Youth Suicide Prevention, Intervention, and Postvention
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School Safety Center

Youth Suicide Prevention, Intervention, and Postvention

In Washington State, suicide is the second leading cause of death among those ages 10-34. According to the most recent Healthy Youth Survey (2014), more than 30% of youth in grades 10 and 12 report depressive feelings, including feeling sad or hopeless for at least two weeks. Twenty-five percent of 8th graders report depressive feelings. Suicide is preventable through a comprehensive prevention approach. The Office of Superintendent of Public Instruction strives to provide resources and support through the School Safety Center to help inform Educational Service Districts, School Districts, and Schools in the development of Suicide Prevention Plans.

that require

Know the warnings and take action if you see:

  • Talking or writing about suicide or death
  • Giving direct verbal cues, such as "I wish I were dead" and "I’m going to end it all"
  • Giving less direct verbal cues, such as "You will be better off without me," "What’s the point of living?", "Soon you won’t have to worry about me," and "Who cares if I’m dead, anyway?"
  • Isolating themselves from friends and family
  • Expressing the belief that life is meaningless
  • Giving away prized possessions
  • Exhibiting a sudden and unexplained improvement in mood after being depressed or withdrawn
  • Neglecting his or her appearance and hygiene
  • Dropping out of school or social, athletic, and/or community activities
  • Obtaining a weapon (such as a firearm) or another means of hurting themselves (such as prescription medications)

What can Schools Do?

Incorporate School-Based Prevention

School-based prevention can be especially effective when implemented in the context of a comprehensive risk prevention or health promotion program. Such programs can reduce levels of self-harm and other risk behaviors as well as improve levels of wellness and the academic performance of the school.

Incorporate School-based prevention with existing crisis response plans
Schools can help prevent suicide by providing teachers and students with the mechanisms necessary to identify and respond to students who are at risk of suicide as well as other risk and self-destructive behaviors. A comprehensive school crisis plan helps a school respond to any emergency, from a natural disaster to violence in the school community. Such a plan should include procedures for addressing students who try to harm themselves as well as those who are only contemplating it. See Prevention and Resources for available training and model plans shown to be effective school based prevention plans.

Implement a Recognition and Referral Program
Training is available (see Resources) for those who have regular contact with young people, such as teachers, to do the following:

  1. Recognize behavioral patterns and other warning signs that indicate that a young person may be at risk of suicide;
  2. Actively intervene, usually by talking to the young person in ways that explore the level of risk without increasing it;
  3. Ensure that young people at risk receive the necessary services; and
  4. Be prepared to engage in postvention. "Postvention" is a term used to describe prevention measures implemented after a crisis or traumatic event to reduce the risk to those who have witnessed or have been affected by the tragedy.

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Develop and Implement a Prevention Plan

The purpose of a prevention plan is to protect the health and well-being of all students by having procedures in place to prevent, assess the risk of, intervene in, and respond to students in crisis. Prevention of youth suicide, violence, and substance abuse and the early identification and treatment of behavioral health disorders are most effective when students, staff, parents, and community members have access to prevention information and resources.

Develop and Implement an Emotional, Behavioral and Suicide Crisis Plan
Engrossed Substitute House Bill 1336, passed by the state Legislature in 2013, requires that each Washington school district have a plan for recognition, screening, and response to emotional or behavioral distress in students, including possible sexual abuse. OSPI and the Youth Suicide Prevention Program offer a draft Model Plan based on best practices for suicide prevention.

Learning Standards in Support of Suicide Prevention Education
Second Substitute House Bill 1163, passed by the state Legislature in 2011 requires school districts to have in place in elementary schools, middle schools, and high schools assessments or other strategies chosen by the district to assure that students have an opportunity to learn the essential academic learning requirements in health and fitness. Health and fitness includes, but is not limited to, mental health and suicide prevention education.

Substance Abuse and Mental Health Services Administration (SAMHSA)
The Preventing Suicide: A Toolkit for High Schools toolkit can be used to help high schools, school districts, and their partners design and implement strategies to prevent suicide and promote behavioral health among their students.

The Trevor Project
In collaboration with the American Foundation for Suicide Prevention, the American School Counselor Association, and the National Association of School Psychologists, created this model policy development document.
Model School Policy

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Know and Respond to the Warning Signs (Intervention)

School staff have day-to-day contact with many young people, some of whom have problems that could result in serious injury or suicide. Therefore, those who work in schools are well-positioned to observe students’ behavior and act when they suspect that a student may be at risk of self- harm and/or suicide.

Specific steps should be followed in order to identify and help young people at risk, including a referral to someone else in the school once the student is identified. Schools have created structures that supports efforts to recognize the signs, refer students to appropriate resources, and create a reentry plan for students coming back to school after a suicide attempt. This may be within the school safety plan or a separate suicide prevention plan.

Warning Signs that require immediate action:

  • Talking or writing about suicide or death
  • Giving direct verbal cues, such as "I wish I were dead" and "I’m going to end it all"
  • Giving less direct verbal cues, such as "You will be better off without me," "What’s the point of living?", "Soon you won’t have to worry about me," and "Who cares if I’m dead, anyway?"
  • Isolating themselves from friends and family
  • Expressing the belief that life is meaningless
  • Giving away prized possessions
  • Exhibiting a sudden and unexplained improvement in mood after being depressed or withdrawn
  • Neglecting his or her appearance and hygiene
  • Dropping out of school or social, athletic, and/or community activities
  • Obtaining a weapon (such as a firearm) or another means of hurting themselves (such as prescription medications)

Warning Signs that may indicate a youth is at risk and needs to be referred for screening:

  • A sudden deteriorating academic performance. Teens who were typically conscientious about their school work and who are now neglecting assignments, cutting classes, or missing school altogether.
  • Self-mutilation. Some young people resort to cutting their arms or legs with razor blades and other sharp objects to cope with emotional pain. Self- mutilation is an unmistakable sign that something is wrong.
  • A fixation with death or violence. Teens may express this fixation through poetry, essays, doodling, or other artwork. They may be preoccupied with violent movies, video games, and music, or fascinated with weapons.
  • Unhealthy peer relationships. Teens whose circle of friends dramatically changes, who don’t have friends, or who begin associating with other young people known for substance abuse or other risky behaviors may signal a change in their emotional lives.
  • Volatile mood swings or a sudden change in personality. Students who become sullen, silent, and withdrawn, or angry and acting out, may have problems that can lead to suicide.
  • Indications that the student is in an unhealthy, destructive, or abusive relationship. This can include abusive relationships with peers or family members. Signs of an abusive relationship include unexplained bruises, a swollen face, or other injuries, particularly if the student refuses to discuss them.
  • Risk-taking behaviors. Risk-taking behaviors often co-occur and are symptomatic of underlying emotional or social problems. Such behaviors as unprotected or promiscuous sex, alcohol or other drug use, driving recklessly or without a license, petty theft, or vandalism can be an indication that something is wrong.
  • Signs of an eating disorder. An eating disorder is an unmistakable sign that a student needs help. A dramatic change in weight that is not associated with a medically supervised diet may also indicate that something is wrong.
  • Difficulty in adjusting to gender identity. Gay, lesbian, bisexual, transgender, queer, and intersex teens are a vulnerable population and have higher suicide attempt rates than their heterosexual peers. While coming to terms with gender identity can be challenging for many young people, LGBTQI youth face social pressures that can make this adjustment especially difficult.
  • Bullying. Children and adolescents who are bullied, as well as those who bully, are at increased risk of depression and suicidal ideation. (Bullying and Suicidal Ideation and Behaviors: A Meta-Analysis Melissa K. Holt, Alana M. Vivolo-Kantor, Joshua R. Polanin, Kristin M. Holland, Sarah DeGue, Jennifer L. Matjasko, Misty Wolfe, Gerald Reid
    Pediatrics Feb 2015, 135 (2) e496-e509; DOI: 10.1542/peds.2014-1864)
    • CDC Resource: The Relationship Between Bullying and Suicide: What We Know and What it Means for Schools

Responding to the Warning Signs:
It takes time and courage to reach out to students on a personal level, but your interest can be a lifeline to a child in crisis. Young people—need support, and school can be a vital part of that support. School may be the last positive social connection for vulnerable young people.

  • Ask the Tough Questions: Do not be afraid to ask a student if they have considered suicide or other self-destructive acts. Research has shown that asking someone if they have contemplated self-harm or suicide will not increase that person’s risk. Rather, studies have shown that a person in mental distress is often relieved that someone cares enough to inquire about the person’s well- being. Your concern can counter the person’s sense of hopelessness and helplessness. However, you need to be prepared to ask some very specific and difficult questions in a manner that doesn’t judge or threaten the young person you are attempting to help. For example:
    1. I’ve noticed that you are going through some rough times. Do you ever wish you could go to sleep and never wake up?
    2. Sometimes when people feel sad, they have thoughts of harming or killing themselves. Have you had such thoughts?
    3. Are you thinking about killing yourself?
  • Be Persistent: A student may feel threatened by your concern. The student may become upset or deny that he or she is having problems. Be consistent and firm, and make sure that the student gets the help that he or she may need.
  • Be Prepared to Act: You need to know what to do if you believe that a student is in danger of harming him- or herself. Know the school’s procedures from the crisis response plan for this situation and explain them to the student.
  • Do Not Leave a Student at Imminent Risk of Suicide Alone: If you have any reason to suspect that a student may attempt suicide or otherwise engage in self-harm, you need to remain with the student (or see that the student is in a secure environment, supervised by caring adults) until professional help can be obtained.
  • Get Help When Needed: If you believe that the student is in imminent danger, you, or another member of the school staff, should call 911 or (800) 273-TALK (8255). Tell the dispatcher that you are concerned that the person with you "is a danger to themselves" or "cannot take care of themselves." These key phrases will alert the dispatcher to locate immediate care for this person with the help of police. Do not hesitate to make this call if you suspect that someone may be a danger to him- or herself. It could save that person’s life.
  • Use Your School’s Support System: School districts have crisis plans for working with suicidal or violent students, students who are at risk of suicide or violence, or other students who are not in this acute state of crisis but still need support to stay in school and stay healthy. Familiarize yourself with these plans and use them when appropriate.
  • Connect with Parents or Guardians: If a student opens up to you about self-destructive thoughts or actions, contact that student’s parents or legal guardian. Do not promise confidentiality to a child when it comes to issues regarding the child’s safety—but always talk privately with a student before letting others know of your concerns for the student’s safety. If you believe that contacting the parents or guardians may further endanger the child (if, for example, you suspect physical or sexual abuse), contact the proper authorities. School staff are mandated reporters and are required to report suspected child abuse.

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Postvention - Recovery

Suicide, or violent or unexpected death, of a student, teacher, or even a celebrity can result in an increased risk of suicide for other vulnerable young people. Although rare, a suicide in the community (or even a remote suicide that receives substantial press coverage) can contribute to an increased risk of suicide. Appropriately responding to a tragedy is an essential part of any crisis or suicide prevention plan. Refer to your school’s crisis plan for the established protocols to use in Postvention.

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Media and Online Communications

Suicide is a public health issue. Media and online coverage of suicide should be informed by using best practices. Some suicide deaths may be newsworthy. However, the way media cover suicide can influence behavior negatively by contributing to contagion or positively by encouraging help-seeking.

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Helpful Resources

Crisis Lines, Text lines, Apps, and Websites:

  • MY3 lets you stay connected when you are having thoughts of suicide. MY3 is available in the Apple App Store and Google Play, free of charge.
  • National Suicide Prevention Lifeline provides immediate assistance to individuals in suicidal crisis by connecting them to the nearest available suicide prevention and mental health service provider through a toll-free telephone number: (800) 273-TALK (8255). Ayuda en Español
  • Lifeline Crisis Chat provides online emotional support, crisis intervention, and suicide prevention services. The chat specialists listen and support you through whatever difficult times you may be facing.
  • Crisis Text Line: Text START to 741741 from anywhere in the USA, anytime, about any type of crisis. A live, trained Crisis Counselor receives the text and responds quickly.
  • Trans Lifeline 877-565-8860 This line is primarily for transgender people experiencing a crisis. This includes people who may be struggling with their gender identity and are not sure that they are transgender. While our goal is to prevent self harm, we welcome the call of any transgender person in need. We will do our very best to connect them with services that can help them meet that need.

Training for School Professionals:

  • See the Professional Educator Standards Board for the list of approved trainings for School Professionals: applies to school nurses, school counselors, school psychologists, and school social workers earning or renewing their second tier certification beginning July 1, 2015. Requirement: 3 hours (minimum) of training in suicide prevention from an approved curriculum.

School-based Suicide Prevention Training and Programs:

  • Youth Suicide Prevention Program (YSPP) is an organization whose mission is to reduce youth suicide attempts and deaths in Washington State. YSPP builds public awareness, offers trainings, and supports communities taking action.
  • The Suicide Prevention Resource Center Page for Resources and Programs has a searchable database of evidence-based programs and practices for education, screening, treatment, environmental change that can be filtered based on intended population.
  • Jason Foundation, Inc. educates young people, parents, teachers, and others who work with young people about youth suicide. The foundation offers programs, seminars, and support materials on suicide awareness and prevention.
  • Sources of Strength is a best practice program designed to prevent suicide by increasing help seeking behaviors and connections between peers and caring adults with a focus on Hope, Help and Strength.
  • Youth Suicide Prevention Intervention and Postvention Guidelines: A Resource For School Personnel developed by the Maine Youth Suicide Prevention Program and designed for schools to use within existing protocols to assist at-risk students and to intervene appropriately in a suicide-related crisis.
  • The Youth Suicide Prevention School-Based Guide was developed by the Florida Mental Health Institute at the University of South Florida. It provides a framework for schools to assess their existing or proposed suicide prevention efforts (through a series of checklists) and provides resources and information that school administrators can use to enhance or add to their existing program. Information is offered in a series of issue briefs corresponding to a specific checklist. Each brief offers a rationale for the importance of the specific topic together with a brief overview of the key points. The briefs also offer specific strategies that have proven to work in reducing the incidence of suicide, with references that schools can use to explore these issues in greater detail.
  • Livingworks Education, Inc. provides training and support for the Applied Suicide Intervention Skills Training (ASIST) program, a suicide recognition and referral program.
  • Question. Persuade. Refer. (QPR) Institute offers gatekeeper training programs to the general public and to professionals, including firefighters, clergy, and teachers.
  • Forefront advances innovative approaches to suicide prevention through policy change, professional training, campus- and school-based interventions, media outreach, and support for persons affected by suicide

National Resources on Suicide and Suicide Prevention:

  • The American Foundation for Suicide Prevention is the leader in the fight against suicide. They fund research, offer educational programs, advocate for public policy, and support those affected by suicide.
  • Suicide Prevention Resource Center (SPRC) provides prevention support, training, and materials to strengthen suicide prevention efforts.
  • American Association of Suicidology is a nonprofit organization dedicated to the understanding and prevention of suicide. It promotes research, public awareness programs, public education, and training for professionals and volunteers and serves as a national clearinghouse for information on suicide.

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References & Publications

  • Washington Healthy Youth Survey (HYS)
  • Suicide: Washington 2016 Facts and Figures, American Foundation for Suicide Prevention
  • Centers for Disease Control and Prevention (CDC). Web- based Injury Statistics Query and Reporting System (WISQARS)
  • Center for Disease Control (CDC) Injury and Violence Prevention Research and Publications
  • Substance Abuse and Mental Health Administration (SAMHSA)
  • The Trevor Project is the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender and questioning (LGBTQ) young people ages 13-24
  • Bullying and Suicidal Ideation and Behaviors: A Meta-Analysis Melissa K. Holt, Alana M. Vivolo-Kantor, Joshua R. Polanin, Kristin M. Holland, Sarah DeGue, Jennifer L. Matjasko, Misty Wolfe, Gerald Reid Pediatrics Feb 2015, 135 (2) e496-e509; DOI: 10.1542/peds.2014-1864
  • Lester (Ed.), Suicide prevention: Resources for the millennium (pp. 213–238). Philadelphia: Brunner- Routledge. Overview of school-based prevention and an outline of a comprehensive school-based suicide prevention program.
  • Maris, R., Berman, A., & Silverman, M. M. (Eds.). (2000). Comprehensive textbook of suicidology. New York: Guilford Press. Chapters of interest to school staff include Suicide, Gender, and Sexuality; Indirect Self- Destructive Behavior; and In the Wake of Suicide: Survivorship and Postvention.Posner, M. (2000). Preventing school injuries: A comprehensive guide for school administrators, teachers, and staff. New Brunswick, NJ: Rutgers University Press. This book contains information on implementing suicide prevention, postvention, and crisis preparation activities in the context of a comprehensive school injury prevention program.
  • Velting, D., & Gould, M. (1997). Suicide contagion. In S. Cavetto, R. Maris, and M.
  • Silverman (Eds.), Review of suicidology (pp. 96–137). New York: Guilford Press. This book chapter reviews the literature on suicide contagion and the influence of media portrayals of suicide.

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For immediate assistance call National Suicide Prevention Lifeline (800) 273-TALK (8255)

For immediate assistance call National Suicide Prevention Lifeline (800) 273-TALK (8255)

    For more information, contact:
    Camille Goldy
    Suicide Prevention Program Supervisor


Contact the Safety Center

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   Updated 10/14/2016

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