Florida School Toolkit for K-12 Educators to Prevent Suicide

the series aired (O’Brien, Knight, & Harris, 2017), including searches for the phrases “how to commit suicide” (26%), “how to kill yourself” (9%), and “commit suicide” (18%). Fortunately, some of the increased searches were for seeking help—including “suicide hotlines” (12%) and “suicide prevention” (23%). However, “Past studies have validated that Internet searches mirror real-world suicide rates, so suicide rates have likely gone up as a result of this program” (Ayers, Althouse, Leas, Dredze, & Allem, 2017). In fact, 25% of youth who died by suicide conducted a suicide-related Internet search shortly before their deaths (O’Brien et al., 2017). Point clusters More easily identifiable, suicide point clusters have occurred in several school communities such as those Poland and Lieberman worked with in Palo Alto, CA (2002, 2009, and 2014); Fairfax County, Virginia (2014); Colorado Springs, Colorado (2017); and Salt Lake City, Utah (2018). Other clusters have likely gone undetected or were intentionally not reported. In some of these communities, epidemiology studies were conducted in conjunction with the CDC. Results were reviewed by Poland and Lieberman at the most recent National Association of School Psychologists (2018) and American Association of Suicidology (2017) conferences. They identified the following risk factors from these clusters: male gender, mental health issues, history of suicidal ideation or suicide attempt, substance abuse issues, relationship problems, a recent crisis, cutting behavior, parents not recognizing the severity of the mental health needs of their child, sleep deprivation, academic pressure, sexual orientation, and intimate partner violence (Annor, Wilkinson, & Zwald, 2017; Garcia- Williams et al., 2016; Spies et al., 2004). Exposure to Suicide Research has found that a death by suicide may touch approximately 135 people, one third of whom experience a severe life disruption as a result (Cerel et al., 2018). Exposure to a peer’s suicide has been found to be associated with suicidal ideation or behavior in adolescents that can persist for up to 2 years. Among at-risk adolescents, a schoolmate’s suicide appears to amplify preexisting negative life events and increase serious suicidal ideation or behavior. In other words, a single exposure to the suicidal behavior of another person does not result in imitative behavior in the absence of adolescent vulnerability factors. Such factors include: current or past psychiatric conditions, family history of suicide or past suicide attempts, substance abuse, stressful life events, access to lethal methods, incarceration, social impairments, environmental factors, and lack of protective factors (Gould et al., 2018). Suicide is complex, particularly with regard to causality; yet, identifying individual students who are at-risk after a suicide is one of the primary tasks of suicide prevention efforts undertaken in the schools to prevent contagion (Lieberman, Poland, & Kornfeld, 2014). Research has supported the fact that though friendship with the student who died by suicide is associated with increased risk for suicidal ideation or behavior, it is not the closest friends, but rather the less close friends that knew the deceased who have the highest rates of suicidal ideation or behavior as a result (Gould et al., 2018). Though previously, a “continuum of survivorship” was assumed, we now know that focusing solely on those students closest to the student who took their life will likely leave many vulnerable students unidentified. Preventing Suicide Contagion: Guidelines for Media It has been well established that at-risk individuals with a recent history of suicide attempt or a concurrent severe depression are more likely to attempt suicide in the wake of a media report of suicide (Gould, Kleinman, Lake, Forman, & Midle, 2014). Specifically, media stories that were published after the index suicide (the first) and were associated with clusters employed: front page placement of story, headlines containing description of method, presence of a picture, and detailed description of the suicide (Gould et al. 2014). Therefore, organizations such as the World Health Organization (WHO, 2017) have set Florida S.T.E.P.S.