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I am an elementary counselor in Austin, TX.  This padlet is intended for other new elementary, middle, or high school counselors. This topic was chosen to outline legal and ethics guidelines for counselors who are working with students who are making a suicide outcry.

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Phyllis Chessher
School Counselor
Cox Elementary

Mrs. Chessher's Google Site: https://sites.google.com/leanderisd.org/cox-school-counseling/contact-information?authuser=0

How is this Impacting the field of School Counseling
The topic of working with students who talk about suicide is of utmost importance to a school counselor.  Counselors are met with these challenges often and should be well versed in the knowledge of how to handle a student who is discussing suicide. Many counselors complete several Suicide Risk Assessments (SRA) each month and more and more students are living with suicide ideation. Suicide intervention programs and strategies are also a part of staff development for school counselors (Phyllis Chessher, Personal communication, November 22, 2019).

Best Practices related to Student Suicide Assessment
1. Take any discussion or threat of suicide seriously.
2. Always contact the parent and keep a record of the SRA. Make sure the student knows and understands confidentiality and the need to contact parents if harm to self or others is possible.
3. Always follow up with a plan of action.
4. Touch base with the student shortly after the SRA is completed.
(Phyllis Chessher, Personal communication, November 22, 2019).

Emerging Issues related to Student Suicide
The increase of academic expectations and the constant filter of information through social media is a concern related to the increase in student suicidal thoughts and outcries.  When students, especially teens, are on social media and see what others are doing, maybe even things they weren't invited to, they begin to compare themselves. Social media and online interactions also allow more opportunities for students to be bullied which leads to a decline in self- esteem and withdrawal from normal activities. Having conversations about these emerging issues is an important part of intervention strategies (Phyllis Chessher, Personal communication, November 22, 2019).

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Take Action, Save Lives

Belyeu (2014), the Educational Director of The Trevor Project, has written a detailed article about adopting the Model School District Policy to prevent tragedies and create a supportive framework for schools. The Trevor Project, ASCA , and other organizations worked collaborated to provide policy tools that will be useful to educators (Belyeu, 2014).

Belyue, N. (2014). Take action, save lives. [PDF file]. Retrieved from

https://www.schoolcounselor.org/asca/media/asca/

ASCAU/Mental- Health-Specialist/TakeActionSaveLives.pdf

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#4 - Current Article- What it Takes to Make Suicide Prevention a Priority in Schools

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#4 - Current Article- What it Takes to Make Suicide Prevention a Priority in Schools

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Neiskens and Robbins (2018) outline a Mulit-tiered System of Support used in Montana schools.
* The schools implemented prevention and intervention programs.
* Provided additional mental health resources by establishing relationships with providers.
* Created a school environment that supports the mental health of students.

Nieskens, H. & Robbins, M. (2018). What it takes to make suicide prevention a

priority in school. Retrieved from https://www.edweek.org/ew/a

rticles/2018/11/28/what-it-takes-to-make-suicide-prevention.html

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Commentary

Mental health is an educator's responsibility

Montana has some of the most beautiful vistas in America within Glacier and Yellowstone National Parks. However, the state is also associated with an ugly statistic: Montana has the highest suicide rate in the nation. The rate, 29.2 suicides for every 100,000 residents, is nearly twice the national average. In Montana, suicide is the leading cause of death for children ages 10-14 and the second leading cause of death for children 15 to 24.

Montana's 2017 High School Youth Risk Behavior Survey data emphasizes the concern. Thirty one percent of the state's high school students felt sad or hopeless almost every day for two weeks or more in a row. Over 20 percent seriously considered attempting suicide. More than 16 percent made a plan about how they would attempt suicide. Nearly 10 percent attempted suicide. These awful statistics have educators around our state hastening to implement suicide prevention programs with staff and students.

Although there are many contributing factors to youth suicide, our school realized that to implement meaningful suicide prevention strategies, we had to acknowledge larger concerns regarding student mental health. Regrettably, approximately 1 in 5 American adolescents is contending with a serious mental-health condition. The prevalence of these conditions in our youths and the effect they can have on learning caused us to take a hard look at how to provide social, emotional, and behavioral supports for all learners.

And, so, four years ago, we implemented the Multi-Tiered Systems of Support, a continuous improvement framework intended to identify and support students who were struggling academically, socially, emotionally, or behaviorally. We built staff consensus around the precept that we have a professional responsibility to ensure all students have the necessary supports to be successful. We cultivated the belief with staff that social-emotional needs were just as essential for student success as academic needs. We built upon the existing schoolwide positive behavior intervention program and added pathways of increasingly intensive, data-driven interventions for individual students.

We focused on implementing schoolwide prevention and intervention programs which positively and personally impacted every student. We began assigning each student a staff member to serve as their personal academic trainer, who advocates for student success and well-being. They meet with students daily in middle school and at least weekly in high school to set goals, develop plans for how to achieve these goals, motivate students, and celebrate student successes.

In this special Commentary package, current and former school leaders share insights from how they managed and recovered from some of the most difficult-and often unexpected-circumstances of their careers.
Read more from the package.
These trainers also identify academic or social-emotional challenges that a student may be experiencing. They are asked to develop a positive, personal relationship with students so they may serve as a supportive resource if a student encounters challenges-be they academic, social, emotional, or behavioral. Since implementing this personal academic trainer program three years ago, we have reduced by more than two-thirds the number of students in our school who need a more intensive student assistance intervention plan, including in-school mental-health services.

We also realized we needed to draw upon the expertise of teachers to further identify which students required strategic or intensive mental-health services. Now, teachers screen all students twice annually using the Systematic Screening for Behavior Disorders, a universal behavioral screening system. Based on the results, some students are connected with regular, school-based mental-health services, both counselors and private providers operating in school facilities.

The high student-to-staff ratios and inadequate state and federal funding to support school mental-health services often leave counselors with limited resources. In our school, for example, our two guidance counselors each handle an average of more than 220 students; our sole school psychologist covers all 442 students.

To provide additional mental-health resources, we have established partnerships with multiple therapists, psychologists, and other private mental-health service providers. These providers deliver a Comprehensive School and Community Treatment program which includes access to school-based therapy, behavioral, and life-skills training.

Providers bill Medicaid and private insurance for the students' sessions, and the school provides the offices necessary to allow the therapists or case managers to meet with students during the school day. Now, roughly 10 percent of our school's population receives in-school mental-health-therapy services through CSCT, up from 4 percent four years ago when we greatly expanded the program.

Creating a school environment that continually and comprehensively supports the mental well-being of every student must be a focus for all educators. All schools should be looking for creative ways to address how to improve student mental health and prevent student suicide. Unfortunately, we both have had years in our careers where we lost one or more students to suicide.

It is a sad state of affairs when, at the conclusion of each academic year, we look forward to breathing a sigh of relief that we did not lose a student to suicide.

Published in Print: November 28, 2018, as Suicide Prevention Is Our Responsibility

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how principals navigate challenge series

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What It Takes to Make Suicide Prevention a Priority in School

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Commentary Montana has some of the most beautiful vistas in America within Glacier and Yellowstone National Parks. However, the state is also associated with an ugly statistic: Montana has the highest suicide rate in the nation. The rate, 29.2 suicides for every 100,000 residents, is nearly twice the national average.

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#5 -Current Article -Talking about Suicide in Schools

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#5 -Current Article -Talking about Suicide in Schools

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Gallagher (n.d.) discusses the importance of having conversations about suicide with students.
She discusses
1. appropriate ways to discuss suicide
2. Implementing prevention
3. What else can educators do?

Gallagher, T. (n.d.) Talking about suicide in schools. Retrieved from

https://afsp.org/talking-suicide-schools/

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Many people find it difficult to talk about suicide...even mental health professionals! It can be uncomfortable and scary and makes many of us feel out of our comfort zone. So, is it important to talk about suicide? Or should we listen to those uncomfortable feelings that tell us to ignore, walk away, hold back, and avoid this topic?

As a clinical psychologist at the University of Pennsylvania's Center for the Treatment and Study of Anxiety and a member of the Anxiety and Depression Association of America (ADAA), I value bringing awareness about mental health issues to the public. We know that talking about suicide and suicide prevention in productive ways is very important for both the individuals suffering from suicidal ideation, and the people who so desperately want to help them. Suicide can affect everyone. The good news is, there is room for all of us to get involved with suicide prevention.

School-based interventions that involve students, faculty, and parents are one way we can promote and implement suicide prevention efforts. This work can begin with school administrators, but can easily extend to students and parents as well.

So how do we start talking about suicide in our schools? And what are productive ways in which to do this?
One way is to create small groups for students to discuss difficult issues like mental health problems, family difficulties, interpersonal challenges, and painful emotions. This is especially important as it is more likely that a student will report something to another student rather than to an adult. Helping establish relationships between students and faculty can also serve as a preventative measure with regard to suicidal ideation, violence, bullying, etc. Preventative measures should include promoting help-seeking, emotional well-being, and networks of social support and "connectedness" among students, faculty, and parents. After-school clubs and relationship-building activities are also ways to connect students to each other and provide alternatives to negative behaviors and isolation.

How do we implement preventative interventions?
It's important to enhance resilience and life skills among children and adolescents. Sponsoring mindfulness and stress reduction workshops can help individuals take control in managing their mental health. Providing information about self-help tools, coping, and emotion regulation, and connecting students to apps they can use on their phones that assist in building these skills can help in the management of life stress and mental health challenges. Incorporating lessons about empathy, forgiveness, and behavior management into curriculums can help expand one's insight and understanding. Other helpful interventions include showing kids how to reach out, encouraging them to do so, making care available and ensuring that a suicide hotline number is easily accessible. Teaching bullying prevention is also important, as it is linked to a variety of mental health issues, not just suicide.

What else can we do?
Identify students at risk! This includes prior attempts, misuse of drugs, family history of suicide, chronic illness or disability, and lack of access to mental health care. School-based screening programs that protect student identity while identifying the presence of suicidal ideation and risk factors can also help with suicide prevention. These screenings should include parents, school personnel, and students in this process in a collaborative way. Screening should be done with efforts to educate and reach out to students regarding suicide in order to empower individuals to be aware of their own mental health as well as signs of people suffering around them.

Making concerted efforts to reach LGBTQ groups in schools is also critical, as stress from discrimination is a known risk factor for LGBTQ youth. It is important to educate students, parents, and faculty as to the warning signs of suicide. These include but are not limited to suicide notes or plans, making final arrangements, preoccupation with death, changes in behaviors, thoughts, and/or feelings.

How do we manage death by suicide?
In the event that someone dies of suicide in the school, plans for the presence of extra mental health counselors, grief groups, etc. should be established so that students and parents and faculty can talk, healthily process their feelings, and support each other.

So what do we do now?
Start the conversation! The point is that social support and connection are key factors that buffer against suicide. In school and out, we should all strive to find more ways to communicate and connect about our own struggles and personal challenges...even when it is hard or uncomfortable.

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Many people find it difficult to talk about suicide...even mental health professionals! It can be uncomfortable and scary and makes many of us feel out of our comfort zone. So, is it important to talk about suicide? Or should we listen to those uncomfortable feelings that tell us to ignore, walk away, hold back, and avoid this topic?

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Judicial Law- Rogers v. Christina Sch. Dist., C.A. No. N10C-07-060 JRJ (2013)

Rogers v. Christina School District (2013)
- The student spoke with his school counselor about thoughts of suicide for four hours
- The counselor did not believe the student was at risk and sent him back to class and emailed his teachers and update.
- The counselor did not inform the guardians and sent the student home without supervision where he took his life.
-The school could be held liable because the counselor did not notify guardians.

The original source of law can be found here: https://courts.delaware.gov/opinions/download.aspx?ID=166760

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Judicial Law- Eisel v. Montgomery County Board of Education, 597 A.2d 447 (1991)
- Counselor and administrator were informed of a student's suicide plan.
- The school staff did not inform the father.
- The student was a part of a murder-suicide pact.
- The court found the counselor was not liable, but the court claimed “the consequence of the risk is so great that even a relatively remote possibility of a suicide may be enough to establish duty” (Eisel vs. Board of Education of Montgomery County, 1991)

The original source of law can be found here: https://casetext.com/case/eisel-v-board-of-education

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Federal Statute- Family Education Rights and Privacy Act

FERPA original source of law:
https://www2.ed.gov/policy/gen/guid/fpco/ferpa/leg-history.html

Family Educational Rights and Privacy Act of 1974, 20 U.S.C. § 1232g (1974).

Education records are covered under FERPA but when dealing with student safety regarding suicide outcries those records may be disclosed to appropriate parties if the knowledge is necessary to protect the safety of the student.

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Armijo vs. Wagon Mound Public Schools (1998)
- School counselor drove a special education student home after he was suspended.
- The student made a comment that he wished he was dead to a teacher on campus, but this was not assessed and parents were not notified.
- The student was home alone with firearms and took his life.
-This decision was not released but it is believed the district was found liable.

Original source of law: https://caselaw.findlaw.com/us-10th-circuit/1274775.html

Armijo v. Wagon Mound Public Schools, 159 F.3d 1253 (10th Cir. 1998)

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Leander ISD Elementary School Student and Parent Handbook outlines the confidentiality standards and district expectations for parent contact and school protocols for suicide outcries and Suicide Risk Assessments.

The original source of law can be found here: https://www.leanderisd.org/UserFiles/Servers/Server_79234/File/departments/Student%20Support%20Services/Handbooks/ElemHandbook_1920.pdf

Leander ISD. (2019). Elementary School Student and Parent Handbook,

Suicide Prevention and Early Mental Health Intervention §P.54

Retrieved from https://www.leanderisd.org/UserFiles/

Servers/Server_79234/File/departments/Student%

20Support%20Services/ Handbooks/Elem-Handbook_1920.pdf

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ASCA (2016) Ethical Standard A.2. Confidentiality, " d. Explain the limits of confidentiality in developmentally appropriate terms through multiple methods such as student handbooks, school counselor department websites, school counseling brochures, classroom lessons and/or verbal notification to
individual students" is directly related to the topic of suicide outcries. School counselors must make sure students understand the limits of confidentiality as it relates to harming oneself, harming others or being harmed. Students must understand that your office is a safe place, but that you must report suicide outcries and behaviors.

American Association of School Counselors. (2016). ASCA ethical standards

for school counselors. Retrieved from https://www.schoolcounselor.

org/asca/media/asca/Ethics/EthicalStandards2016.pdf

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#12- Helpful Resources- American Foundation for Suicide Prevention Website

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#12- Helpful Resources- American Foundation for Suicide Prevention Website

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American Foundation for Suicide Prevention (2019) https://afsp.org/take-action/bring-prevention-school/ is a website that covers finding support, how to take action, how to donate, and also offers a blog about suicide and prevention. This site is a great resource as it discusses opportunities to be involved in prevention and also how to implement interventions in schools.

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American Foundation for Suicide Prevention

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Learn about suicide, how you can help prevent it, and resources for those affected, from the American Foundation for Suicide Prevention. Our mission: save lives and bring hope to those affected by suicide

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* Explain limits of confidentiality in developmentally appropriate terms.
* Always call a parent/guardian when an outcry is made.
* Remove any means for self-harm.
* Provide supervision. Do not leave the child alone.
* Focus on the concern. Do not place blame on the child.
* Continue to check in with the child after the outcry.
* Refer students for outside counseling services when needed.
* Call or reach out to a colleague or local authority to consult regarding the next steps for the student.