-19 restrictions on campus will help forge student connections.

Skill building, Leshin said, is about helping students find what they've lost amid a pandemic that has disrupted social-emotional learning opportunities and prevented them from gaining the maturity that typically comes from being on a college campus. WPI also aims to help students develop impulse control and mental health awareness.

"We know that this moment has been incredibly difficult for our students," Leshin said.

Beyond enacting the recommendations made in the Mental Health and Well-Being Task Force report, WPI has also added three full-time counselors to its staff at the Student Development & Counseling Center, added off-hours counseling services, engaged an outside firm to evaluate campus mental health practices, held a recent online forum for parents to learn how to talk to their children about suicide and launched a resource page-which extends to WPI social media postings-and a biweekly newsletter focused on mental health and well-being.

When students leave for the summer, Leshin said, counseling will still be available via telehealth.

A National Mental Health Crisis

WPI is hardly the only U.S. campus that has experienced an increase in student mental health issues as a result of the pandemic.

In December, U.S. surgeon general Dr. Vivek Murthy issued an advisory on youth mental health, pointing to "persistent feelings of sadness or hopelessness" and increased suicidal ideation.

"The pandemic era's unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced," Murthy wrote.

John Seeley, an education professor at the University of Oregon whose research includes school-based mental health interventions, said the issues that arose during the pandemic are unsurprising given the sudden changes, including social distancing and isolation.

"The additional stressors put on life, and changes in scripted behaviors and expectations, often lead to more mental health issues," Seeley said. "It's not surprising that the pandemic would impact the mental health of individuals, especially given that social isolation has been a key way to stem the pandemic. But that also contributes to depression and suicidal ideation."

He added that the challenges for students are compounded by the fact that many universities "are averse to dealing with the issue due to fear of litigation if they don't respond in the most appropriate manner." That often means referring students to outside care providers, which may require more time and money. An additional issue, he said, is the lack of providers amid an ongoing counselor shortage.

Laura Horne, chief program officer at the mental health advocacy group Active Minds, believes that the pandemic is "augmenting the mental health issues that were already there" for students. The one plus side, she noted, is that the pandemic has made mental health struggles more relatable through a widely shared experience, which helps bring those issues into the light.

"Back when I started in the field, a decade ago, it would often take a catastrophic event, like a series of suicides or some kind of optics nightmare, for a college or university to take action," Horne said. "I think many of us in the field are hoping that the pandemic has made it easier for colleges and universities to take action on this need and actually apply resources to suicide prevention. It's something that we've needed for a really long time, even before the pandemic."

College Mental Health Efforts

WPI is far from the first campus to experience a series of student suicides. Cornell University has seen student suicides over the years, including a string of such deaths back in 2010. The university has responded by continuing to build out mental health resources.

"For over a decade, Cornell University has utilized a comprehensive public health approach to mental health," Cornell spokesperson Gillian Smith wrote in an email. "Our campus framework reflects the best practices advocated by the Suicide Prevention Resource Center and The Jed Foundation Model for Comprehensive Suicide Prevention and Mental Health Promotion. It is a population-based strategy to reduce risk factors and enhance protective factors for suicide."

The University of North Carolina at Chapel Hill also saw two students die by suicide in 2021. UNC responded by offering students mental health days and announcing the launch of the campuswide Heels Care Network campaign "to promote and support mental health awareness."

Stanford University also saw two student suicides in 2019 but did not respond to multiple inquiries about how it is addressing student mental health.

In the absence of a playbook on how colleges can deal with such issues, experts encourage them to increase resources for mental health but also to change the conversation around it, expanding such issues into broader marketing campaigns focused on overall student health.

Still, there's work to be done.

"I would like to see colleges and universities apply funding and resources towards mental health in a more preventative way," Horne said. "And that first prong is definitely shoring up mental health resources and making them more accessible."

Redefining mental health and destigmatizing such issues is also an important measure.

"A lot of [suicide prevention] is around gatekeeper training and trying to train individuals to identify the warning signs," Seeley said. "A key issue here is how do we reduce the stigma associated with suicide when we don't talk about it? When we put our head in the sand and we ignore the problem? We need to destigmatize mental health in general, but suicide in particular, so that we deal with it directly rather than avoiding the topic."

Baker, the WPI student, recalls discussing his own attempt to harm himself with others while he was in the hospital, an experience he felt reduced the stigma around it and allowed him to open up. Now he hopes others on the WPI campus can have the same conversations and point students in crisis to the mental health resources they need.

"I understand that it may be an uncomfortable topic, but the more you listen, you could actually be saving someone's life, quite literally," Baker said. "And I don't mean to be dramatic or anything, but I firmly stand by the fact that a conversation can save someone's life."
The National Suicide Prevention Lifeline is a free, confidential 24-7 service that can provide people in suicidal crisis or emotional distress, or those around them, with support, information and local resources. 1-800-273-TALK (8255).

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Seven student deaths in the last eight months have left the Worcester Polytechnic Institute community grief-stricken. Compounding that tragedy is the fact that at least three of those lives were lost to suicide; two deaths are under investigation, according to the university. "Certainly any loss of a student is devastating," said WPI president Laurie Leshin.

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https://www.congress.gov/bill/116th-congress/house-bill/5619/text
Suicide Prevention Act

In September 2020, the US Congress passed a law (42 U.S.C. 247b–23) giving State, local, Tribal, and territorial public health agencies grants to expand their existing surveillance of self-harm programs. Congress will also be allowed to collect data from each program on nonfatal suicide attempts and fatally suicides.

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Text - H.R.5619 - 116th Congress (2019-2020): Suicide Prevention Act

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Text for H.R.5619 - 116th Congress (2019-2020): Suicide Prevention Act

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https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=37&pt=11&ch=351&rl=13

Texas Administrative Code 37 Tex. admin. code § 351.1-2  identifies the legal framework that educational agencies should use as the foundation for their suicide prevention plan.
(d) Suicidal Youth.
(1) Prevention Plan.
(A) Each facility shall have a written suicide prevention plan developed in consultation with a mental health professional that addresses the following components:
(i) definitions of high risk and moderate risk suicidal behavior;
(ii) screening methodology to assess a resident's risk of suicide upon admission and upon any indication a resident previously screened may now be at moderate or high risk for suicidal behavior;
(iii) communication among facility staff, mental health professionals, the resident, and the resident's parent or guardian including communication regarding observations or indications a resident previously screened may now be at moderate or high risk for suicidal behavior;
(iv) level of supervision for residents assigned to moderate or high risk for suicidal behavior;
(v) policy and procedure for intervening in suicide attempts;  (vi) reporting of resident suicides and attempted suicides in accordance with any applicable state law, administrative standard, or local policy or ordinance;
(vii) training on the contents and implementation of the suicide prevention plan;
(viii) housing of residents assigned to moderate or high risk of suicidal behavior including the removal from the resident's presence any dangerous objects; and      (ix) mortality reviews designed to review the facility's compliance and possible needed revisions to the suicide prevention plan following a resident's suicide.

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(c) Medication. In accordance with Texas Human Resources Code Section 142.005, the juvenile board shall adopt a policy concerning the administration of medication to residents. The policy shall include which facility employees are authorized to administer medication to residents.

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Moody, J. (2022). Inside Higher Ed. Multiple suicides leave WPI reeling. https://www.insidehighered.com/news/2022/02/03/multiple-suicides-leave-wpi-reeling

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Killeen Independent School District student handbook, (p.45. 2022), list the district's policy for addressing mental health, behavioral health and substance abuse. Each can be a contributor for suicide.

Mental Health Support (All Levels)
The district has implemented programs to address the following mental health, behavioral health, and substance abuse
concerns:
• Mental health promotion and early intervention;
• Building skills to manage emotions, establish and maintain positive relationships, and engage in
responsible decision-making;
• Substance abuse prevention and intervention;
46
• Suicide prevention, intervention, and postvention (interventions after a suicide in a community);
• Grief, trauma, and trauma-informed care;
• Positive behavior interventions and supports;
• Positive youth development; and
• Safe, supportive, and positive school climates

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In 2020 my second oldest son lost three friends to suicide and my oldest son had one of his best friends kill himself hours after complaining about how difficult life had become. Neither of my sons knew what to do. Suicide not only impacts the victim but it sends ripples into the lives of everyone who cares about them. Counselors play a vital role in offering help and support for suicidal students, their family members, and friends. The isolation caused by Covid-19 shows how vulnerable our youths are and how many of them are struggling with mental issues that adults in their lives are unaware of. Neither of the four students who committed suicide reached out to their parents, they all reached out to friends. Killeen Independent School District (KISD) has a program that aims to help students build skills to help them manage emotions, establish and maintain positive relationships, and engage in responsible decision-making as outlined in their 2021-2022 student handbook.