How to Deal with Suicide Threats
Suicide is on the increase. In a time when family instability and mobility are on the rise, and other traditional factors, such as neighborhoods and churches, are losing their influence, many children are finding it difficult to cope with life. How can we identify a student who may be prone to suicide before it is too late?
There are no exact tests or ways to determine this but health officials often point to these signs of trouble:
1. A previous attempt. Eight out of ten suicide attempts involve people who have tried to kill themselves previously.
2. A threat. A previous study found that two-thirds of would-be suicides had given off serious signals of distress by word or behavior. It is not safe to assume that because someone has threatened before, he or she won't go through it this time.
3. Problems in school. School officials are in the best position to detect a wide range of danger signs such as a drop in grades, falling asleep in class, emotional outbursts, inability to communicate, problems with drugs or alcohol. By themselves,, none of these factors necessarily mean that a student is going to try to commit suicide, but experts believe that at least some of these changes are evident in most students who contemplate taking their life.
4. Other symptoms. A sudden change in physical appearance, disturbed sleeping and eating patterns, depression, and expressions of low self-esteem are often part of adolescence but, if persistent, can reflect thoughts about suicide.
Information obtained from "Adolescent Suicide: Some Clues to understanding and prevention," (Boy's Town, Nebraska, Father Flannigan's Boy's Home)
What can you do?
A persistent myth about suicide it that talking about it will plant the seed to perform it. However, experts say that not talking about it is even riskier since the student may feel you don't care. If you detect any of the danger signs, you must attempt to talk to the student about your concerns. Even if the student has nothing to say, continue "coming back and coming back until they're willing to talk to you," says psychologist Dr. Michael Peck, project director of the Life Clinic of the Los Angeles Suicide Prevention Center. Most students will eventually begin to talk, the first step in providing help.
For some it is helpful to have the student sign a life contract with you. In it you will have the student promise not to hurt him/herself during a specific period of time.
It is important as part of you crisis plan to outline the steps your school will take to deal with suicide threats. Be sure your principal has read and approved of the steps. Also, every team member needs to know the plan thoroughly.
What Do I Do for Immediate Threats?
For students who are in imminent danger of hurting themselves the following steps should be taken:
1. Have on of the clinical team members assess the suicidality of the student and inform the principal of the situation immediately. If the suicidal risk is unclear, a second clinician should also interview the student.
2. The parent needs immediately contacted and informed of the situation and asked to take the child to an emergency room for evaluation.
3. If an outside therapist or agency is involved, contact them right away. This is another reason why it is extremely critical to do in-take interviews with all students in order to obtain this information in advance.
4. Try to ensure the student's safety first by removing any dangerous objects or equipment. If the student is attempting to jump from a window ledge, try to bring them inside. Remember to remain calm at all times. Stay with the student and clear any other students from the scene. It is essential to monitor the student's behavior constantly. A student can not be left unattended.
5. Contact B-CARS (Baltimore Child & Adolescence Crisis Response System) on 410-558-2244 (direct phone), 410-894-0642 (pager), and 410-558-2244 (fax). Patricia Wilson is the project coordinator and will send a team to the school to evaluate the student and seek admittance in the hospital if necessary.
6. Contact the school police and the local police on 911. If the local police are resistant, inform them that the school clinician has made a clinical decision that this student is a danger to self and needs to be taken to the nearest emergency room. If necessary, contact the police supervisor.
7. If all else fails, as a very LAST resort, contact the nearest magistrate and file an emergency position on behalf of the child. Be sure to identify the risk and seriousness of the situation first. The magistrate can issue a court order, which requires the police to transport the child to the emergency room. It also requires the ER to perform a psychiatric exam. It does NOT, however, require the hospital to hospitalize the child.
8. Send a verbal or brief written (preferable) report to the ER, clinic, private practitioner or magistrate who will be involved in such a case.
9. Ensure the student's right to privacy and confidentiality. Only those who need to know about this situation (administrators, program staff) should know. However, you do not need parental consent or other authorization to report suicidal ideation, threat, gestures or attempts to other professionals, police, court, etc.
10. Treat the student with respect, support and empathy. Students in crisis are NOT bad but may be crying for help or indicating serious problems.
11. It is essential to inform the principal of every action taken during this entire process.
After the Crisis:
1. Be certain to document everything attempted and completed.
2. Reflect on the steps leading up to the crisis and determine if anything could be handled differently.
Emergency Contacts:
Maryland youth Crisis Hotline &endash; 1-800-422-0009
Grassroots: 1-301-531-6677
Grassroots 24-hour Hotline: 1-800-422-0009
B-CARS: 410-558-2214
The Office of Guidance has developed a "Suicide Prevention Handbook: Save Our Students" for our school system. Please contact them on 396-8907 to obtain a copy.
