Suicide Support &

Prevention
Katie Chilton
November 11, 2013
Salem College
Anne Sourbeer Morris, Ed.D.

Introduction
All school conduct fire drills, many have detailed plans for coping with floods, hurricanes, or earthquakes.
Today, we practice chances that an armed intruder will go on a shooting rampage. But most schools are
unprepared to deal with a far more common threat to their students: suicide. Suicide is the third leading cause
of death in the United states for 10-19 year olds, yet only 1 in 10 schools has a plan to prevent it (Portner, 2000,
pg. 178).

Understanding Why Suicide Prevention

in Schools is Important
Suicide prevention is so important because it contributes
to our societies future. We do not want statistics to be on
the rise about younger children taking their own lives, we
do not want the teenage girl to feel she has no way out, we
do not want parents to feel they had no warning signs, we do
not want communities in shambles. When we begin to
understand the importance and necessity of suicide
prevention programs in schools then we begin to see
hope for our future.

Statistics
The following data are for 2009, for youth aged 10 to 24:

NUMBER OF SUICIDES: 4,630 died by suicide

A LEADING CAUSE OF DEATH: Suicide was the third

leading cause of death for 10- to 24-year-olds.

SUICIDE RATES: Rates of suicide are highest for older

youth. For youth aged 20 to 24, 12.5 per 100,000 youth died
by suicide. For youth aged 15 to 19, 7.8 per 100,000 died,
while for youth aged 10 to 14, 1.3 per 100,000 died.

GENDER: Male youth die by suicide over four times more

frequently than female youth.

RACE: Native American/Alaska Native youth have the

highest rate with 17.4 suicides per 100,000. White youth are
next highest with 7.5 deaths per 100,000.

METHODS: The majority of youth who died by suicide

used firearms (45 percent). Suffocation was the second most
commonly used method (40 percent). (Centers for Disease
Control and Prevention, National Center for Injury
Prevention and Control).

The following data are for 2009, for youth aged 10 to 24:

NUMBER OF SUICIDES: 4,630 died by suicide

A LEADING CAUSE OF DEATH: Suicide was the third

leading cause of death for 10- to 24-year-olds.

SUICIDE RATES: Rates of suicide are highest for older

youth. For youth aged 20 to 24, 12.5 per 100,000 youth died
by suicide. For youth aged 15 to 19, 7.8 per 100,000 died,
while for youth aged 10 to 14, 1.3 per 100,000 died.

GENDER: Male youth die by suicide over four times more

frequently than female youth.

RACE: Native American/Alaska Native youth have the

highest rate with 17.4 suicides per 100,000. White youth are
next highest with 7.5 deaths per 100,000.

METHODS: The majority of youth who died by suicide

used firearms (45 percent). Suffocation was the second most
commonly used method (40 percent). (Centers for Disease
Control and Prevention, National Center for Injury
Prevention and Control).

The Role of the School Counselor and

Response to Suicide
As a school mental health provider, you have an important role to play. You are in a key position to:
Observe students behavior and act when you suspect that a student may be at risk of self-harm.
Provide needed expertise, support, and information to teachers,
other school staff, students, and parents who may notice that
one of their students, peers, or children is having difficulties
but may not know what to do about it.
Determine the next steps to take regarding a students safety and
treatment.
(http://www.sprc.org/sites/sprc.org/files/SchoolMentalHealth.pdf).

Identify Students Who May be at Risk

Researchers have identified a large number of risk factors for
suicide. The most significant ones are:

Other risk factors include the following circumstances and

problems:

Prior suicide attempt(s)

Recent death of a friend, especially if by suicide

Substance abuse

Recent death of or separation from a family member

Mood disorders

Engaging in self-harm

Access to lethal means

Problems in school (academic and/or discipline)

Relationship problems or breakups
Bullying or other forms of violence
Discrimination based on sexual orientation or gender
nonconformity
Family problems or abuse, current or in the past
Legal issues
Serious illness or injury
Other stressful events
http://www.sprc.org/sites/sprc.org/files/SchoolMentalHealth.
pdf

Identify Students Who May be at Risk

Verbal Cues:

I cant go on
I wish I was dead
Im not the person I used to be
Theres only one way out
You wont be seeing me around anymore
Life has no meaning anymore
Im tired of living
Here take these I wont be needing it anymore

Themes or Preoccupations in Thinking:

Wanting to escape from the situation which seems

intolerable
Wanting to join a friend or family member who is dead
Wanting total commitment to a relationship or goal
Wanting to be punished
Want to avoid being punished
Wanting revenge
Wanting to control when death will occur.
Wanting to end unresolvable conflict
Wanting to become a martyr for a cause (Capuzzi,
Golden, 1988).

Responding to Students at Risk

Take the following steps right away:
1. Talk with the student. Listen without judging and show you care.
2. Assess the student for risk of suicide and other forms of self-injury.
3. Take away any potential method of harm, such as a knife or pills.
4. Do not leave the student alone (not even in a restroom) until a plan for next steps has been made.
5. Collaborate with the school administration and any other available behavioral health staff in making decisions about next
steps.
6. Notify and involve the parents/legal guardians. They must always be notified when there appears to be any risk that a student
may harm himself or herself, unless doing so would place the child in a dangerous situation. It is important to be sensitive to
the familys culture, including attitudes towards suicide, mental health, privacy, and help-seeking.
7. Provide parents with any needed referrals to mental health resources.
8. Document all actions to ensure communication among school staff, parents, and service providers and to make sure the
student gets needed services.
9. Follow up with the parents to determine how best to provide the student with support after the crisis.
(Adapted from Los Angeles Unified School District, 2010, and SAMHSA, 2012)

Students Talk of Suicide

Being Prepared

Examples of postvention crisis response include:

Grief counseling for students and staff

Identification of students who may be put at risk by a traumatic incident

Support for students at risk

Support for families

Communication with the media to reduce the possibility of unsafe news coverage that could lead to additional suicides or
emotional trauma

Check-ins with students at risk at later times in the year, e.g., within a month or the anniversary of the death (www.sprc.
org).

Crisis Response
1. Be a Good Listener
2. Be Supportive
3. Assess Lethality
4. Make a Decision about Intervention

School Wide Suicide Prevention Plan

Based on suicidal awareness and prevention programs the following should be considered to help set up a schoolwide program.
1. A proactive approach to suicide prevention should be considered. A proactive approach, before a problem exists, provides a
climate that enhances through program development and implementation of comprehensive prevention programs.
2. Effective suicide prevention programs involve a broad base of community involvement and support.
3. A school should have a crisis resource team to help students, staff, and community deal with crisis situation. The team, often
composed of a psychologist, nurse, social worker, teacher, administrator, counselor, and student be responsible for dealing with the
impact of a crisis in the school setting and for being of help to the student or family in crisis.
4. Many schools have approached suicide prevention by including information on suicide in school curriculums- Education is key
to suicide prevention. If just one adolescent is helped because an educator identified him/her as being at risk- if just one suicide
attempt can be avoided because parents have picked up on clues- if just ones life can be save because a friend has learned how to
help- a beginning will have been made (Shneidman, Swenson, 1964).

Best Practices in School Suicide

Prevention
SOS High School Program

SOS Middle School Program

SOS Booster Program

The SOS Signs of Suicide High School

Program incorporates peer intervention as
part of its implementation strategy.
Research indicates that adolescents are
more likely to turn to peers than adults
when facing a suicidal crisis. By training
students to recognize the signs of
depression, self-injury, and suicidality and
empowering them to intervene when
confronted with a friend who is exhibiting
these symptoms, SOS capitalizes on an
important social/emotional aspect of this
developmental period.

The SOS Signs of Suicide Middle School

Program was created to assist in prevention
efforts and to address the problems of youth
depression, suicide, and self-injury
simultaneously and age appropriately. The
program uses a universal approach to assist
in identification of at-risk youth.
Similar to the high school program, the
SOS Middle School Program teaches
students that depression is a treatable
illness.

The SOS Signs of Suicide Booster

Program is a "refresher course" for students
preparing for life beyond high school,
teaching them how to identify and respond
to serious depression and potential
suicidality in themselves or a friend. The
SOS Booster Program "graduates" the
ACT acronym to be more relevant for
individuals approaching adulthood,
replacing the Tell in ACT: Acknowledge,
Care, Tell with TreatmentSeek treatment
for yourself or a friend. Lastly, the program
familiarizes students with college and
community-based mental health services.
(mentalhealthscreening.org).

Counseling Interventions

Conclusion

References
Capuzzi, D.; Golden, L. (1988). Preventing Adolescent Suicide.
Accelerated Development Inc. Muncie: Indiana.

Lester, D. (1997). Making Sense of Suicide. The Charles Press,

Publishers, Inc.: Philadelphia, PA.

Centers for Disease Control and Prevention (CDC). (2010). Web-based

injury statistics query and reporting system (WISQARS).
Retrieved from http://www.cdc.gov/injury/wisqars/fatal.
html

Los Angeles Unified School District. (2010). Intervening with suicidal

youth. Retrieved from http://preventsuicide.lacoe.
edu/admin_staff/administrators/guidelines_suicide.php

Centers for Disease Control and Prevention (CDC). (2012). Youth risk
behavior surveillance United States, 2011. Surveillance
Summaries. MMWR, 61(4). Retrieved from http://www.
cdc.gov/mmwr/pdf/ss/ss6104.pdf
Chang, V.N., Scott, S. T., & Decker, C. L. (2013). Developing helping
skills: A step-by-step approach to competency (2nd ed.).
Belmont, CA: Brooks/Cole, Cengage Learning.
De Jong, P., & Berg, I. K. (2013). Interviewing for solutions (4th ed.).
Belmont, CA: Brooks/Cole, Cengage Learning.

Mental Health Screening. (2010). Youth Program: SOS Suicide

Prevention Programs. Retrieved from: http://www.
mentalhealthscreening.org/programs/youth-preventionprograms/sos/
National Suicide Prevention Lifeline. (n.d.). What are the warning signs for
suicide? Retrieved from http://www.
suicidepreventionlifeline.org/Learn/WarningSigns

References
Portner, J. (2002) Suicide: Many schools fall short on prevention.
Education week. Retrieved January 20, 2002, from http:
//www.edweek.org/ew/ew_printstory.cfm?
slug=32solution.h19

Rochlen, A. B. (2007). Applying counseling theories: An online, case-based

approach. Upper Saddle River, NJ: Pearson Education,
Inc.
Suicide Prevention Resource Center. (2012). The Role of Mental Health
Providers in Preventing Suicide. Retrieved from:http:
//www.sprc.org/sites/sprc.org/files/SchoolMentalHealth.
pdf
Williams, R. (2007). To Tell or Not to Tell: The Question of Informed
Consent. ASCA School Counselor. Retrieved from: http:
//www.ascaschoolcounselor.org/article_content.asp?
edition=91&section=140&article=955

Resources

Suicide Resources