Florida School Toolkit for K-12 Educators to Prevent Suicide

Depression A high-risk factor for suicide is a current mental health disorder, such as depression. A promising addition to suicide prevention is depression screening. Before the development of depression screening programs, youth suicide prevention programs only focused on training adults to recognize suicidal warning signs. This was most often referred to as “gatekeeper training.” The problem is that students are most likely to share thoughts of suicide with their friends. Signs of Suicide (SOS) uses a questionnaire for students in grades 6–12 that asks about energy level, enjoyment of life, and thoughts of suicide. Students score their own questionnaire and can determine if they are likely suffering from depression and need mental health services. SOS is inexpensive and sometimes the material has been provided by SOS to schools at no charge. SOS is a secondary school-based suicide prevention program that includes screening and education. Students are referred for professional help when needed. Students also view a video that teaches them to recognize signs of depression and suicide in themselves and others. An appropriate response to these signs is to use the ACT (Acknowledge, Care, Tell) technique: acknowledge that there is a problem, let the person know you care, and tell a trusted adult. Students also participate in guided classroom discussions. Research on the program has shown it to reduce suicide attempts, increase knowledge about suicide and depression, and increase help- seeking behavior among middle and high school students. A concern often expressed by educators is the capacity to follow up as needed, if such a program identifies many students as suicidal. The SOS website (mindwise.org) provides many practical suggestions and recommends that only a manageable portion of the student body be screened at a time so that follow-up and intervention can be provided promptly. Bullying and Suicide Prevention Research has found a strong association but has not proved that bullying causes suicide, as it is difficult to rule out the many other possible factors that involve family, abuse, mental illness, trauma, and loss. That said, parents have charged in lawsuits following a child’s suicide that bullying at school was a significant factor. To date, we are not aware of any schools that have been found liable in these cases, but a number have settled out of court. Students who are depressed or anxious, have low self-esteem, and possess few problem-solving skills are likely to be the target of bullying. Children who have been bullied have reported a variety of behavioral, emotional, and social problems. Suicide is the second-leading cause of mortality for 10- to 19-year-old children. Studies report positive associations between all bullying types and suicidal risks. Consider the following: • Both victims and perpetrators are at higher risk than peers. • Personal characteristics, such as internalizing problems, low self-esteem, low assertiveness, increase the risk of being bullied. These factors are also associated with risk for suicide. • It is difficult to control all the risk factors to determine if being bullied was a proximal cause of a youth suicide. • LGBTQ youth have higher rates of suicide attempts and deaths than their heterosexual peers, but there is nothing inherently suicidal about same-sex orientation. Suicide may be linked to external factors, such as bullying, harassment, abuse, rejection, and lack of support. The strongest protective factor for an LGBTQ youth is parental acceptance. Related Behaviors to Consider Depression, Bullying, and Non-Suicidal Self-Injury 23