School-Based Programming for Suicide Prevention

Using a Multi-tiered System of Supports (MTSS) approach familiar to education systems, schools can implement universal programming for all students and families, selective interventions for students with some risk, and individualized interventions for students with high risk.

Universal Programming

Universal programming can include upstream prevention efforts for all students, families, and school staff. Universal programming can include awareness and education efforts; integrate social emotional learning (SEL) into the curriculum; strengthen protective factors; and focus on climate, school connectedness, and fostering positive relationships between youth and adults at school. Upstream prevention can help reduce the onset of suicidal thoughts and behaviors and also have an impact on likelihood of suicide death. Students who feel connected to their school are less likely to report suicidal thoughts and behaviors, and students who can identify at least one trusted adult are less likely to attempt suicide.

Examples of universal programming include:

• Good Behavior Game (GBG) is a classroom management strategy for first and second grade students with proven long-term results. In playing GBG, students learn teamwork, receive positive reinforcement for promoting and following classroom rules, and practice monitoring and managing their own behavior. Longitudinal studies have found that students who play GBG are less likely to need behavioral health services, are less likely to have substance use disorders, are less likely to have been delinquent or incarcerated for violent crimes, and have lower rates of antisocial personality disorder, depression, and suicide in adulthood.
• Sources of Strength is based on the premise that youth are more likely to tell a peer than an adult that they are suicidal. Sources of Strength uses peer leaders to help identify students who may have suicidal thoughts and bridge the gap between students and adults. Research on this program found that trained peer leaders help strengthen positive behaviors in a social network, are more connected with adults, and are more likely to refer a suicidal friend to an adult, all of which could ultimately save a life.
• Signs of Suicide (SOS) is a program for middle schools and high schools that teaches students how to identify signs of depression and suicide in themselves and their peers, while training school professionals, parents, and community members to recognize at-risk students and take appropriate action. During a single class period, it teaches students through videos and discussion guides and concludes with a seven-question screening for depression. Studies have found that the SOS program has shown a reduction in self-reported suicide attempts and increased knowledge of suicide and depression.

All school staff should be trained on how to identify suicide risk and warning signs and take the appropriate steps to connect the student to care.

Selective Interventions

Selective interventions address some students who may be at increased risk for suicide. Types of selective interventions include outreach and screening for higher risk groups. High risk groups may include LGBTQI+ youth, individuals with mental health or substance use disorders, and youth experiencing stressful life events. School support staff, such as guidance counselors, school resource officers, nurses, social workers, or special education aides, as well as school mental health staff, should be trained in validated screening and identification measures and implement a standardized procedure for screening students for suicide risk.

Individualized Interventions

Individualized interventions and supports are delivered to few students in the school where suicide or suicidal behaviors have been identified as a concern. These interventions should be conducted by trained school support staff and school mental health staff. They include assessment of risk, brief intervention for suicide, triage and referral if needed, family engagement, collaboration with community mental health, follow up, and planning for a safe return to school.

Implementation Considerations

It is important to make informed decisions when implementing suicide prevention programming and utilizing resources. Schools conducting screenings should follow recommendations for School-Based Suicide Prevention Screening.

Schools should also always consider developmental and cultural appropriateness when implementing universal programs and individualized services. School-based programming should be conducted in a collaborative manner with youth, families, and if applicable, community providers and school professionals.

Resources to Learn More

Collaborative for Academic, Social, and Emotional Learning (CASEL)
Website
Advocates through research, practice, and policy evidence-based social and emotional learning (SEL) as an important part of education for all students — preschool through high school — by collaborating with leaders to provide SEL knowledge and resources to educators, parents, and policymakers.

Suicide Prevention for Teens and Young Adults with Dr. Ali Mattu
Video/Multimedia
Discusses the importance of having conversations with teens and young adults about their experience of suicidal thoughts during times of heightened stress as a suicide prevention method. Offers suggestions for additional prevention strategies useful for helping others get the assistance they need when experiencing suicidal thoughts.
Author(s): Mattu, A.
Organization(s): Columbia Psychiatry
Date:09/2018

Youth Suicide: Awareness, Prevention and Postvention
Tutorial/Training
Offers a training course to educate school staff and students on youth suicide including the risk factors, response procedures, suicide prevention strategies, and postvention best practices.
Author(s): Poland, S.
Organization(s): Vector Solutions, SafeSchools

Youth Suicide Prevention Referral and Tracking Toolkit
Document
Offers a comprehensive approach to suicide prevention with a focus on the collection and entry of early identification, referral, and follow-up data. Includes tools, resources and recommendations for data collection and how to appropriately use the data to inform and assess suicide prevention practices.
Organization(s): Maine Youth Suicide Prevention Project, Suicide Prevention Resource Center (SPRC)
Date: 2/2012