Prevention

Prevention involves taking action to prevent mental health issues that may lead to suicidal thoughts, as well as educating people about the warning signs of suicide and how to help.

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Education

It is extremely important that all staff, including teachers, aides, custodians, and lunch workers, are trained in what to look for and how to help students. Education for students may occur in a health class by a school nurse, school psychologist, counselor, or social worker. Creating a safe and non-threatening environment for all students is one of the important stages to begin with. All education and training should address the factors that contribute to suicidal thoughts in students. Schools should not have assemblies about suicide. In large groups, it is difficult to see how students are being affected by the content. Some who are already dealing with mental health issues may be triggered and put at increased risk. It is better for training to be done in classroom settings so students feel more comfortable talking about suicide. Source

PTA meetings, community councils, and other types of meetings in a school setting may present an opportunity to educate parents and the community about depression and suicidal behavior. Outside mental health professionals should be allowed to discuss their programs with students to increase awareness of services.

Youth Suicide

Suicide is the second leading cause of death for people ages 10–24. For most people, the thought of wanting to take one’s own life is incomprehensible. The factors that lead to a suicide attempt are complex and usually involve multiple internal and external issues. Typically, the person is in extreme emotional pain and sees suicide as the only solution. But when schools, communities, and mental health organizations come together for suicide prevention, they can give young people the support they need to find hope and choose life. Source

Risk Factors

Risk factors are situations or events that increase the risk someone will die by suicide. By decreasing risk factors in someone’s life, you help decrease the chance that they will consider suicide as an option. By being aware of risk factors, you can be on alert for warning signs that someone is thinking about suicide.

Predisposing risk factors

  • Mental or physical illness
  • Family history of suicide
  • Previous suicide attempt

Long-term risk factors

  • Victim of bullying
  • An unfulfilling or toxic relationship
  • Lack of social connection and support
  • Family conflict
  • Familial and social expectations
  • Abuse or neglect

Life event risk factors

  • Loss of a loved one
  • The end of a relationship
  • Parents’ divorce
  • Exposure to someone’s suicide
  • Sexual harassment or assault

Source

Mental Illness

One in five Americans live with a mental illness. Environmental stresses, genetic factors, and chemical imbalances can cause mental illness. They change how people think, feel, or act and can cause minor and major disruptions in their lives. Source

While the majority of people with mental illnesses do not consider suicide, research shows that 46% of people who die by suicide had a known mental illness. Illnesses closely linked to suicide risk include major depressive disorder, bipolar disorder, generalized anxiety disorder, conduct disorder, substance use disorder, and eating disorders. Reducing the stigma surrounding mental illness and help-seeking is one of the greatest ways you can support someone living with a mental illness. Source & Source

Half of mental illnesses develop by age 14, and the earlier a young person can access mental health care, the more effective it can be. Schools should partner with trained community mental health professionals to bring mental health services into the school if possible. Source

National Alliance on Mental Illness: resources and information about mental illnesses

Mental Health America: online mental health screening

Hope Squad educates students on mental illness and trains them to recognize and reduce the stigma surrounding mental illness in their schools.

Protective Factors

Protective factors are circumstances or characteristics that protect against suicide ideation. They include skills, strengths, and resources that increase resilience and the ability to handle stress. Positive resistance to suicide is not permanent, so programs that support and maintain protection against suicide should be ongoing. Source 

Internal Protective Factors

  • Resilience
  • Problem-solving skills and conflict resolution
  • A sense of personal control over actions
  • Sense of purpose and self-esteem
  • A healthy fear of risky behavior and pain
  • Hope for the future

External Protective Factors

  • Safe home and school environment
  • Positive connections to family, friends, and the community
  • Cultural and religious beliefs discouraging suicide
  • Responsibilities at home or in the community
  • Access to healthcare and clinical treatment
  • Restricted access to lethal means Source 

One of Hope Squad’s primary roles is to increase protective factors, such as connectedness, which benefits everyone in the school community.

Bullying

“Bullying is ongoing aggressive behavior that involves a real or perceived power imbalance.” Source

While there is not enough research to conclude that bullying causes suicide, children who bully and are bullied are at higher risk of suicide-related behavior.  Source

The following traits and circumstances can put someone at risk for bullying. Source

  • Few or no friends
  • Substance use
  • Being perceived as different from peers (race, sexual orientation, physical features, disability, etc.)
  • Unable to defend him or herself (vulnerable)
  • Is depressed, anxious, or has low self-esteem
  • Does not get along well with others

Keep up with technology. Bullying often takes place in areas hidden from adult supervision. Cyberspace has become such an area.

Pay special attention to the needs of LGBTQ youth and young people who do not conform to gender expectations.

Use a comprehensive approach. Reducing the risk of bullying and suicide requires interventions that focus on the individual’s mental health as well as school and home environments. 

Research evidence-based bullying intervention strategies. Research has found that restorative justice is a promising approach, while zero-tolerance policies may actually cause more problems. Source & Source

Bullying prevention is one of Hope Squad’s five areas of focus and a key component in elementary Jr. Hope Squads.

Talking with Young Children (Ages 4-8)


What to Say and Do

  • Talk with young children about their feelings. Help them label their feelings so they will better understand and be more aware of what is going on inside them. You might ask: “How are you feeling? Are you feeling sad or angry? Do you feel sad or angry only once in awhile or do you feel it a lot of the time?”
  • Encourage young children to express their feelings. Talking to them helps to strengthen the connection between them and you. It also lets them know they can share feelings safely with adults they know. Teach that feelings of hurt and anger can be shared with others who can understand and give support.
  • If a child does not seem to feel comfortable expressing feelings verbally, support other ways to express feelings, such as writing, drawing or being physically active. Give young children healthy ways to express themselves and work through feelings.
  • Explain to young children that being sad from time to time is normal. Sadness is the emotion people feel in times of loss, disappointment or loneliness. Teach children that talking about feeling sad or angry, and even shedding tears or being upset, is OK. Be clear that they should talk to others or do something else when feeling sad, but should not seek to harm themselves in any way.
  • Take steps to ensure that young children do not have easy access to materials they could use to harm themselves. Be certain knives, pills and particularly firearms are inaccessible to all children.
  • Focus on active involvement with young children that provides them with a focus for their feelings and energies. Play games, participate in sports, visit playgrounds and do other activities together. Stay closely connected to them so you can intervene and provide support if necessary. Source

Unfortunately, even students in elementary school attempt suicide. It’s important to remember that younger children express feelings more through actions than words. Play therapy is an excellent resource to use when working with younger children. Be sure to contact your local mental health agency for assistance.

Talking to Young Children (Ages 9-13)

 

What to Say and Do

  • Be aware of depression and its symptoms in adolescent children. Depression often does not go away on its own and is linked to risk of suicide when it lasts for periods of two weeks or more. Talk with individuals who have knowledge of depression in children to further understand the symptoms and how to intervene.
  • Adolescents have many stressors in their lives and sometimes consider suicide as an escape from their worries or feelings. Be aware of your adolescent’s stressors and talk with him or her about them. Let your child know you care and emphasize that “suicide is not an option; help is always available.” Suicide is a permanent choice.
  • Assist adolescents so they don’t become overwhelmed with negative thoughts, which can lead to thoughts of suicide. Help them learn to manage negative thinking and challenge thoughts of hopelessness. If needed, treatment or therapy can help an adolescent deal with negative thoughts.
  • Emphasize that alcohol and drugs are not a helpful source of escape from the stressors of an adolescent’s life. An adolescent who is suffering from depression and also turns to alcohol and drugs is at a greater risk of attempting suicide.
  • Be attentive to risk factors in an adolescent’s life, as suicide is not always planned at younger ages. Recognizing the warning signs that might be leading to suicide is important.
  • Encourage adolescents to talk about and express their feelings. Provide a listening ear and be a support so they can visit with you about how they feel. Adolescents deal much better with tough circumstances when they have at least one person who believes in them. Source

Talking to Teens (Ages 14-18)


What to Say and Do

  • Recognize the signs and symptoms of depression in teens. These may include feelings of sadness, excessive sleep or inability to sleep, weight loss or gain, physical and emotional fatigue, continuing anxiety, social withdrawal from friends or school, misuse of drugs or alcohol and related symptoms. Intervene and get professional help and resources if necessary.
  • Ask teens about what they are feeling, thinking and doing. Open communication helps teens talk freely about their concerns and seek support. Make yourself available to talk with teens often. Avoid being critical or judgmental; listen, don’t immediately “fix” the problem.
  • Provide support if a teen expresses thoughts related to suicide or shares stories of suicide attempts. Stay with him or her and seek additional help. Guide the teen to professional therapists who can give assistance.
  • Listen to teens and pay attention to language related to hurting themselves or others, wanting to “go away” or “just die,” or similar ideas. Such expressions always should be taken seriously. Respond with support for the teen and access resources to provide further counseling or guidance.
  • Encourage teens to be attentive to their peers and quickly report to a respected adult any threats, direct or indirect, that suggest the possibility of suicide. Teens often are aware of such threats among their peers before others and can serve to support peers and provide resources. Talk about the idea that being a true friend means not keeping secrets that could lead to someone being dead. Source

Bullying may be a concern for students in this age category, leading to at-risk behavior and depression. Assessments are helpful to determine the most at-risk students. Peer to peer programs are most successful in preventing bullying and assisting at-risk students

LGBTQ+ Youth

LGBTQ+ youth across the nation face challenges every day. Hope Squad seeks to help the LGTBQ+ community by being compassionate, understanding and supportive of every individual. 

Hope Squad aims to change the dialogue and support the mental health of ALL teens. Every individual is a worthwhile person and deserves to be treated with respect and love. Positive environments are important to help all youth thrive. However, the health needs of LGBTQ+ Youth can differ from their heterosexual/cisgender peers and often face additional pressures and concerns. In comparison to the mainstream population, LGBTQ+ youth experience higher rates of suicidal thoughts and behavior. Often alienated from family and school, LGBTQ+ youth struggle against stigma and discrimination. However, it is important to remember that most LGBTQ+ youth who experience these stressors do not consider suicide.

Educators must provide a safe non-threatening school environment for all students, ensuring that LGBTQ+ students are not bullied, victimized, or excluded.  Caring adults must take the lead in creating safe places for all students through the following efforts:

  • Become aware of issues for LGBTQ+ youth within and outside of the school community.
  • Ensure that LGBTQ+ youth who need behavioral health services are connected with providers who have experience offering services to LGBTQ+ youth.
  • Model appreciation for all youth, condemn any discrimination, and promote an advocacy role for all youth.
  • Respect youths’ decisions about coming out to others.
  • Promote protective factors such as family support and acceptance, safe schools, caring adults, high self-esteem amongst youth, and positive role models for youth.
  • View LGBTQ+ students as a part of, and not separate from, other persons and groups.
  • Allow students to openly discuss the topic in a courteous, respectful, and professional manner.
  • Create safe spaces where LGBTQ+ youth can receive support.
  • Serve as a resource to families by providing accurate information on sexual orientation and gender identity.

Source

Source

LGBTQ+ Lifelines

LGBTQ+ National Youth Hotline (to age 25): 1-800-246-7743

Trevor Lifeline: 866-488-7386

Trevor Text: Text “Trevor” to 1-202-304-1200

Trevor Chat: thetrevorproject.org/pages/get-help-now

LGBTQ+ National Hotline (all ages): 1-888-843-4564

LGBTQ+ Resources

The Trevor Project: lifeline, chat, and support center. The Trevor Project is a national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender and questioning (LGBTQ) young people under 25.

GSA Network: trains youth leaders to educate and advocate for LGBTQ+ rights

It Gets Better ProjectThe mission of the IGB Project is to give LGBT youth across the world hope that things do get better. In response to raised incidents of students committing suicide after being bullied in school, syndicated columnist Dan Savage created the organization to provide both inspiration and resources, including pledges and educational videos.

Q Card Project: The Q Card is a simple and easy-to-use communication tool designed to empower LGBTQ youth to become actively engaged in their health, and to support the people who provide their care.

Gay, Lesbian, and Bisexual Teens: Facts for Teens and Their Parents: If you’ve ever wondered if you’re gay, lesbian, or bisexual, you’re not alone. Many teens ask themselves this question, and here are ways to find some answers.

For parents and caregivers, finding out your son or daughter is gay, lesbian, or bisexual can present challenges. Learn more about how to be supportive.

CenterLink: Founded with the mission to build sustainable LGBTQ community centers, this organization now has over 200 locations in 46 states and five countries. Aside from strengthening local LGBTQ communities, the organization also provides networking, technical assistance and training, and capacity building services.

Resources for youth and family

Responding To Children’s Questions on LGBTQ Topics

Improve School Experiences for LGBT Youth

Talking with Teacher & Staff


The Role of Teacher and School Personnel.
Teachers or school personnel are not responsible for counseling at-risk students.  Teachers and school personnel may refer these students to the appropriate helping resource as directed by the school’s policy or protocol. Schools often instruct teachers to relay concerns about individual students to a counselor, a school nurse or another support person in the school. In some cases, teachers may be encouraged to talk directly to a student’s parent or guardian about changes in behavior that may suggest a problem. Teachers and school personnel are encouraged to obtain a copy of their school’s policy or protocol for referring students in need of mental health services. Source

Teachers and school personnel have day-to-day contact with students and are well-positioned to observe students’ behavior and to act when they suspect a student may be at risk of self-harm. Schools need to create a structure of support for teachers and school personnel outlining steps for identifying and assisting at-risk students.

How to Identify Students in Distress and At Risk for Suicide

Any sudden or dramatic change affecting a student’s performance, attendance, or behavior should be taken seriously, such as:

  • Lack of interest in usual activities
  • An overall decline in grades
  • Decrease in effort
  • Misconduct in the classroom
  • Unexplained or repeated absence or truancy
  • Excessive tobacco smoking or drinking, or drug (including cannabis) misuse
  • Incidents leading to police involvement and student violence. Source

These signs help identify students at risk for mental and social distress, which may cause thoughts of suicide and ultimately lead to suicidal behavior. If a teacher or school personnel identifies any of these signs, the school team should be alerted and arrangements made for a thorough evaluation of the student.

National Association of School Psychologists Tips for Teachers

  1. Know the warning signs!
  2. Know the school’s responsibilities. Schools have been held liable in the courts for not warning the parents in a timely fashion or adequately supervising the suicidal student.
  3. Encourage students to confide in you.  Let students know that you are there to help, that you care.  Encourage them to come to you if they or someone they know is considering suicide.
  4. Refer student immediately. Do not “send” a student to the school psychologist or counselor.  Escort the child yourself to a member of the school’s crisis team.  If a team has not been identified, notify the principal, psychologist, counselor, nurse or social worker. (And as soon as possible, request that your school organize a crisis team!)
  5. Join the crisis team. You have valuable information to contribute so that the school crisis team can make an accurate assessment of risk.
  6. Advocate for the child. Sometimes administrators may minimize risk factors and warning signs in a particular student.  Advocate for the child until you are certain the child is safe. Source

From the Suicide Prevention Resource Center (SPRC)