Mental health is an important issue for all middle and high schools. Nationally, suicide is the second-leading cause of death for 10- to 14-year-olds and the third-leading cause of death for 15- to 24-year-olds. In some states, suicide is the leading cause of death for youth and young adults. How can schools think about suicide as a public health and safety issue?
The Suicide Prevention Resource Center (SPRC) provides a set of guidelines schools can follow to take action. Through a comprehensive approach that aligns efforts to address different facets of the problem, schools can decrease suicide rates and support survivors.
Developing a Comprehensive Approach
Even as schools can equip teachers with the tools to recognize warning signs and refer out for additional support, any valuable program to address suicide needs to be broad and multifaceted. SPRC suggests a six-step process of suicide prevention programming. Prevention programming is carried out within the comprehensive school team, which can include school counselors, administrators on the school or district level, mental health professionals, school nurses, teachers, and coaches. A school or district may wish to develop its own program and activities to specifically fit its community or use a preexisting curriculum.
A comprehensive system should increase awareness of the risk factors that may increase the likelihood of suicide. Although knowledge of these factors can support the work of suicide prevention, no single risk or protective factor fully predicts or explains suicidal ideation.
The following are possible risk factors:
- Prior suicide attempt(s)
- Mental disorders (especially depression/mood disorders)
- Use and abuse of alcohol or drugs
- Access to lethal means
- Being close to someone who died by suicide
- Chronic health issues
- Lack of access to mental health care
Even though knowing risk factors is important, it is vital to reinforce the protective factors that decrease the likelihood of suicide. A school can proactively support suicide prevention by a streamlined support system and making resources more accessible.
Prevention education: We can work toward destigmatizing mental health issues and suicidal ideation through prevention education around warning signs, correcting myths, and building knowledge among the student body. Prevention education can help students recognize and manage their emotions. It can also increase help-seeking behaviors for students who are struggling as well as identify and reinforce knowledge about support and resources.
Building protective skills: Life skills and resiliency are key protective factors in suicide prevention. Skills such as critical thinking, stress management, conflict resolution, problem-solving, coping, positive self-perception, and optimism all overlap with CASEL’s social and emotional competencies. Many times, schools are already implementing these within social and emotional curriculum programs, behavior intervention or management plans, and restorative justice practices.
Relationship building: Another protective factor is promoting positive social-connectedness systems. The Centers for Disease Control and Prevention defines connectedness as “the degree to which a person or group is socially close, interrelated, or shares resources with other persons or groups.” However, not all social connections are healthy or positive. Purposeful focus on building robust relationships and connections between youth and positive adults, between families and their community, and between supportive peers is important.
Best practices for talking about suicide
Even though talking about suicide is an important way to break taboos and support those struggling, it can be scary. Many people worry about saying the wrong thing or don’t know how to approach the subject. Many people also believe that talking or asking about suicide might “put the idea” in someone’s head. Research has proven this wrong. Talking about suicide or asking if someone is having thoughts of suicide is much more likely to save a life. Stigma thrives in silence. The best way to reduce stigma is to lean into difficult situations and actively face your own and society’s stereotypes. Here are some best practices when approaching the subject.
Disclose mandatory reporter status: Being open about mandatory reporter status is an important first step in class or schoolwide discussions of suicide. It sets up honest expectations and transparency that help build trust even when you can not maintain confidentiality.
Keep composed: Students pick up how the speaker is feeling about their subject. If you are nervous and uncomfortable, the students will feel uneasy too. If you can embrace the hard discussions with compassion and kindness, the students are more likely to follow suit. It also increases their confidence in you as a trusted adult in hard situations. Projecting as composed and caring even when feeling nervous is hard but important.
Give trigger warnings: Talking openly about suicide is important, but springing the subject on unsuspecting people can be re-triggering. Give the students and/or audience trigger warnings when the topic of suicide is coming up. For example, when encountering suicide in a video or reading passage, adding a trigger warning beforehand is beneficial. When teaching suicide prevention programs, giving students a road map and trigger warning is also helpful.
After giving a trigger warning, support self-preservation and self-soothing actions. This may be part of a schoolwide safety plan, like going to a safe place for a person when triggered. Many times it is a Tier 1 classroom management strategy—for example, allowing students to take a walk or water break, do coloring, use a fidget, or “pass” in discussions, and providing opt-outs and alternative options as needed.
Choose your language carefully: Language matters when talking about suicide. Never speak directly about means or places of suicide. Research has shown increases in similar suicides when that specific information is shared. When talking about suicide, use phrases such as “died by suicide” or “attempted suicide” instead of “completed,” “committed,” or “failed” suicide. It is OK to be matter-of-fact: Suicide is either fatal or not. It should not be talked about as successful or failed, as that sends the wrong message. Instead of describing someone as “suicidal,” consider “facing suicide,” “thinking of suicide,” or “experiencing suicidal thoughts or ideations.”
Emphasize hope: When addressing suicidal ideation, continually circle back to hope. Remind students that people who struggle with suicidal thoughts can and do recover. It is rarely a quick fix, but with ongoing support, building resiliency, positive social connections, and mental health/medical intervention, most people who face suicidal ideations feel better and move beyond their suicidal thoughts. Identify ways that students can support friends. Remind students that their number one responsibility is their own health and safety. I like to use the phrase “You can be a life line but you are never someone’s bottom line.” Recognize trusted adults and resources for them and/or peers. Finally, connect back to protective factors to help students take proactive steps for mental wellness.
Resources for teachers, coaches, and mentors
If a student comes to you with mental health concerns or to tell you that they are suicidal, refer them to the appropriate person in your school. Never agree to keep suicidal thoughts secret or feel like it’s your job to help the person on your own.
Teachers are already making a significant difference in supporting students who struggle. The foundation of all good teaching is building a safe environment within the classrooms and developing meaningful connections with students.
Unfortunately, many teachers are never given guidance for the work they already do to support student well-being. How do we set up teachers, coaches, and mentors for success in the work they already do? There are a few different systems, such as Mental Health First Aid or Question, Persuade, Refer, to help schools streamline the process of supporting faculty when working with students who are struggling with mental health issues. These systems typically include recognizing warning signs, identifying struggling students, and referring them to further support.