School-based suicide prevention is a multi-faceted process that includes school staff, parents, and students. Resources for helping schools in this process are broken down into the following action steps:
OVERVIEW & CONNECTIONS
The process of recognizing and examining what initiatives and components of a Comprehensive Youth Mental Health System are already in place in your school and intentionally utilizing those as youth suicide prevention access points.
Suicide Prevention is a part of comprehensive prevention programming. The following module, “School-based Suicide Prevention: Overview and Connections,” explains how a comprehensive approach to school-based youth suicide prevention connects with initiatives and programming that schools/districts are already implementing; identifying those as possible access points for suicide prevention.
Ensuring that your district has a comprehensive suicide program, it should be considered one component in a larger system for improving and sustaining positive student mental health. Here are resources mentioned in the Overview and Connections module that your district should consider when developing and implementing a suicide prevention program.
- DPI Comprehensive School Mental Health Framework
- DPI Modules that accompany the Comprehensive School Mental Health Framework: Mental Health e-Learning webpage & Mental Health Framework webpage
- DPI Trauma Sensitive Schools
- DPI Trauma Sensitive Schools Professional Development Modules
- DPI Comprehensive Approach to Bullying Prevention
- DPI Mental Health Referral Pathways
- School Mental Health Quality Guide: Self-Assessment and Resource Mapping
- DPI Social and Emotional Learning
- Collaborative for Academic, Social, and Emotional Learning (CASEL)
- Compassion Resilience (WISH Center) and Compassion Resilience Toolkit
State Suicide Prevention Laws and DPI Annual Model Notice
- 2023 Suicide Prevention Memo
- 2023 Suicide Prevention Model Notice
- Fact sheet on laws pertaining to youth suicide prevention
Wisconsin Suicide Prevention Statutes
POLICY & PLANNING
Intentionally instituting school or district policies addressing youth suicide prevention, intervention, and postvention. When policies are in place, districts or schools should begin to design their comprehensive model through prevention and intervention planning. Prevention planning begins by creating a crisis response team, undertaking action planning steps to create or modify school safety plans, educating staff, and choosing classroom or school-wide curriculum or programming. Intervention planning includes the process of preparing to respond in a consistent, equitable, and efficient manner when a student presents as suicidal, attempts suicide, and/or re-enters school following a hospitalization.
This section’s content and resources give districts assistance in creating and implementing policies and planning practices that address youth suicide.
- Fundamental Question: What is considered a suicide?
DEFINITION of suicide: According to the CDC, the criteria for determining suicide are:
- There is evidence that death was self-inflicted. This may be determined by pathologic (autopsy), toxicologic, investigatory, and psychologic evidence and by statements of the decedent or witnesses.
- There is evidence (explicit and/or implicit) that, at the time of injury, the decedent intended to kill himself/herself or wished to die and that the decedent understood the probable consequences of his/her actions. Evidence of intent may include:
- Explicit verbal or nonverbal expression of intent to kill self; or
- Implicit or indirect evidence of intent to die, such as preparations for death inappropriate to or unexpected in the context of the decedent's life, expression of farewell or the desire to die or an acknowledgment of impending death, expression of hopelessness, expression of great emotional or physical pain or distress, effort to procure or learn about means of death or to rehearse fatal behavior, precautions to avoid rescue, evidence that decedent recognized high potential lethality of means of death, previous suicide attempt, previous suicide threat, stressful events or significant losses (actual or threatened), or serious depression or mental disorder. (CDC: Current Trends Operational Criteria for Determining Suicide)
Model School District Policy and Guidance
- Wisconsin-specific district policy from Neola:
Collaboratively developed by Neola, the Wisconsin Department of Heath Services, the Wisconsin Department of Public Instruction, Wisconsin’s Office of Children’s Mental Health, Prevent Suicide Wisconsin, and Wisconsin youth, the suicide prevention and suicide memorialization district policy templates provide schools with language pertaining to best practices in youth suicide prevention, intervention, and memorialization. The policy templates are designed to be personalized to fit the myriad of district and community environments, resources, and existing prevention programming. Topics included in the templates include staff training and roles in suicide prevention, identification of at-risk youth, response to suicide ideation, response to a suicide death, and memorials. Any school district may access the policy templates free of charge by contacting Neola Associate Scott Brown by email at firstname.lastname@example.org.
- WISH Center memorial brief: A Brief Guide to School-Related Memorials - Google Docs
- The Trevor Project provides a model policy that has been approved by pupil services national organizations (NASP, ASCA) and the American Foundation for Suicide Prevention: Model School Policy Booklet
School Safety Plans that can provide an outline for responding at any stage of the crisis.
- Suicide Prevention Resources Center
- Developing a suicide prevention component in a school safety plan, from the Readiness and Emergency Management for Schools website: Policies and Protocols Addressing The Needs of Youth Who Have Attempted or are Considering Suicide
- Wisconsin-specific district policy from Neola:
- Prevention Planning
It is important for school districts to intentionally plan their comprehensive approach to suicide prevention. These available resources are here for districts to use as they undertake the planning process.
Utilizing Models for Suicide Prevention Planning
- The Wisconsin Components of School-Based Suicide Prevention, Intervention, & Postvention Model: The suicide prevention, intervention, and postvention guidelines are designed for schools to use within existing protocols to assist at-risk students and intervene appropriately in a suicide related crisis. From Mental Health America - Wisconsin
- The Youth Suicide Prevention School-Based Guide is a publication developed by the Louis de la Parte Florida Mental Health Institute at the University of South Florida. It is not a program but a tool that provides a framework for schools to assess their existing or proposed suicide prevention efforts (through a series of checklists) and provides resources and information to enhance or add to existing programs.
- Wisconsin’s Suicide Prevention Plan from Prevent Suicide Wisconsin: Suicide in Wisconsin - Impact and Response
- A Guide for Suicide Prevention in New York Schools - Publication from the New York State Office of Mental Health.
- Guide for Suicide Prevention for School Personnel (Companion to the New York State Office of Mental Health’s A Guide for Suicide Prevention in New York Schools) is a publication from the University of the State of New York and the New York State Education Department
- Action Planning
- 2022 Action Plan for Youth Suicide Prevention
- From the field: Sample Hospitalization and Aftercare Guide (Neenah Joint School District)
- Your Action Plan
- Mental Health Screening Action Planning Checklist
Data to use when ‘making the case’ for comprehensive suicide prevention:
- Suicide Prevention Infographic
- Youth Risk Behavior Survey
- Wisconsin Office of Children's Mental Health 2022 Annual Report
- Wisconsin 2017 Youth Risk Behavior Survey Special Topic: Suicide and Help Seeking
- Prevent Suicide Wisconsin
- Prevent Suicide Wisconsin: Statistics and Reports webpage (includes links to state statistics, county statistics, “Burden of Suicide in Wisconsin” Report, and searchable Wisconsin Department of Health Services WISH Query System)
- CDC Suicide Data for U.S
- Culturally and Linguistically Competent Mental Health
- Intervention Planning
When undertaking Comprehensive Suicide Prevention planning, it is important to consider intervention protocols and establish clear expectations should a student indicates they are thinking of suicide, is identified by another as at risk of suicide, or is practicing non-suicidal self-injury behaviors.
- Establishing the School Crisis Team
- Professional Development for School Staff
- Development of Crisis and Suicide Crisis Protocols
1. School Crisis Team
- A crisis team is vital to effectively identifying and intervening in a situation that involves suicide ideation. Each member of the team should be tasked with a specific role on the team and have a clear understanding of who every team member is and what each member does. Cross training of members to serve as substitutes for members out of the building during a crisis is encouraged.
- In addition, the School Crisis Team should be intimately involved with the development of suicide risk assessment and intervention policies and protocols; as well as the execution of the plan to insure student safety during a crisis.
- Possible team members include building administrators, pupil services staff (school nurse, school social worker, school counselor, school psychologist), school safety staff, office support staff, teachers, and school-based community mental health providers.
2. Professional Development for School Staff
- Training school staff in the principles of suicide prevention risk and protective factors is critical for a comprehensive plan. All school staff are the front line in identifying students at risk of suicide.
- Professional development topics could include:
- educators’ roles in suicide prevention and mental health promotion,
- mental health literacy,
- suicide risk factors (student at risk of developing suicide ideation),
- suicide warning signs (student experiencing ideation and in imminent danger),
- protective factors, and
- the use of developmentally appropriate prevention materials.
3. Development of Crisis and Suicide Crisis Protocols
- Schools should have knowledge and understanding of clear policies and protocols to be followed during a suicide crisis.
- Protocols could include:
- First and foremost the safety of the student in crisis. Students in crisis should not be left alone or allowed to leave school.
- Assessment of suicide risk.
- Parent/guardian notification.
- Attempted de-escalation and emotional regulation of student.
- Connection with crisis or mental health professional - 988, Trevor Project, 911, county-based crisis or mobile crisis units. The creation of a resource map helps this process immensely.
- Development of safety plan.
- Plan for documentation of incident and intervention processes.
- Reintegration plan.
- Follow-up plan for student and family.
The following is just one resource that contains sample protocols for student experiencing ideation, students who attempt suicide, safety planning, suicide risk assessment, and parent notification: Suicide Prevention Guide for School Personnel
The Suicide Prevention Resource Center (SPRC) provides some specific planning resources:
- Suicide Prevention Resource Center webpage
- Suicide Prevention Toolkit for High Schools - (Can be adapted for Middle School)
- Role of High School Teacher in Suicide Prevention
- Role of High School Mental Health Provider in Suicide Prevention
- Training: Making Educators Partners in Youth Suicide Prevention: ACT on FACTs
- Society for Prevention of Teen Suicide
- After a Suicide Toolkit
American Foundation for Suicide Prevention webpage also contains resources.
PROGRAMMING FOR YOUTH SUICIDE PREVENTION
The process of selecting developmentally appropriate and culturally/linguistically competent prevention programs that fit within a comprehensive approach to suicide prevention. These may include classroom curriculum, peer prevention programs, collaborations with local partners, and engaging parents and families in prevention efforts.
Prevention programming is a key component of a comprehensive suicide prevention model. These prevention strategies and resources are designed to be used with educational staff, families, student classrooms, student groups, and individual students. Click below for specific resources for the population you wish to address.
- Programming For Staff & Students
Question, Persuade, Refer (QPR): QPR Institute | Practical and Proven Suicide Prevention Training QPR Institute (en-US) (for a $30 cost; online)
Prevent Suicide Wisconsin QPR Gatekeeper Training (find a trainer by county/city)
QPR from Wisconsin Safe and Healthy Schools Center (WISH Center)
Youth Suicide Prevention Curriculum
- DPI Module: “Suicide Prevention Curriculum in Heath Education: Overview”
- DPI Suicide Prevention Curriculum: This curriculum is based on the Signs of Suicide (SOS) Curriculum (currently undergoing revision)
- Signs of Suicide (SOS): Suicide Prevention | SOS Signs of Suicide by MindWise Innovations - Acknowledge Care Tell (ACT) response to suicide ideation.
- DBT Skills in Schools: STEPS-A
REDgen - Resilience through education for a new generation (REDgen) that values connection, resilience, reflection, transformation, and authenticity.
- DPI Peer-to-Peer Suicide Prevention Programs
- Sources of Strength - Evidence-based, peer-to-peer high school and elementary programs.
- Hope Squad - Evidence-based, peer-to-peer high school program focused on safety, connectedness, bullying prevention, mental wellness, reducing stigma, and substance abuse prevention.
- Best Practice Prevention Programming Resources For Specific Topics And Populations
Prevention of Suicide Attempts
- Lethal Means Safety is the surest way to prevent death.
- Means Matter - promoting activities that reduce a suicidal person’s access to lethal means.
- Be SMART - The Be SMART framework is designed to help parents and adults normalize conversations about gun safety and take responsible actions that can prevent child gun deaths and injuries.
Wisconsin Department of Health Services Resources
- Dose of Reality: Drug Take Back Day
- Dose of Reality: Safe Disposal of Medications and Medical Supplies
SPRC Prevention Programming Tool: Finding evidence-based prevention programs.
Prevention Programming for Parents, Caregivers, and Trusted Adults
The process of enacting the variety of strategies identified in the school’s/district’s preparation for crisis response and intervention plan.
An integral part of a school’s comprehensive suicide prevention program involves having strategies to intervene when a student presents as being at-risk for suicide ideation. Below you will find sections devoted to providing resources that address specific intervention topics.
- Practice Intervention Resources
Resources for Strategies at Middle/High School
- Recovery/Aftercare/Individual Student Safety Plans: Individual Student Safety Plans - These plans are best developed and used when a student is not in an immediate crisis. They are commonly used upon reentry from a care facility, from the Centre for Suicide Prevention.
- From the National Association of School Psychologists: Recommendations for Administrators and Crisis Teams
Non-Suicidal Self Injury Resources
- Nonsuicidal Self-Injury vs. Suicide - A podcast with Dr. Jennifer Muehlenkamp
- Assessments And Screening
There are many considerations to review before implementing an assessment component to your safety plan.
Suicide and Non-suicidal Self-Injury Risk Assessment(s)
- Columbia Suicide Severity Rating Scale (CSSRS)
- From the School Social Work Network
- SOARS Model NSSI Assessment (Muehlenkamp Contemporary Pediatrics article from 2016)
- The School Counselor and Suicide Risk Assessment
- ASCA Suicide Prevention and Response Resources
One of the best ways to identify youth at-risk for suicide is through screening. There are many things that need to be in place before implementing a screening program. Before implementing screening, make sure that staff have been trained in suicide warning signs, referral procedures, and that pupil services staff are prepared to respond to a student who may be thinking about suicide.
- DPI Mental/Behavioral Health Screening Webpage
- Information on multiple screening tools.
- Global Appraisal of Individual Needs - Short Screener (GAINS-SS) - The WISH Center receives funding from the Wisconsin Department of Public Instruction/DHS for up to 50 schools to be licensed to utilize the GAIN-SS online screening tool.
- Resources That Address Equity
- The Trevor Project
- Suicide Prevention Resources Center (SPRC)
- Mental Health America-WI: PRISM Program
Resources for Strategies When Working with Black, Indigenous, and People of Color (BIPOC) and Their Allies
- Black Community
- Tribal Community
- Hispanic and Latino Community
- Asian Americans and Pacific Islanders Community: Asian Americans and Pacific Islanders | Suicide Prevention Resource Center (sprc.org)
- Live Another Day - Extensive information on mental health and substance use resources for People of Color. Their mission is equal access to life-saving resources.
Youth with ADHD
Postvention Planning & Strategies
The process of planning and enacting an equitable response to a suicide that neither glamorizes nor minimizes the death in a way that mitigates contagion.
Responding to a suicide can be both difficult and incredibly important. Schools must achieve a balance between supporting their school community and giving it appropriate space to grieve, while simultaneously avoiding situations that may lead to contagion or suicide clusters. Materials and resources here give districts tools to use as they strategically design their response protocols.
- COMING SOON: Online module “School-based Suicide Prevention: Postvention Strategies and Protocols”
- Suicide Prevention Resource Center (SPRC) and the American Foundation for Suicide Prevention (AFSP) : After a Suicide: A Toolkit for Schools (2nd ed.). This collaborative resource assists schools in implementing a coordinated response to the suicide death of a student.
- National Suicide Prevention Lifeline Online Postvention Manual: Comprehensive manual full of protocols and topics for consideration as schools plan for and respond to a suicide.
- Heard Alliance: Postvention Response to a Suicide toolkit - This resource includes a breakdown of resources into the areas of daily postvention protocols, clusters and contagion, newspaper/media, grief, and self-care.
- Children’s Hospital of Los Angeles, National Center for School Crisis and Bereavement: Guidelines for Schools Responding to a Death by Suicide - These guidelines are designed to help school administrators, teachers, and crisis team members respond to the needs of students and staff after a suicide has impacted the school environment as well as when an individual student’s life may be impacted by a suicide within the family.
- Fairfax County Virginia Neighborhood and Community Services: Suicide Postvention Toolkit - Though not school-specific, this resource offers an overview of postvention for organizations and individuals, key components of postvention, and a collection of general and community-specific postvention resources.