By Richard Lieberman & Scott Poland

Suicide is a leading, preventable cause of death in our nation for youth ages 10­–24, and we are saddened to report that rates have increased slowly, but steadily since 2007. The rate of increase recorded between 2014 and 2015 for the 15–19 year olds was the largest jump in the past decade (from 11.6 to 12.5 per 100,000) and the rate for 10–14 year olds doubled during that 10-year span. While these data highlight a serious public health problem, we know that suicide is preventable. Since 2007, over 30 states have enacted legislation that either recommends or mandates that school districts train all personnel and have comprehensive suicide prevention policies and procedures. In a recent national webinar, the authors conducted a brief poll of thousands of participants and less than half were aware of any current legislation in their state.

History

Suicide prevention legislation that survives the arduous process to be successfully enacted has been accomplished through the passionate voices and unrelenting efforts of suicide survivors. Such was the voice of Clark Flatt, a survivor of his son's suicide, who dedicated his life and fortune to establish the Jason Foundation (JF) of Tennessee. JF has been the driving force behind the Jason Flatt Act (JFA), first adopted in Tennessee and now the law in 19 states (see Table 1). The JFA requires that every educator in the state receive 2 hours of training annually in suicide prevention and awareness in order to gain and maintain certification to teach. When a state passes the JFA, JF agrees to provide and maintain an online library of training modules that will satisfy the requirements for an educator's training. This ensures that any teacher or school or district can satisfy the required training without any cost, thus no fiscal note is necessary, which is very attractive to state legislators. The authors are proud to have contributed to five JF modules on the topics of depression, bullying, nonsuicidal self-injury, LGBTQ, and suicide postvention in schools. In total, 27 states require staff training in suicide prevention but only 10 require that training be conducted annually. One frustration for advocates has been a state's reluctance to mandate anything, and at the last minute change “required” to “recommended.”

Table 1. State Suicide Prevention Legislation Since 2007

Twelve states have taken a more comprehensive approach, requiring schools to develop and adopt suicide prevention, intervention, and postvention policies where staff training is just one component of prevention strategies. In addition to mandating policies and procedures, California's AB2246 goes further to mandate that policy must address the needs of high-risk groups such as students exposed to suicide, youth with a history of suicide ideation or attempts, youth with mental illness or substance abuse disorders, LGBT youth, traumatized youth, and youth in out-of-home settings such as foster care. Missouri is currently debating HB 844, which will consolidate earlier bills mandating that every district create policies and plan for annual 2-hour training of school personnel. The state of Texas, for example, requires a suicide prevention liaison to be identified for every school district. West Virginia requires secondary schools to provide students information about suicide prevention. The California model lists the following components of a model student suicide prevention policy (adapted from California Education Code Section 215, Assembly Bill 2246 California Department of Education Model Pupil Suicide Prevention Policy):

• Policy statement
  • All local education agencies that serve pupils in grades K–12, inclusive, shall adopt a policy on pupil suicide prevention, intervention, and postvention. This policy shall address the needs of high-risk groups and include annual training for all school staff.
• Prevention
  • Safe messaging
  • Training to be offered annually under the direction of school-employed mental health professional
  • Specialized training (suicide risk assessment for school mental health professional)
  • Parent involvement/training
  • Student education
• Intervention
  • Emphasis on collaboration and supervision
  • Referral and assessment procedures
  • Interventions for low, moderate, and high-risk students
  • Notifying parents
  • Action plans for in/out of school student suicide attempts
  • Developing safety and reentry plans
• Postvention
  • Establishing policies to memorialize all student deaths the same way
  • Procedures for crisis response
  • Collaborating with district and community resources
  • Reaching out to family
  • Developing communications for students/parents
  • Triage staff and students
  • Memorials
  • Social media

Moving Forward

Ten things a school psychologist can do to help prevent suicide:

• Be the advocate for suicide prevention in your district and help bring your district into compliance with your state's laws.
• Use California's model to reevaluate your district policies and procedures and determine if additional strategies are necessary for suicide prevention, intervention, and postvention.
• Train school staff in any state that mandates training of school staff.
• Review all the high-quality suicide and crisis resources from NASP.
• Make a commitment to staying current in the field of youth suicide prevention by attending NASP and NASP affiliate sponsored conferences.
• Seek out local suicide prevention advocates in your county and state.
• Search out local offices or chapters of the Jason Foundation, American Foundation for Suicide Prevention, and American Association of Suicidology, and visit their websites and online resources.
• Check out the resources of the national Suicide Prevention Resource Center and sign up for their monthly electronic publication, the Weekly Spark.
• Prepare for suicide postvention by downloading the latest version of AFSP/SPRC After a Suicide: Toolkit for Schools.
• Advocate for suicide prevention efforts in your state if your state is one of the 20 yet to enact any school suicide prevention legislation and reach out to the authors if we can be of any assistance.

Richard Lieberman and Scott Poland have authored the last four suicide intervention chapters in the Best Practices in School Psychology series published by NASP, consulted nationally with schools experiencing clusters, and contributed to both SAMHSA and SPRC/AFSP suicide prevention toolkits for schools