·         We are required by law to report when there is a potential for harm to self or others.  

·         My primary job at that point was to receive her when she returned to school and help her re-acclimate as well as continue to watch, maintain an honest relationship, and to offer her a safe place in which to express any and all feelings and thoughts. 
Emerging Issue:

On February 10, 2022, U.S. Senators Jacky Rosen (D-NV) and Lisa Murkowski (R-AK), both members of the Senate Health, Education, Labor, and Pensions (HELP) Committee, introduced the bipartisan Youth Mental Health and Suicide Prevention Act, which would authorize the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide direct funding assistance to school districts for comprehensive student mental health promotion and suicide prevention efforts. Senator Rosen states “As we work together to recover from COVID-19, we must prioritize supporting our students and their mental health needs. My bipartisan legislation would allow the federal government to fund comprehensive, equitable, and evidence-based resources and programs in K-12 schools to further promote our students’ mental health, and help prevent student suicides.” This bill, if signed into law, would support schools in equipping students to navigate mental health challenges, and to recognize and connect students in need with mental health care." SAMHSA grant funding authorized by the Rosen-Murkowski bill would support a wide range of mental health evaluation, planning, programming, and suicide prevention strategies in K-12 schools, including:

Interviewee:
David Cook, M.A.Ed: Couns, CSC

Counselor, Elisha M. Pease Communications and Technology Academy

·         Schools play an important role in identifying risk for suicide, linking young people to care, providing comprehensive suicide-prevention programs, and facilitating social connections among youth.

·         Only 8% of students identified “interacting with teachers/school employees” as an activity that helped them maintain a positive state of mind in school during the pandemic.

 

WARNING SIGNS ASSOCIATED WITH SUICIDE

·         Talking about wanting to die

·         Looking for a way to kill oneself

·         Talking about feeling hopeless or having no purpose

·         Talking about feeling trapped or in unbearable pain

·         Talking about being a burden to others

·         Increasing the use of alcohol or drugs

·         Acting anxious, agitated or recklessly

·         Sleeping too little or too much

·         Withdrawing or feeling isolated

·         Showing rage or talking about seeking revenge

·         Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide but may not be what causes a suicide.

IF SOMEONE YOU KNOW EXHIBITS WARNING SIGNS OF SUICIDE

·         Do not leave the person alone

·         Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt

·         Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255)

·         Take the person to an emergency room or seek help from a medical or mental health professional

Source: American Foundation of Suicide Prevention

·         In response to the suicides, Dartmouth officials relaxed coronavirus restrictions to allow students to gather; added new counselors, a wellness coordinator, and other staff to the health service; organized a vigil; extended deadlines for students to request courses be marked incomplete or not recorded at all; and partnered with the nonprofit Jed Foundation to develop programs and policies that support campus mental health.

·         Experts say there are some critical actions colleges must take after a suicide to reduce the risk of contagion and to help people on the campus heal. One is to acknowledge the death of the person without adulating them or sensationalizing the suicide.

·         The Centers for Disease Control and Prevention advises that a response team pair those who may be at high risk of attempting suicide with a counselor for a screening interview, reduce access to common methods of suicide, and promote suicide crisis centers and hotlines.

·         Farris said, many faculty, staff, and students have become certified in mental-health first aid, which teaches risk factors and warning signs for mental-health and addiction issues, as well as skills for helping people in crisis.

·         Campus leaders say they’re listening and making changes in a long-term effort to bolster the Morgantown institution’s mental-health services. In the fall, the university will be rolling out Healthy Minds University, a long-term mental-health clinic. Services will include psychiatric care, case management, and therapy, WVU officials said.

·         “College students want an adult on campus that knows their name and cares about them,” he said. “Period. Not just someone who they see in classrooms, but someone that has their back, and is not just going to ask them about their grades but understands kids are experiencing that in the context of romantic relationships, breakups, in the context of their parents, roommate struggles, and is interested in them as a whole person.”

·         “Everyone knows a piece of the student,” he said. “But what college students want is someone that knows the whole them and understands that all these pieces interconnect.”

·         If you are in crisis and would like to talk to someone, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text “HELLO” to the Crisis Text Line at 741741. Both services are free, confidential, and available 24/7.

·         If there is an immediate suicide risk, do not leave the student alone. 

·         Escort to a secure location where student is monitored. 

·         Contact parents. 

·         Call 911. 

·         Persuade the person at risk and their parents to seek help. 

·         Refer the student for outside treatment. 

·         (a) In General.—The Secretary, acting through the Director of the Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration, may carry out a program to award grants, on a competitive basis, to eligible entities to enhance services for high school students with mental health and behavioral health issues that can lead to school failure, including depression, substance abuse, and suicide attempts.

·         (b) Application.—To be eligible for a grant under this section, an eligible entity shall submit to the Secretary an application in such form, at such time, and containing such information as the Secretary determines appropriate, including, at a minimum—

·         (1) a description of identified mental health and behavioral health needs of high school students served by such eligible entity;

·         (2) a description of existing Federal, State, local, private, and institutional resources available to address the needs described in paragraph (1);

·         (3) a description of the outreach strategies of such eligible entity to promote access to services, including a proposed plan for mental health equity and assisting students most in need of mental health services;

·         (4) a description of how such eligible entity will involve, as appropriate, students and peer representatives in the planning, implementation, and evaluation processes;

·         (5) a description of how such eligible entity will support other students and the school community if a student dies by suicide;

·         (6) a plan to—

·         (A) implement the activities described in subsection (c); and

·         (B) evaluate the outcomes of such activities; and

·         (7) an assurance that such eligible entity will submit to the Secretary, for each fiscal year in which grant funds are used, a report with respect to—

·         (A) the activities carried out under subsection (c); and

·         (B) the outcomes of such activities.

·         (c) Grant Uses.—A grant awarded under this section may only be used, with respect to high school students served by an eligible entity, for—

·         (1) evaluating existing program activities and prevention strategies;

·         (2) educational seminars;

·         (3) educational awareness campaign materials for students, families of students, and school staff to increase the awareness of potential mental and behavioral health issues of students;

·         (4) peer-to-peer program support;

·         (5) programs that assist schools in adopting a public health approach to mental health;

·         (6) social media applications used for mental and behavioral health purposes, such as suicide risk and mental health screenings;

·         (7) providing mental health services for students through telehealth;

·         (8) training programs for students and high school teachers, school leaders, and other school personnel to learn to respond effectively to students with mental health and behavioral health issues that can lead to school failure, including depression, anxiety, substance abuse, and suicide attempts; and

·         (9) the creation of an infrastructure to facilitate communication between high schools served by a local educational agency or State educational agency that does not have mental health services, including health care providers who can treat mental health and behavioral health issues.

·         (d) Matching Requirement.—

·         (1) IN GENERAL.—An eligible entity receiving a grant under this section shall provide non-Federal matching funds (including funds from donations from public or private entities) equal to the amount of the grant.

·         (2) DETERMINATION OF AMOUNT CONTRIBUTED.—

·         (A) IN-KIND SUPPORT.—Non-Federal matching funds described in paragraph (1) may include cash or in-kind support.

·         (B) FEDERAL SUPPORT.—Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government may not be included when determining the amount of non-Federal matching funds provided.

·         (3) WAIVER.—The Secretary may waive the matching funds requirement of paragraph (1) with respect to a grant made to an eligible entity under this section if the Secretary determines that such eligible entity has demonstrated extraordinary need for such a waiver.

·         (e) Study And Report.—

·         (1) STUDY.—For each fiscal year during which grants are awarded under this section, the Secretary shall conduct a study on the results of the grant program.

·         (2) REPORT.—For each study conducted under paragraph (1), the Secretary shall submit to Congress a report on the results of such study, including—

·         (A) an evaluation of the outcomes of the grant program, including a summary of activities carried out by eligible entities and the results of such activities; and

·         (B) recommendations with respect to improving access to mental health and behavioral health services at high schools, including efforts to reduce the occurrence of suicide and substance abuse.

·         (f) Definitions.—In this section:

·         (1) ELIGIBLE ENTITY.—The term “eligible entity” means a local educational agency or State educational agency that serves at least one secondary school.

·         (2) ESEA TERMS.—The terms “high school”, “local educational agency”, “secondary school”, and “State educational agency” have the meanings given such terms in section 8101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801).

(3) SECRETARY.—The term “Secretary” means the Secretary of Health and Human Services, in consultation with the Secretary of Education and the heads of other appropriate agencies. 

·         Counselor talked to students and parents and suggested counseling. 

·         D.B. then sent text messages to a friend, threatening suicide. 

·         Counselor took no additional action and D.B. died by suicide a few days later. 

·         D.B.’s father sued the school district and the school counselor.

·         The trial court found that the district was protected by the state’s qualified immunity while finding that the case against the counselor could go to trial.

·         The Ohio Court of Appeals upheld the trial court finding that there was a genuine question as to whether the counselor acted recklessly (i.e., in conscious disregard or indifference to a known or obvious risk of harm), thus eliminating her immunity.  

·         Teacher told student to return to the locker room where there was no one there to supervise. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         Student tried to hang herself and after other students found her and called her help, she survived but was left with permanent impairments. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         Two other incidents contribute to the suicide attempt. Student had been raped when she was 13 and was later counseled by the nurse and the guidance counselor.  Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         School officials should have known of the rape and should not have sent Jamie "alone and unsupervised away from the area he was monitoring when he knew or should reasonably have known that she was despondent or distressed." Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         The other background event was that seven other students in the Winthrop Middle School had also attempted suicide in the three months prior to May 1996. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         According to the complaint, the school failed to take various possible measures to cope with the epidemic, such as offering special counseling and monitoring programs within the school and providing more information to parents about the outbreak. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         On April 30, 1998, just short of two years after Jamie's suicide attempt, the Hasenfus parents brought suit in the district court on behalf of Jamie and themselves. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         The gist of the wrongful acts charged to the town, school board, superintendent, and principal were the failure to take a range of preventive actions listed in the complaint to cope with the suicide epidemic and, specifically as to Jamie, three narrower failures or mistakes discussed at the end of this opinion. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         The defendants moved to dismiss the section 1983 counts for failure to state a claim, Fed.R.Civ.P. 12(b)(6), and asked that the state claims then be dismissed for lack of federal jurisdiction, Wagner v. Devine, 122 F.3d 53, 57-58 (1st Cir. 1997), cert. denied, 118 S.Ct. 880 (1998). Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         In the district court and in their opening brief on appeal, the Hasenfuses argued forcefully that — contrary to the district court's view — the school had an affirmative duty to protect Jamie as a student entrusted to its care. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         But elsewhere the reply brief itself returns to the allegation that school officials acted recklessly "by standing by throughout the suicide epidemic and doing nothing to identify at-risk students or to train personnel to effectively deal with these students at risk." Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         In closing, we emphasize again that the due process clause is not a surrogate for local tort law or state statutory and administrative remedies. The federal courts have no general authority to decide when school administrators should introduce suicide prevention programs, or whether an unruly or upset school child should be sent out of class, or what should be said to other parents about a tragic incident at school. Substantive due process is not a license for judges to supersede the decisions of local officials and elected legislators on such matters. Cf. Collins v. City of Harker Heights, 503 U.S. 115, 128-29 (1992).Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         In principle, Maine law does allow civil claims by citizens for serious misconduct by state or local officials, and the district court's dismissal in this case was without prejudice to the assertion of the Hasenfuses' state claims in state court. As is quite common, Maine provides broad immunity protection for its officials, Me. Rev. Stat. Ann. tit. 14, §§ 8104-D, 8111, grants governmental entities immunity from civil suit with certain exceptions possibly not applicable here, id. §§ 8103, 8104-A, and places a monetary cap on the amount of damages available against individual employees and the government itself, id. §§ 8104-D, 8105. Whether Maine should be more generous is a matter for its citizens to decide. Hasenfus v. LaJeunesse, 175 F.3d 68, 74 (1st Cir. 1999)

·         A child may consent to counseling for: o suicide prevention; o chemical addiction or dependency; or o sexual, physical, or emotional abuse. Tex. Family Code § 32.004

·         A licensed or certified physician, psychologist, counselor, or social worker having reasonable grounds to believe that a child has been sexually, physically, or emotionally abused, is contemplating suicide, or is suffering from a chemical or drug addiction or dependency may: o counsel the child without the consent of the child's parents or, if applicable, managing conservator or guardian; o with or without the consent of the child who is a client, advise the child's parents or, if applicable, managing conservator or guardian of the treatment given to or needed by the child; and o rely on the written statement of the child containing the grounds on which the child has capacity to consent to the child's own treatment under this section. Tex. Family Code § 32.004

·         Unless consent is obtained as otherwise allowed by law, a physician, psychologist, counselor, or social worker may not counsel a child if consent is prohibited by a court order. Tex. Family Code § 32.004

·         A physician, psychologist, counselor, or social worker counseling a child under this section is not liable for damages except for damages resulting from the person's negligence or willful misconduct. Tex. Family Code § 32.004

A parent, or, if applicable, managing conservator or guardian, who has not consented to counseling treatment of the child is not obligated to compensate a physician, psychologist, counselor, or social worker for counseling services rendered under this section. Tex. Family Code § 32.004 

http://www.sccenter.org/wp-content/uploads/2016/11/Texas_laws_suicide.pdf

H.R. 1803 – Youth Mental Health and Suicide Prevention Act of 2021 https://www.congress.gov/bill/117th-congress/house-bill/1803/text?q=%7B%22search%22%3A%5B%22HR+1803%22%5D%7D&r=1&s=2