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Suicidal Students

I am viewing the topic of suicidal students from the perspective of a junior high counselor. My targeted audience is the junior high school staff.

I chose this topic because in my current role as a junior high counselor, this issue comes up on a regular basis. Some weeks there are multiple students who are considered suicidal. School staff always has good intentions when talking to and working with these students, but they seem to try to handle some of the situations on their own and they are not addressed properly or to the fullest extent that is required by law.

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According to Chavers, J. (personal communication, November 29, 2021):

1) This topic is becoming more prominent in the world due to all of the educational changes and uncertainty with COVID. Counselors and school staff have a huge responsibility concerning student mental health and more students are experiencing anxiety and depression and at times this is leading to suicide thoughts and attempts. Knowing the counselor's role in these situations is key to protecting students and keeping them safe.

2) Ensure that the counselor is promoting a positive school culture and taking all bullying situations seriously. Talk to students involved immediately if there is ever a concern of suicidal thoughts. Contact parents when there is any concern or doubt so that the counselor's responsibilities have been fulfilled.

3) Students are becoming more stressed and anxious about the idea of the world being shutdown again and having to do school at home. Students have the need to be around people and feel like they are a part of something and being in isolation can lead to higher levels of anxiety and depression. If the school shuts down again counselors must be prepared to provide outreach and resources to students virtually.

4) Jennifer Chavers- Fairfield High School Counselor, Fairfield ISD

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This article by the ASCA (2020) discusses how school counselors play a key role in  situations where a student has expressed suicidal idealization. The counselor should contribute to writing district policies regarding suicide protocol and the counselor is also responsible for contacting parents to discuss the student's risk of suicide and what steps they should take.

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The School Counselor and Suicide Risk Assessment - American School Counselor Association (ASCA)

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According to the Prothero (2020):

Shelter in place orders brought on by COVID impacted students because of isolation, their concerns for financial stability, and experiencing the loss of loved ones.

Suicide is the second leading cause of death among people ages 10-19 years old in the US.

During times of shutdown, students who experience troubling home lives do not have a trusted adult to check on them and this can contribute to suicide.

Schools should adapt their suicide prevention protocols to include virtual options.

Schools should continue to provide virtual lessons so that they can continue to strengthen social-emotional skills in students.

Schools should provide parents with tips and tricks for supporting their students during these times.

Reference:
Prothero, A. (2020, June 19). 'A Punch to the Gut': Dealing With Suicide in a Pandemic. Education Week. Retrieved November 27, 2021, from https://www.edweek.org/leadership/a-punch-to-the-gut-dealing-with-suicide-in-a-pandemic/2020/06.

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California schools closed in mid-March to prevent the spread of coronavirus. In the first full week of April, Chris Evans, the superintendent of a Sacramento-area school district, received a call one evening informing him that two high school students had died by suicide in the past 24 hours. One was from his district, Natomas Unified, the other from a neighboring district.

"When something like this happens, it's a punch to the gut," said Evans. "One of my biggest worries I had with the shelter-in-place order, was the social-emotional effect it's going to have on so many people. In particular, my job is to really worry about students and their parents."

Later that week, 50 miles away in Stockton, Calif., Hillary Harrell, the principal at Bear Creek High School would receive a similar call from her school's resource officer notifying her that one of her students had died by suicide.

The mother of the young woman who took her life told local media she believed that the social isolation imposed by the lockdown contributed to her daughter's tragic decision.

"I honestly don't remember a lot of the specific details [of the phone call], because it was so horrifying to think about," said Harrell. "I am a mother and have worked as an educator for 20 years. This is not the first student I have lost this way. It's just really hard to describe what you feel in these experiences."

These are the phone calls that educators dread to get even in normal times. But now Harrell and Evans were facing the daunting prospect of notifying and supporting their school community with buildings shuttered, staff and students scattered, and families struggling to take on many of the responsibilities of their children's education.

The pandemic has presented distinct challenges to schools in both preventing and responding to student suicides-which are the second leading cause of death among 10- to 19-year-olds in the United States.

And the stress the pandemic is putting on students-in the form of social isolation, family financial instability, or death of loved ones-doesn't disappear when classes are out for the summer.

Indeed, surveys of students conducted by the nonprofit groups Common Sense Media and America's Promise Alliance have found that the pandemic has been hard on teenagers' mental health, and that it's disproportionately affected black, Latino, and Asian youth.

Social isolation is uniquely hard on teenagers, said Rob Coad, a school psychologist and a member of the National Association of School Psychologists' School Safety and Crisis Response Committee.

"One of their main jobs in life is developing social connections," he said. "Their job is to differentiate from their parents and establish relationships with peers, and we're blocking that. They're missing an important developmental moment."

Already a Crisis

While the pandemic is throwing new mental health challenges at students, rising rates of suicide among adolescents, teens, and even children was a major concern even before the coronavirus outbreak began.

Suicide rates among teens have risen dramatically over the past decade, according to the U.S. Centers for Disease Control and Prevention. From 2007-2017, the suicide rate among 15- to 17-year-olds has increased by 76 percent to nearly 12 deaths per 100,000. It nearly tripled for 10- to 14-year-olds to 2.5 deaths per 100,000, following periods of stability and even declining rates in the early 2000s.

Even some children as young as 9 think about killing themselves, according to a recent study by researchers from Washington University in St. Louis.

No one is sure why these numbers have been going up, although the rise of social media and smartphone use-which create new avenues for unhealthy comparisons and for bullies to pick on their victims-is frequently pointed to as a potential culprit.

"We don't have an absolute [explanation] why this is occurring, we just know that suicide is very complex and it's a complex set of behaviors and issues that come together in a perfect storm," said Coad. "That's why when we talk about the risk factors ... it's a challenge for us to put together what of those factors are putting pressure on an individual student."

While experts are concerned the pandemic may drive more young people to harm themselves, it is not clear what the net effect of the pandemic will be on suicide rates among children and teens.

For a student who, say, was being bullied for being gay, as long as their family is supportive, their school getting shut down this spring may have benefited their mental health, said Jonathan Singer, a professor of social work at Loyola University, Chicago, and an expert on youth suicide.

"But imagine another kid, who had a very toxic home environment," said Singer, "whose reasons for living revolved around their friends at school and the fact that their teachers gave them all sorts of positive support, where school was the only safe place. Then you have a kid who is isolated from that and is now at increased risk."

The home lives of many students are also likely to get much rockier. Job loss and eviction brought on by the economic recession, which the U.S. economy entered in February, will only add to students' emotional stress.

Aside from the obvious-that it's harder for school psychologists, counselors, or social workers to check up on students when school is out-the fact that students are interacting with fewer adults overall is a concern to Singer.

One adult might see a red flag that all the others have missed or didn't even have an opportunity to see-say, a coach who notices that a student athlete's game is off.

"In a pandemic, it's only the parents seeing the kid," said Singer. "If you're [a teacher] on a Zoom call with 25 other kids, you're not going to be picking up on these things. Everybody is acting differently now. So, Joey's acting differently today, well, it's a pandemic, what do you expect?"

Pandemic-related school closures have forced schools to lean even more heavily on teachers to spot suicidal behavior in students, said Coad. Therefore, it's crucial that teachers not only know the risk factors and warning signs, but also who to contact in the district to get the student help immediately.

Warning signs in students include giving away possessions, making statements about wanting to kill themselves, and talking about being gone and gauging people's reactions. Those red flags require an immediate response, said Coad.

Risk factors include mood disorders, substance abuse, loss such as a death, exposure to violence or another suicide.

This is a big ask of teachers right now, concedes Coad, so it's imperative, he said, that schools don't leave them without support.

Putting Supports in Place

Schools will very likely continue to rely on remote learning to some degree in the fall semester, either from the get-go as a means to facilitate social distancing in school buildings or sporadically should a local surge in coronavirus cases force buildings to shut down entirely. For that reason, school districts need to adapt their suicide prevention and response plans to include telehealth and other virtual service delivery platforms, according to the National Association of School Psychologists.

Knowing what community resources are available and being in the position to connect students with those resources is also critical, says the organization. Suicide can happen at any time of day or year and schools cannot tackle suicide prevention on their own.

"The extent to which schools are siloed from community supports" is a significant weakness exposed by the mass school shutdowns this spring, said Singer.

Schools should also continue to help students strengthen their social and emotional skills, NASP recommends, especially focusing on building resiliency among high-risk students.

Finally, heading into the summer months, schools should try to make staff accessible to students and families, said Coad, through phone calls, email, and social media.

Schools don't have to rely just on staff, he said. He's enlisted students at his school, Walnut High on the east side of Los Angeles, to do outreach and share information about suicide and how to get help with their classmates.

Fellow students can be a valuable resource for raising awareness about suicide-how to prevent it and where to get help.

Maggie Patrick, who graduated from high school in Fairfax County, Va., this spring, led suicide awareness efforts at her high school.

Patrick thinks schools should train students annually on what suicide warning signs look like and what to do if see they them in a peer.

"I know not everyone is going to listen, but if even just a dozen kids do, that matters," said Patrick.

A friend of Patrick's died from suicide their freshman year of high school. She said the school, which she left the following year, handled her friend's death poorly.

"They basically tried to ignore the entire thing," she said, with one exception: "In memoriam of her, they had a kindness day where everyone had to be nice, but if you have clinically diagnosed depression, being nice is no good, it's not enough. There were so many other things they needed to talk about."

But schools also face a high-stakes balancing act when responding to a student suicide. While experts say it's important for school leaders to address the issue openly with students, they must be careful not to overwhelm students with information that will further traumatize, especially with anxiety levels already high from the pandemic, said Paul Warren, the student support services coordinator for the Lodi Unified School District in California, which includes Bear Creek High.

School leaders must be careful to not inadvertently romanticize suicide. Otherwise, it could spur other vulnerable students to take their lives. For that reason, memorials can be dicey, said Warren.

" As important as a [funeral] is for closure for kids ... when you think about people that are at high risk for suicide and depression that go and they hear messages [about the deceased] like 'they're in a better place, they're at peace, they're happy' and you hear people getting up and talking about how much they love them ... that's very appealing to somebody who is having severe suicidal thoughts," said Warren. "They may be thinking to themselves, 'I want to be at peace.' ... Depending upon the developmental age of students, they sometimes have magical thinking about their mortality. They don't understand the finality."

Staying Connected

For Evans, in Sacramento, the deaths underscored how crucial it was for schools to remain connected to the students through the shelter-in-place order. School psychologists and counselors in Natomas had been reaching out to students since the buildings had shut down.

The district provided parents with tips on how to talk to their kids about suicide and the additional stressors from the pandemic. It launched a dedicated website with social emotional resources for families where parents and students can request a call from the school psychologist. And the district is using a social media monitoring service that alerts school officials should a student search or post something relating to harming themselves.

After the suicide deaths, the district had 50 instances over the course of April where either the monitoring service flagged something, a parent reached out concerned about their child, or a student reached out to a school staff member asking for help.

"I do really believe by us communicating and being open about it ... has probably saved lives," Evans said. "And that was because we chose not to let [the suicides] just go quietly, but to let people know that they are not alone."

For Harrell, the principal in Stockton, the news of her student's death came in a particularly painful year at Bear Creek: The school of 2,200 had already lost two students in separate car accidents.

"There was a lot of sadness and there was anger" among the students, said Harrell, "and frustration that they are constantly losing their peers. They are tired of losing."

With this suicide death, Harrell relied on a routine that she has developed through the loss of other students. She made the family of the student who died by suicide and their immediate circle the first priority.

Next, she ensured that staff, students, and families knew where to go if they needed help.

She was careful that anyone she had to inform about the death was in a place where they were safe and alone, then Harrell shared the facts as quickly and with as few words as possible.

And finally, Harrell took notes.

"Often in that first experience of grief we hear beautiful stories," she said.

Grief comes in waves, she said, and Harrell saves these stories to share with a parent, friend, or teacher for when they may need them-whether it's a month later or two years.

"You never know when a good story may help someone," she said, adding: "High school is all about rites of passage and celebration-a couple of years down the line this young lady's class will be graduating and we will want those stories."

In the past, said Harrell, the Bear Creek school community has relied on being able to come together physically and not being able to do so has deepened the sense of isolation for some.

It's highlighted the need to have procedures and resources in place to help students cope remotely, she said, "because you never know when the world can turn upside down."

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.

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'A Punch to the Gut': Dealing with Suicide in a Pandemic

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California schools closed in mid-March to prevent the spread of coronavirus. In the first full week of April, Chris Evans, the superintendent of a Sacramento-area school district, received a call one evening informing him that two high school students had died by suicide in the past 24 hours.

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According to Jahn (2021):

The University of Nebraska-Lincoln police department is trying to better understand suicide protocol and how to help students who are suicidal or potentially suicidal.

It is stated that they take an approach that is more about how to help the student in the time of need and connecting  them to resources that are available.

The department has seen an increase in calls about students who are potentially suicidal and calls from family members and friends wanting welfare checks on students.

On calls concerning mental health, the department takes a calm approach and try to be there more as needed assistance instead of confrontational.

Students are taken to the hospital for evaluations if needed and the campus police department will provide transportation back to campus if needed.

It is all about supporting the student in a suicidal situation, not condemning them.

Reference:
Jahn, C. (2021, November 11). UNLPD continues suicide prevention protocols. The Daily Nebraskan. Retrieved from http://www.dailynebraskan.com/news/unlpd-continues-suicide-prevention-protocols/article_524dba32-4284-11ec-a842-67acbdfee59c.html.

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Approximately every in the United States, someone dies by suicide. For people aged 15-24, many who are in high school or college, it is the second leading cause of death, shortening thousands of lives every year.

The Daily Nebraskan reached out to the University of Nebraska-Lincoln Police Department to better understand its protocols with suicidal or potentially suicidal students.

John Backer, captain of patrol services at UNLPD, said suicidal thoughts do not exist on a continuum and it depends on what that person is feeling at a particular time, which means someone's mental state can change in a relatively short time frame.

"Our approach when we try to determine if someone is suicidal or not, it's more so what services are needed at this point in time, what services are best going to help the student," Backer said.

Backer said UNLPD's protocol for handling a suicidal student has not really changed during his time at UNLPD, which includes the past decade, but he has noticed more available resources, such as the 24-hour line at Counseling and Psychological Services.

Anecdotally, Backer said he has seen an increase in the number of calls involving suicidal students in the last five to 10 years at UNL. Since the start of the fall 2021 semester, UNLPD has received 15 mental health investigations, which may include a suicide attempt, and 16 welfare checks, Backer said.

Welfare checks are in-person check-ins from at least one officer and they are requested by someone else, usually a family member or friend, who is concerned about the student, Backer said. If UNLPD officers are conducting a welfare check and they find that the student's mental health is suffering, such as from depression, then the officers will work with them and it will be classified as a mental health investigation.

When someone calls UNLPD with concerns about a student being suicidal or potentially suicidal, Backer said officers try to get as much information from the person reporting as they can. This includes questions like, "What led them to believe that?," "Did the person they are concerned about make any statements?" or "Were there any weapons involved or mentioned?," according to Backer.

"On every call, we always try to start with the lowest, calmest approach," Backer said. "It's not confrontational, it's assistive in nature, and really our purpose when we first show up is just to learn how the student is doing, what's been going on lately and what they need from us."

If a student who is feeling suicidal calls UNLPD, Backer said dispatchers' first priority is to find out where they are so they can get officers en route and send medical assistance as soon as possible if needed.

During a welfare check, mental health investigation or following a call from a potentially suicidal student, Backer said there are a few procedures UNLPD officers can follow if it is deemed that the student is at risk for suicide or is experiencing suicidal thoughts. Backer said UNLPD officers will try to coordinate with CAPS, especially if that student has a pre-existing relationship with the resource.

If CAPS is unavailable or if it's after hours, Backer said some students have been transported to the mental health triage unit at Brian West hospital. Some students are released the same day or later on, but Backer said if they need help getting back to campus, UNLPD officers will also bring them back to campus.

If the student needs medical attention, UNLPD officers will contact or transport them to medical professionals, according to Backer. Police officers are allowed to take someone into custody if they feel that a person is in imminent danger to themselves or others, even before mental health assistance or before mental health board proceedings can happen, Backer said.

"That's not our ideal approach because that is, in a sense, involuntary custody of that student, of that person," Backer said. "And in talking with CAPS and talking with other mental health professionals, what's really most beneficial for the student is if they are an active participant in their wellness and in those steps towards becoming better, so we strive for that if at all possible. But as a last resort, if it is necessary to protect their safety or the safety of others, that is an option."

Backer said UNLPD officers usually check in with the student for the following days after a call or mental health investigation.

"The difficulty for the officers is just knowing that student's going to be OK," Backer said. "There's a sense of personal investment and personal care for this student."

Backer said officers sometimes feel they are the only resource for that student, especially if their family lives far away or they do not have other people to lean on. The difficulty for them is to ensure they are recommending the student the resources they need.

"We really do see ourselves as a bridge more than anything for those resources," Backer said. "I think we do a good job acknowledging that we are a very short-term response for that student at that point in time. We are proud to do it. We're glad to be there to provide that assistance. We just know we are not the professionals that are in the best situation to get them into a better state long term."

When a student does die by suicide, Backer said UNLPD's protocol and approach is student and family centered. It's a difficult balance between the amount of information that is released to the UNL community versus the privacy and well-being of the family that has just been affected by this tragedy, he said.

If a student is feeling suicidal, Backer said to call 911 or UNLPD immediately, whether they live on or off campus.

"I have faith in all of our officers to be able to approach that situation for the benefit of the student and handle that appropriately for them," Backer said.

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UNLPD continues suicide prevention protocols

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Approximately every in the United States, someone dies by suicide. For people aged 15-24, many who are in high school or college, it is the second leading cause of death, shortening thousands of lives every year. The Daily Nebraskan reached out to the University of Nebraska-Lincoln Police Department to better understand its protocols with suicidal or potentially suicidal students.

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(38 Tex. Educ. Code  § 38.351 (2019))

Schools must implement research based programs for suicide prevention, intervention, and postvention.

Suicide prevention training must be provided to all school staff.

School staff needs to recognize students at risk of suicide and students engaged in or victims of bullying.

Schools should have procedures for contacting parents and providing resources as needed for students who are suicidal.

Schools should have procedures for integrating students back into school after treatment for suicide attempts or outside treatment for mental health concerns.

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EDUCATION CODE CHAPTER 38. HEALTH AND SAFETY

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Sec. 38.002. IMMUNIZATION RECORDS; REPORTING. (a) Each public school shall keep an individual immunization record during the period of attendance for each student admitted. The records shall be open for inspection at all reasonable times by the Texas Education Agency or by representatives of local health departments or the Texas Department of Health.

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(Nguyen v MIT, 2018):

After his son's suicide, Mr. Nguyen sued MIT for wrongful death.

School staff recommended that he received mental health assistance after he expressed concern over test taking stress, but he declined the assistance.

MIT suggested he participate in their campus mental health counseling services, but he declined services after a couple of visits and received outside counseling instead.

Multiple MIT staff members kept in contact with Nguyen and each other during his time there in regards to his mental health and the help he was receiving.

Nguyen denied suicidal thoughts multiple times.

After receiving multiple mental health treatments and treatments for insomnia, MIT staff all agreed Nguyen seemed to be in a better place and he eventually received a job as a teaching assistant before committing suicide.

At the time of his suicide, the university did not have actual knowledge of his suicide contemplation or plans, therefore they were not held liable for his actions.

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(U.S. Const. amend. IX)

The 9th amendment of the US Constitution ensures that it is understood that there are rights that may not necessarily be listed fully.

Students have rights to a safe environment that may not be listed specifically.

Parents have rights to their student and student's information that may not be listed specifically.

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Ninth Amendment, amendment (1791) to the Constitution of the United States, part of the Bill of Rights, formally stating that the people retain rights absent specific enumeration.

The full text of the Ninth Amendment is:

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

Prior to, during, and after ratification of the Constitution, debate raged about the protection of individual rights. Eventually, a Bill of Rights was added to the Constitution at the urging of the Anti-Federalists, who feared that without one, too much power would be vested in the federal government. Federalists, who believed that the Constitution had created a limited central government, countered that an enumeration of protected rights would be a possible detriment to individual liberties and render other liberties presumably unworthy of constitutional protection. Thus was born the Ninth Amendment, whose purpose was to assert the principle that the enumerated rights are not exhaustive and final and that the listing of certain rights does not deny or disparage the existence of other rights. What rights were protected by the amendment was left unclear.

Since the enactment of the Bill of Rights, the U.S. Supreme Court has never relied solely (or primarily) on the Ninth Amendment, and through the mid-1960s it was mentioned only sparingly. Indeed, in 1955 in a lecture (later turned into book form) titled "The Supreme Court in the American System of Government," Justice Robert H. Jackson admitted that the Ninth Amendment was a "mystery" to him. Since that time, however, the Ninth Amendment has been used as a secondary source of liberties and has emerged as important in the extension of the rights of privacy.

In Griswold v. State of Connecticut (1965), the Supreme Court held that married couples had the right to use birth control. The majority decision rested on Fourth and Fifth Amendment grounds, but Justice Arthur Goldberg based his concurring opinion squarely on Ninth Amendment principles, stating that

the language and history of the Ninth Amendment reveal that the Framers of the Constitution believed that there are additional fundamental rights, protected from governmental infringement, which exist alongside those fundamental rights specifically mentioned in the first eight constitutional amendments.

Taking that argument one step further, Goldberg claimed that

other fundamental personal rights should not be denied such protection or disparaged in any other way simply because they are not specifically listed in the first eight constitutional amendments.

Goldberg's invoking of the Ninth Amendment was criticized in a dissenting opinion by Justice Potter Stewart who wrote that

to say that the Ninth Amendment has anything to do with this case is to turn somersaults with history. The Ninth Amendment, like its companion, the Tenth...was framed by James Madison and adopted by the States simply to make clear that the adoption of the Bill of Rights did not alter the plan that the Federal Government was to be a government of express and limited powers, and that all rights and powers not delegated to it were retained by the people and the individual States. Until today, no member of this Court has ever suggested that the Ninth Amendment meant anything else, and the idea that a federal court could ever use the Ninth Amendment to annul a law passed by the elected representatives of the people of the State of Connecticut would have caused James Madison no little wonder.

In the decades since the Griswold decision, numerous claims were made in federal filings that additional rights were protected by the Ninth Amendment (almost all were rejected), and there has been considerable debate as to what protections, if any, are guaranteed by it. Some federal courts have used the Ninth Amendment as a guidepost in their decisions, but it still has not been central to any decision.

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Ninth Amendment | Definition, Text, & Interpretation

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Ninth Amendment, amendment (1791) to the Constitution of the United States, stating that the people retain rights absent specific enumeration. The text of the amendment is: 'The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.'

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(19 Tex. Admin. Code § 153. 1013 (2016)):

All school districts must provide suicide prevention training to all staff.

Yearly, all new staff should receive this training during new employee training.

Training must be from a program on a list best practices programs provided by the Department of State Health Services.

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According to Fairfield ISD (2020):

There are plans in place to communicate mental health concerns and potential suicide attempts to parents.

Campus mental health liaison will contact parents within reasonable amount of time of identifying the concern.

Campus mental health liaison will provide parents with identifying risk factors, educational materials, and options for treatment on and off campus.

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School counselors are aware that it may not always be possible to obtain informed consent and they may make counseling decisions on students' behalf to promote student welfare (ASCA, 2016).

A parent may not have consented to their student talking with the school counselor, but if there are reports or suspicion of suicide thoughts or a potential attempt, the counselor has an ethical responsibility to talk with the student. In a situation such as this, the child's welfare is potentially at stake.

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Laws and ethical decision-making are a part of my everyday life as a junior high counselor. I was fortunate to have a job as a counselor while I have been attending school. There have been situations where I have had to call parents and inform them about self-harming behaviors from their child. Many times, students are not happy with me about making these phone calls, but I make it clear that it is my job to help them and make sure they are safe. Laws and ethics pave the way on a daily basis to become a better counselor because they are in a sense, professional development.

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Schools should maintain positive campus climates.

School staff should report any suspicion of suicidal thoughts or attempts to the counselor for further investigation.

School counselors should contact parents at any suspicion of suicidal thoughts or attempts.

Use clear and direct information with the parents and student when discussing suicide and avoid changing the wording to make the conversation softer.

Encourage parents to seek outside resources anytime it is necessary.

Administration should immediately investigate any reports of bullying.

Have clear protocols for students returning to school after treatment for suicide thoughts or attempts.

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(19 Tex. Admin. Code § 153. 1013 (2016))

(38 Tex. Educ. Code  § 38.351 (2019))

American School Counselor Association. (2016). ASCA Ethical Standards for School Counselors. Retrieved from https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf

ASCA. (2020). The school counselor and suicide risk assessment. The School Counselor and Suicide Risk Assessment - American School Counselor Association (ASCA). Retrieved November 27, 2021, from https://schoolcounselor.org/Standards-Positions/Position-Statements/ASCA-Position-Statements/The-School-Counselor-and-Suicide-Risk-Assessment.

(Chavers, J., personal communication, November 29, 2021)

Fairfield ISD. (2020). PK-8th Grade Student Handbook. Retrieved from https://docs.google.com/document/d/1B18pDtNjs1Tsgs5JXjsIUgWO7ruMtQOQphSkkI6rtjA/edit

Jahn, C. (2021, November 11). UNLPD continues suicide prevention protocols. The Daily Nebraskan. Retrieved from http://www.dailynebraskan.com/news/unlpd-continues-suicide-prevention-protocols/article_524dba32-4284-11ec-a842-67acbdfee59c.html.

(Nguyen v MIT, 2018)

Prothero, A. (2020, June 19). 'A Punch to the Gut': Dealing With Suicide in a Pandemic. Education Week. Retrieved November 27, 2021, from https://www.edweek.org/leadership/a-punch-to-the-gut-dealing-with-suicide-in-a-pandemic/2020/06.

(U.S. Const. amend. IX)