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School Health

Creating a Culture of Caring: Suicide Prevention in Schools

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Mental health awareness is on the rise in education, and with good reason. According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death for youth between the ages of 10 and 19 — only accidents cause more. It’s prompted many education leaders to consider what role they can play in supporting students affected by mental health challenges.

Theodora and Steve Schiro have thought about this more than most. They’re former educators and current mental health advocates who focus on suicide prevention in schools. The Schiros took up this mantle after losing their son to suicide in 2011.

“We as a society continue to shy away from having serious and ongoing conversations about mental health and suicide, but more teenagers and young adults die by suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined,” says Steve.

The solution, Theodora and Steve say, is to “create a culture of caring.” But what exactly does that mean? And what steps can district leaders take to foster it?

It Starts at The Top

Decision makers at the district and campus levels have a crucial part to play in the creation of a culture of caring. “You set the tone at your school or district, your actions determine the climate and establish the norms…you’re in charge of safety, which means you’re also in charge of suicide prevention,” says Theodora.

One basic way district leaders can do this is by implementing a standard of annual suicide prevention training for teachers and staff. These employees spend the most time with students, so it makes sense that they should be the ones most familiar with the warning signs.


“You set the tone at your school or district, your actions determine the climate and establish the norms…you’re in charge of safety, which means you’re also in charge of suicide prevention,” says Theodora.


But training teachers and staff isn’t enough to prevent suicide altogether. District leaders should prioritize hiring in-school mental health professionals on a full-time basis.

This goes a long way toward fostering an environment where students of all ages can “talk to a trusted adult about their mental health” candidly, says Theodora. With enough mental health professionals in your school, every student can receive the attention they need to make this possible.

Administrators should strive for a ratio of one counselor per 250 students, though many schools struggle to meet that recommendation. Others, like Boston Public Schools, have created models that empower school psychologists to offer a broad range of services to all students, not just act as gatekeepers for special education, which is sometimes the case.

Small Steps Still Help

Of course, money is always a factor in making these ideas come to fruition. Districts with fewer resources may feel hamstrung by their budgets, but that doesn’t mean they can’t use other tactics to help students feel supported mentally and emotionally.

Small improvements can have a snowball effect over time. “The best advice we can share to districts just starting out is to start small, one step at a time,” says Steve.

“Evaluate what you’re already doing, and then take it to the next level.”

One good way to do this is to engage resources geared toward mental health in the community at-large. “If a school can’t sustain full-time staff members, they can forge partnerships with community-based resources to bring help into the school…even one day a week will help,” says Theodora.

A Three-Phase Approach

Even with buy-in from administrators, no culture is reset overnight. That’s why it’s important for every district to establish overarching strategies to deal with the problem of suicide. These strategies should be designed for three different components: suicide prevention, intervention, and postvention.

Prevention

Prevention starts with administrative buy-in, staff training, and mental health professional empowerment described above. Staff should be aware of the causes of suicide, know the warning signs, and understand the risk factors.

When each student receives attention to their mental well-being, it becomes easier for schools to identify those who are at risk.

Another part of prevention is to introduce mental health concepts to students when they’re young to destigmatize talking about mental and emotional struggles. This “upstream strategy” can lead to teaching lessons about coping and emotional skills, which can help kids nurture their own mental health.

Together, these things can help bring about deeper discussions that can provide your school’s mental health professionals with added insight into your students’ lives.

The third component of prevention is about cultivating a school-wide sense of belonging. This too should start early by emphasizing concepts of tolerance from a young age. This, combined with student participation in activities and clubs, can help build connectedness over time, something the CDC says is crucial to maintaining mental health.

Such connectedness is the culture of caring in action. For schools, this means students attend a learning environment where they know there are people who care about them, and vice versa.

In all, the idea propelling your suicide prevention initiative is to do more than just identify the kids at risk, “it’s about preventing kids from getting to the point where they are at risk,” says Theodora.

Intervention

Even with ideal counselor-to-student ratios and proper staff training, there will still be some students who may require intervention.

These students may have an increased risk of suicide for a number of reasons, including adverse childhood experiences, family discord, disrupted friend groups, and ended romantic relationships.

When teachers and staff can be more aware of their students’ lives, they can better identify who may be at risk, and take steps to mitigate it. The seeds of this are planted in the prevention phase.

Students should be empowered to recognize and respond to warning signs of suicide among their friends, and within themselves, as well. They should feel able to tell a trusted adult in the school about their concerns for a fellow student.

This can only happen if they are made aware of those warning signs, and what to do about them.

Postvention

Unfortunately, there are situations where prevention and intervention efforts will not be enough to stop a suicide from happening. While you hope to never have to use it, having a plan about what to do in the wake of a suicide is crucial.

This plan should have “suggestions on how to interact with the family and communicate with the community, and will also help school personnel respond during an emotional time.”

It’s important to remember that creating a culture of caring in your own school district takes time and refinement. Theodora and Steve have shared an abundance of resources to help you along this path, which you can find here, along with their suicide prevention webinar.