Responding to Students Who May be At-Risk for Suicide-School Counselors

 
School counselors have a legal duty to protect students if they foresee or should have foreseen that the student was potentially dangerous to himself or herself. It is impossible to predict suicide – school counselors are expected to exercise reasonable care (take precautions) to protect students from foreseeable harm.


Be able to make evaluations of whether a student may be at-risk for suicide.

Understand the myths of suicide, warning signs, and how to respond
  • On-going training
  • Consult and follow district and school plans
  • Consult with peers and experts when possible
Involve everyone in this process
Train teachers and administrators to recognize and refer
Provide in-service training, information, etc.
        • Myths of suicide, warning signs
        • What teachers may do in their classrooms
        • Information regarding signs of depression, behavior changes, etc.
        • Information regarding family problems that place students at-risk
        • What to do and where to go if there are concerns
             Suicide awareness programs for parents
      • Information on children’s behavior
      • Myths of suicide, warning signs
      • Specific recommendations for concerned parents
      • Community resources
            Suicide and death awareness programs for students


Working with students who may be at-risk for suicide

Informed consent with students is important – let them know up front when you have to break confidentiality. Be developmentally appropriate.

Talk with and listen to the student. Be direct and empathic.

Lethality assessment . Assessment content and goals are similar to adult assessment, but use developmentally appropriate language (be concrete).


If you have reason to believe the child is at-risk

Remain calm and empathic.

Talk with the student. Begin interventions

Inform parents or guardians if you determine a student is at-risk
Talk with parents/guardians
    • When possible have student be part of the conversation
Be direct and compassionate
    • Express your opinion, reason for concern, and the parent’s obligation
For example: “In our opinion your child may be at risk for harming
him/herself…. We don’t know for sure but you have an obligation to find out…. Here is your obligation….”
    • Obtain a commitment to safe guard the child
    • Get a commitment in writing, if appropriate
    • Give parents options of what they can do to help their child
Family physician for referral
Local hospitals with psychiatric services
Local public mental health agencies
If parents refuse to take action, put this in writing

If parents/guardians cannot be contacted and the child is seriously at risk…
Consider treating the situation as a medical emergency
Refer to student nurse or ask principal to call for ambulance for
transport to a hospital where psychiatric services are available.


Continued care and support for the student

Communicate with mental health personnel working with the child (Release of Information needed).

Continue to offer support and understanding

Possibly work with student on coping skills, expression of feelings, problem-solving skills, etc.

Plan for these situations to occur.
Teach faculty, administration, and students to refer.
Relationships are crucial. Don’t do this alone! Create a plan that involves others.

Decker, R. (1997). When a crisis hits: Will our school be ready?

Gilliland, B. E., & James, R. K. (2001). Crisis intervention strategies (4th ed.). Pacific Grove, CA: Brooks/Cole Publishing.

Isaacs, M. L. (1997). The duty to warn and protect: Tarasoff and the elementary school counselor. Elementary School Guidance and Counseling, 31, 326-342.

King, K. A., Price, J. H., Telljohann, S. K., & Wahl, J. (2000). Preventing adolescent suicide: Do high school counselors know the factors? Professional School Counseling, 3, 255-263.

Miller, D. N., & DuPaul, G. J. (1996). School-based prevention of adolescent suicide: Issues, obstacles, and recommendations for practice. Journal of Emotional and Behavioral Disorders, 4, 221-230.

Nelson, R. E., & Crawford, B. (1990). Suicide among school-aged children. Elementary School Guidance & Counseling, 25, 123-128.