Florida School Toolkit for K-12 Educators to Prevent Suicide

Suicide Assessment Questions • W hat are the current feelings of the student? • W hat warning signs initiated the referral? • W hat is the individual’s current and past level of depression? • W hat is the student’s level of hopelessness? • H as the student currently, or in the past, thought about suicide? • W hat is the method of any previous suicide attempt(s)? • D oes the student have a current suicide plan? • W hat method does he/she plan to use and does the student have access to the means? • W hat are the student’s perceptions of burdensomeness and belongingness? • H ave they been exposed to a suicide? • D o they have history of engaging in NSSI (cutting or burning)? • I s there any history of alcohol or drug use? • W hat are current problems and stressors at home and at school? • H as the student demonstrated any abrupt changes in behaviors? • W hat is the student’s current support system and what protective factors are in place? • W hat is the student’s current mental health status? Is there a history of mental illness? • I s there a history of bullying, victimization, loss, and/or trauma? • Has the student experienced other childhood adversities such as poverty; physical, emotional or sexual abuse; neglect; living with a mentally ill relative; or significant losses of loved ones? • W hat has kept the student alive thus far? Standardized Assessment Scales A thorough interview with a suicidal student with excellent rapport established is essential and standardized assessment scales can be a valuable addition to the interview as they have been published and validated by research. The FDOE has recommended that for suicide screenings, schools use either the Columbia or the SAFE-T (Tools 14a and 14b) or the SAFE-T from SAMHSA (14c). One advantage to using the Columbia is that hospital personnel are very familiar with both versions of it. The brief version of C-SSRS, which consists of six direct questions, is most applicable when a Florida administrator or teacher are making the assessment when a school counselor is not available. The longer version in Tool 14b includes the SAFE-T protocol with the C-SSRS and includes more questions and the identification of protective factors. The C-SSRS is free, appropriate for all ages and has been translated into more than 100 languages. The website ( cssrs.columbia.edu ) provides an overview of the C-SSRS and a link to a video on how to best use the instrument. In addition, SAMHSA provides a free Suicide Safe app that provides directions for medical and mental health personnel on suicide assessment, including case studies and the identification of risk and protective factors. More information about the Suicide Safe app is available at store.samhsa.gov /product/SAMHSA-Suicide-Safe-Mobile-App/PEP15 -SAFEAPP1 . Assessment Response The standard of care is that parents of students assessed at even a low risk for suicide must also be notified of the suicidal concern. The one exception to notifying parents when their child has had suicidal thoughts is if the parents are believed to be abusing their child. In this case, the Florida Department of Children and Families must be called immediately. It is also highly recommended that the parents of a student who is 18 years or older also be notified. Parents might be difficult to reach, and school personnel should keep the student suspected of being suicidal under close supervision until they Florida S.T.E.P.S.