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Journal ArticleDOI

An exploratory study of suicide risk assessment practices in the school setting

01 Sep 2013-Psychology in the Schools (Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA)-Vol. 50, Iss: 8, pp 810-822
TL;DR: In this paper, the authors examined the suicide risk assessment practices of three large school districts and found that all three districts have implemented suicide prevention programs that include risk-assessment practices in an effort to reduce suicidality.
Abstract: Suicidal behavior in children and youth continues to be a major public health problem in the United States. School personnel have a legal and ethical obligation to recognize and respond to the mental health needs of their students and to take steps to ensure their safety. In this exploratory study, suicide risk assessment practices of three large school districts were examined. More than 3,400 suicide risk assessments were conducted in these districts during the 3 years considered. The results indicate that all three districts have implemented suicide prevention programs that include risk-assessment practices in an effort to reduce suicidality. Suicides risk assessments were conducted with at least one child in each grade from kindergarten through 12th in each district, occurring most frequently at the middle school level. Differences by gender were noted in terms of level of risk and hospitalizations, but no significant differences were observed based on race/ethnicity. These risk assessment efforts of these three districts appear to be promising in preventing suicides: none of the students who were assessed went on to commit suicide. Implications for school-based practices and training are discussed.
Citations
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Journal ArticleDOI
TL;DR: The results demonstrate that having a friend or acquaintance attempt suicide is significantly related to risk for suicidal thoughts and behavior, but the support for the relationship between the suicide of a peer and youth suicidal behavior was less consistent.
Abstract: There is considerable evidence that being exposed to the suicide or suicidal behavior of another can increase the risk for suicide. Significant relationships between media coverage and youth suicide have been documented in the professional literature. Exposure to familial suicidal behavior has also been established as a risk factor for youth suicidal behavior; However, peer suicide exposure is not as clear cut as research results in this area have been mixed. In the current paper the empirical literature focused on the associations between exposure to peer suicides and suicide attempts and youth suicidal behavior is critically reviewed. Effect sizes were computed for each of the 23 studies included in the review to allow for cross-study comparisons. The results demonstrate that having a friend or acquaintance attempt suicide is significantly related to risk for suicidal thoughts and behavior. However, the support for the relationship between the suicide of a peer and youth suicidal behavior was less consistent. Implications for clinical practice and suicide postvention as well as areas of future research are discussed.

27 citations

Journal ArticleDOI
TL;DR: In this paper, the authors address behavioral threat assessment and management (BTAM) in the K-12 school setting and the school psychologist's role in risk and threat assessment, including the assessment of risk factors and warning signs, identification of concerns, and follow-up interventions and monitoring.
Abstract: While schools are safer today than in years past, one act of school violence is one too many. Recent reports have conveyed the importance of schools developing and implementing protocols and procedures to prevent or mitigate school violence. To assist with this task, this article addresses behavioral threat assessment and management (BTAM) in the K-12 school setting and the school psychologist’s role in risk and threat assessment. Best practices in establishing a K-12 behavioral threat assessment and management process, including the assessment of risk factors and warning signs, identification of concerns, and follow-up interventions and monitoring are discussed. Ethical and legal considerations are also reviewed.

13 citations


Cites background from "An exploratory study of suicide ris..."

  • ...Helpful caregivers (Crepeau-Hobson 2013; Hall-Lande et al. 2007) and prosocial relationships, especially family re-...

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  • ...Helpful caregivers (Crepeau-Hobson 2013; Hall-Lande et al. 2007) and prosocial relationships, especially family relationships, are important to the mitigation of risk factors (Adrian et al. 2016)....

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Journal ArticleDOI
TL;DR: It is concluded that surveyors should contact the school’s leaders to call attention to its outlier status, but public warning is unwarranted because such an ad hoc decision to issue a warning raises significant practical, legal and ethical issues.
Abstract: Public health agencies regularly survey randomly selected anonymous students to track drug use, sexual activities, and other risk behaviors. Students are unidentifiable, but a recent project that included school-level analysis discovered a school with alarmingly prevalent student suicidality. Given confidentiality protocols typical of surveillance, the surveyors were uncertain whether and how to intervene. We searched literature for duties to warn at-risk groups discovered during public health surveillance, but we found no directly applicable guidance or cases. Reasoning by analogy, we conclude that surveyors should contact the school's leaders to call attention to its outlier status, but public warning is unwarranted. However, such an ad hoc decision to issue a warning, even if only to school leaders, raises significant practical, legal and ethical issues. National public health and education associations should produce guidance that clarifies ethical and legal duties owed to schools and students involved in population health-risk surveillance.

12 citations

Journal ArticleDOI
TL;DR: In this paper, a self-report questionnaire was administered to 133 school psychologists across the United States to identify the prevalence and scope of school reintegration protocols and procedures in middle and high schools.
Abstract: Youth returning to schools following psychiatric hospitalization are at high risk for mental health crises and rehospitalization. Yet, little is known about the current practices schools use to support student reintegration. This study administered a self-report questionnaire to 133 school psychologists across the nation to identify the prevalence and scope of school reintegration protocols and procedures in middle and high schools. Sixteen percent of respondents identified having a formal (i.e., written) school reintegration protocol in place, 45% reported having an informal procedure, and the remaining 38% reporting no such protocol or procedure. Respondents identified several components to successful reintegration including (1) establishing communication with the hospital, (2) meeting with the family prior to the student’s return, and (3) developing an individualized re-entry plan. Having a school reintegration protocol was positively associated with perceived quality of services for students returning from psychiatric hospitalization. Implications for schools considering adopting a consistent strategy for supporting students during this transitionary time are discussed.

10 citations

Journal ArticleDOI
01 Dec 2020
TL;DR: In this article, the authors examined Turkish school counselors' ratings of the importance of factors in deciding to report students' risk-taking behaviours to school administrators (SAs), and found statistically significant group differences with respect to gender, school level of employment, and attending mandatory counselling ethics training.
Abstract: This study examined Turkish school counsellors’ (SCs) ratings of the importance of factors in deciding to report students’ risk-taking behaviours to school administrators (SAs). A sample of Turkish SCs (N = 252) were surveyed. Most and least important factors were determined. Group differences in terms of gender, school level of employment, and attending mandatory counselling ethics training were investigated. Mann-Whitney U and Kruskal Wallis tests were used in group comparisons. ‘Protecting the student’ was rated as the most important factor, and ‘Gender of the student’ was the least important factor. Statistically significant group differences with respect to gender, school level of employment, and attending mandatory counselling ethics training were identified. Implications for future research and practice are discussed.

9 citations

References
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Journal ArticleDOI
TL;DR: SOS is the first school-based suicide prevention program to demonstrate significant reductions in self-reported suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide among students in the intervention group.
Abstract: Objectives. We examined the effectiveness of the Signs of Suicide (SOS) prevention program in reducing suicidal behavior. Methods. Twenty-one hundred students in 5 high schools in Columbus, Ga, and Hartford, Conn, were randomly assigned to intervention and control groups. Self-administered questionnaires were completed by students in both groups approximately 3 months after program implementation. Results. Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group. The modest changes in knowledge and attitudes partially explained the beneficial effects of the program. Conclusions. SOS is the first school-based suicide prevention program to demonstrate significant reductions in self-reported suicide attempts.

405 citations

01 Aug 1998
TL;DR: Early warning signs as mentioned in this paper establish caring and supportive relationship with children and youth, get to know needs, feelings, attitudes, and behavior patterns of students, and review school records for patterns of behaviors or sudden changes in behavior.
Abstract: Early warning Signs Establish caring and supportive relationship with children and youth. Get to know needs, feelings, attitudes, and behavior patterns of students. Review school records for patterns of behaviors or sudden changes in behavior. Do No Harm: The early warning signs should not be used as rationale to isolate, exclude, or punish a child. Understand violence and aggression within a context: Many factors can contribute to aggressive behavior. Some children may act out if stress becomes too great, if they lack positive coping skills, and if they have learned to react with aggression. Avoid Stereotyping: It is important to be aware of false cuesincluding race, socioeconomic status, cognitive or academic ability, or physical appearance. In fact, such stereotypes can unfairly harm children, especially when the school community acts upon them. View warning signs within a developmental context. Children at different levels of development have varying social and emotional capabilities. Understand that children typically exhibit multiple warning signs. Research confirms that most children who are troubled/high potential show multiple early warning signs. Thus, it is important not to overreact to single signs, words or actions.

331 citations

Journal ArticleDOI
TL;DR: Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group, highlighting the program's utility as a universal prevention program.
Abstract: Suicide is a leading cause of death for children and youth in the United States. Although school based programs have been the principal vehicle for youth suicide prevention efforts for over two decades, few have been systematically evaluated. This study examined the effectiveness of the Signs of Suicide (SOS) prevention program in reducing suicidal behavior. 4133 students in 9 high schools in Columbus, Georgia, western Massachusetts, and Hartford, Connecticut were randomly assigned to intervention and control groups during the 2001–02 and 2002–03 school years. Self-administered questionnaires were completed by students in both groups approximately 3 months after program implementation. Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group. Students' race/ethnicity, grade, and gender did not alter the impact of the intervention on any of the outcomes assessed in this analysis. This study has confirmed preliminary analysis of Year 1 data with a larger and more racially and socio-economically diverse sample. SOS continues to be the only universal school-based suicide prevention program to demonstrate significant effects of self-reported suicide attempts in a study utilizing a randomized experimental design. Moreover, the beneficial effects of SOS were observed among high school-aged youth from diverse racial/ethnic backgrounds, highlighting the program's utility as a universal prevention program. clinicaltrials.gov NCT000387855.

291 citations

Journal ArticleDOI
TL;DR: The potential efficacy of the experimental school-based prevention program was demonstrated, however, the necessary and sufficient strategies for suicide prevention need further study as the assessment-only group, who received limited prevention elements, showed improvements similar to those of the Experimental groups.
Abstract: This study tested the efficacy of a school-based prevention program for reducing suicide potential among high-risk youth. A sample of 105 youth at suicide risk participated in a three-group, repeated-measures, intervention study. Participants in (1) an assessment plus 1-semester experimental program, (2) an assessment plus 2-semester experimental program, and (3) an assessment-only group were compared, using data from preintervention, 5-month, and 10-month follow-up assessments. All groups showed decreased suicide risk behaviors, depression, hopelessness, stress, and anger; all groups also reported increased self-esteem and network social support. Increased personal control was observed only in the experimental groups, and not in the assessment-only control group. The potential efficacy of the experimental school-based prevention program was demonstrated. The necessary and sufficient strategies for suicide prevention, however, need further study as the assessment-only group, who received limited prevention elements, showed improvements similar to those of the experimental groups.

222 citations

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What authority is responsible for the establishment of suicide prevention program?

The results indicate that all three districts have implemented suicide prevention programs that include risk-assessment practices in an effort to reduce suicidality.