Florida School Toolkit for K-12 Educators to Prevent Suicide

SMHPs and nurses can also help students keep a trigger log of the situations that caused them to want to self-injure and can explore with them better ways to manage the situation. Parent notification when a student is known to be engaging in NSSI has been a controversial issue. The counseling/psychology literature has been inconsistent, cautioning that it could result in a loss of rapport with the student. Parents should be notified by school personnel when a student is engaging in NSSI. Ideally, a conference with key school personnel, parents, and the student will provide an opportunity to discuss the NSSI behaviors with his or her parents. School personnel should follow notification and referral procedures outlined in this toolkit. A referral needs to be made for the student to receive treatment in the community. The most effective treatment is Dialectical Behavior Therapy (DBT), but some communities may not have therapists trained in DBT. S.T.E.P.S. has emphasized that when a student is believed to be suicidal and parents are not receptive to obtaining community mental health interventions for their child, Florida’s Department of Children and Families (DCF) must be notified. If parents are not receptive to obtaining outside services for their child engaging in NSSI, it is important to clarify whether the student should be reported to DCF. Each school district will have to decide what their protocol is in this situation, but follow-up and support services for the student are essential regardless of whether outside mental health services are obtained. What is the relationship between suicide and NSSI? School personnel may think that the two behaviors are exclusive. However, NSSI has been added as a risk factor for suicide because students engaging in NSSI are becoming comfortable with the habit of harming their bodies. Additionally, NSSI has diminishing returns as a coping mechanism. Research estimates that approximately 30 percent of adolescents who repetitively self-injure ultimately make a suicide attempt. The NSSI risk factors for suicide are • utilizing multiple methods • long standing history of NSSI • reporting little physical pain from NSSI • reporting disassociation when engaging in NSSI School personnel should not hesitate to ask a student known to be engaging in self-injury about thoughts of suicide. Parental notification procedures need to be followed and referrals made to community providers skilled in managing NSSI. If the student admits to suicidal thoughts, then safety planning and pathways to care procedures for suicide outlined in this toolkit must be followed. A video on NSSI created by Scott Poland for the state of Florida provides critical insight into self-injury as he interviewed two young women who received a national award for their willingness to discuss their struggle with self-injury. The free video is available at nova.edu/suicideprevention under training videos. 25