Dr. Jennifer White, assistant professor in the School of Child and Youth Care at the University of Victoria in British Columbia, has dedicated almost 20 years to suicide prevention. Here, she discusses the role schools can play within a broader youth suicide prevention strategy.

What is the picture of youth suicide in Canada?

Among youth, suicide rates tripled between the 1950s and 1980s, and have levelled off since. We can identify clusters of factors that put youth in a higher risk zone, but although they may be good for statistical generalizations, unfortunately, they often don’t tell us that the boy in Grade 11 biology who sits in the back of the classroom is contemplating suicide. You’ll often hear a parent who lost a son or daughter to suicide say these factors were not present in their child’s case. We spend so much time looking at risk factors that we often neglect protective factors.

Why school-based suicide prevention strategies?

School is a natural, logical place to do prevention work because youth are there for a large part of the day and many people in school are in a position to recognize potential risk factors. School-based strategies fit with an educational mandate – to prepare students for real life, including equipping them with coping skills. We also know that many young depressed or suicidal people will talk to friends before an adult. So we need to help those peers recognize who is at risk and how to get help. School is just one piece of a complete suicide prevention puzzle. Beyond school, more work needs to be done to educate families and the community.

Do most schools have suicide prevention strategies?

Canada has no national suicide prevention strategy. Each school district is different. Some are supposed to have a strategy but don’t. Other schools don’t have an official mandate, but they do great things around suicide prevention because they have teachers committed to the issue. A one-off classroom lecture telling students how they can recognize potential risk factors isn’t enough. A strategy needs to augment in-class education with teacher, counsellor and parent education.

What makes an effective school-based suicide prevention program?

The best programs are comprehensive and link to other prevention efforts, including school-based mental health promotion, positive youth development, parent education and school/community gatekeeper training. Here are pointers for developing a strong program:

• Consult with school administrators to ensure that policies and procedures for responding to at-risk students and completed and attempted suicide are in place.

• Develop comprehensive approaches to educating students, faculty, parents and community service providers about youth suicide.

• Complement universal mental health promotion approaches aimed at all students with targeted school-based screening and prevention programs for at-risk youth.

• Ensure that students have access to high-quality information on how to help a distressed peer.

• Provide core educational messages to students, for example: Take all suicide talk seriously. Never promise to keep another student’s suicidal thoughts or behaviours a secret. Always enlist the help of a trusted adult.

• Make sure school personnel and parents are educated about risk factors and warning signs of suicide as well as local referral sources.

• Establish proactive referral links with community-based, child and youth mental health services.
  

Is there resistance to school-based prevention programs?

Suicide often isn’t seen as a big enough problem to warrant a prevention program. Unfortunately, the catalyst to a strategy is often a student’s suicide, and this doesn’t account for or recognize the more likely problem of attempted suicides. A prevention program isn’t just about suicide – its focus is positive youth development.

Some critics argue that talking about suicide in the classroom normalizes suicide. They worry that opening this discussion may lead to suicide. We want to make it clear that talking about suicide is not going to cause kids to kill themselves. We have to be sure not to glamourize suicide. We need to address the misconceptions and misgivings people may have about suicide. But sometimes, well-intentioned people who are not familiar with the research go into the classroom to talk about suicide, which can be harmful.

School-based suicide prevention programs seem to target youth at the secondary school level. Should they be targeting kids earlier?

Absolutely. There are many programs for younger kids that aren’t being called suicide prevention programs. Such programs typically have more of a mental health promotion focus, which includes skill-building and enhancing awareness of factors that promote and support well-being. Programs for older students, in addition to doing mental health promotion, provide more suicide-specific information about how to respond to another student in distress, taking threats and talk of suicide seriously and accessing community resources.

After the crisis

The risk of a repeated attempt or attempts by other students may increase without appropriate after-care procedures. Dr. Jennifer White offers these tips for how school personnel should respond after a student’s suicide attempt.

• Document all information about the attempt, the school’s follow-up and parents’ response.

• Make every effort to facilitate the suicidal student’s return to school.

• Be available, demonstrate concern, maintain realistic expectations, provide perspective and remain sensitive with the attempter and other students.

• Avoid denial, blaming, dramatizing and glorifying the attempt.

Reprinted with permission from CrossCurrents: The Journal of Addiction and Mental Health, © Centre for Addiction and Mental Health, Winter 2006/07.