258 lines
12 KiB
Plaintext
258 lines
12 KiB
Plaintext
|
May 1990
|
|||
|
|
|
|||
|
|
HIGH SCHOOL SUICIDE CRISIS INTERVENTION
|
|||
|
|
|
|||
|
|
By
|
|||
|
|
|
|||
|
|
David Fisher, M.A.
|
|||
|
|
Deputy
|
|||
|
|
Pinnellas County, Florida, Sheriff's Office
|
|||
|
|
|
|||
|
|
|
|||
|
|
Teen suicide--a tragic reality--is a rising national
|
|||
|
|
phenomenon and the second leading cause of death among
|
|||
|
|
teenagers. (1) No school system or police department is immune
|
|||
|
|
from its psychological devastation.
|
|||
|
|
|
|||
|
|
After two students at Dixie Hollins High School in Pinellas
|
|||
|
|
County, Florida, committed suicide, the number of reported
|
|||
|
|
suicide threats rose. To meet this crisis, the school's
|
|||
|
|
administration established a suicide crisis intervention team.
|
|||
|
|
The team is composed of two assistant principals, two guidance
|
|||
|
|
counselors, and the school's resource officer (SRO), each of whom
|
|||
|
|
have counseling experience and graduate degrees.
|
|||
|
|
|
|||
|
|
ROLE OF THE SRO
|
|||
|
|
|
|||
|
|
Most districts within the State of Florida have full-time
|
|||
|
|
school resource officers assigned to specific schools. In
|
|||
|
|
addition to law enforcement duties, SROs counsel students, teach
|
|||
|
|
classes, and act as resources for the school. Also, they receive
|
|||
|
|
training in crisis intervention and are the only persons on
|
|||
|
|
school campuses with the authority to initiate and transport a
|
|||
|
|
student for involuntary psychiatric evaluation.
|
|||
|
|
|
|||
|
|
The key to the effectiveness of SROs is gaining acceptance
|
|||
|
|
and credibility among both the students and faculty. This can be
|
|||
|
|
done in a number of ways. For example, SROs can speak to
|
|||
|
|
students informally to show interest in them, or may discuss the
|
|||
|
|
suicide prevention team with faculty members. Also, through
|
|||
|
|
active involvement in such school activities as sports events and
|
|||
|
|
musical programs, they can change the image of SROs from
|
|||
|
|
``enforcer'' to friend. Presentations by the SROs on stress
|
|||
|
|
awareness and management to students and the faculty can also
|
|||
|
|
help remove the stigma for someone seeking personal help or
|
|||
|
|
referring a friend.
|
|||
|
|
|
|||
|
|
STUDENTS AT RISK
|
|||
|
|
|
|||
|
|
Suicide crisis intervention team members are trained to
|
|||
|
|
identify those students who may be considering suicide. They
|
|||
|
|
also instruct teachers about the warning signs of suicide,
|
|||
|
|
because teachers have the most direct contact with students and
|
|||
|
|
are the most likely to recognize these signs first.
|
|||
|
|
|
|||
|
|
Warning signs can appear in written assignments turned in by
|
|||
|
|
students or in behavioral clues that may express ideas of
|
|||
|
|
self-destruction or depression. Teachers are cautioned to be
|
|||
|
|
particularly attentive to warning signs during the peak stress
|
|||
|
|
times for adolescents, such as grading periods, homecoming, and
|
|||
|
|
prom and graduation weekends.
|
|||
|
|
|
|||
|
|
COUNSELING
|
|||
|
|
|
|||
|
|
Upon referral, each student in crisis is seen by a team
|
|||
|
|
member as soon as possible. Anyone seeking help is assured of
|
|||
|
|
confidentiality up front; however, the counselor will advise the
|
|||
|
|
student that it may become necessary to subsequently notify
|
|||
|
|
mental health professionals to ensure personal safety.
|
|||
|
|
|
|||
|
|
Communication is never discouraged during counseling sessions.
|
|||
|
|
Team members allow the student to express thoughts and beliefs
|
|||
|
|
freely. In many cases, just having an adult show concern and pay
|
|||
|
|
attention to what is being said is all that the student needs to
|
|||
|
|
ease the crisis.
|
|||
|
|
|
|||
|
|
Usually only one team member counsels a student, but the
|
|||
|
|
other team members are later informed of the session. However,
|
|||
|
|
when dealing with an active suicidal threat, it is important to
|
|||
|
|
have several team members involved. In such cases, the potential
|
|||
|
|
victim is kept calm and is never left alone for any reason until
|
|||
|
|
additional help is obtained, and the team member having the best
|
|||
|
|
rapport with the student acts as the primary counselor.
|
|||
|
|
|
|||
|
|
EVALUATION
|
|||
|
|
|
|||
|
|
Understanding teen suicidal behavior aids the evaluation
|
|||
|
|
process. Many times, there is no real intent by the teen to
|
|||
|
|
commit suicide, rather the actions are simply a ``serious cry''
|
|||
|
|
for help. However, talk of suicide should not be dismissed or
|
|||
|
|
taken lightly. There is always the danger that teens making
|
|||
|
|
suicide threats may actually miscalculate and accidently complete
|
|||
|
|
the act or cause serious bodily injury. Oftentimes, in suicidal
|
|||
|
|
pacts, teens may be talked into carrying out suicidal threats by
|
|||
|
|
other students and may feel the need to attempt suicide to ``save
|
|||
|
|
face.''
|
|||
|
|
|
|||
|
|
With transient or situational depression, a young person may
|
|||
|
|
have suffered a loss of a significant relationship, social
|
|||
|
|
status or self-worth or may be reacting to unidentified
|
|||
|
|
stressors. Although such situations may not appear
|
|||
|
|
unsurmountable to adults, the perceived trauma levels may well be
|
|||
|
|
exceptionally high to teens who lack the experience and coping
|
|||
|
|
skills to effectively deal with the stress.
|
|||
|
|
|
|||
|
|
Teens who are organically or chemically imbalanced are
|
|||
|
|
rarely identified, difficult to work with, and can only be
|
|||
|
|
diagnosed by a highly skilled physician. In such cases, when
|
|||
|
|
suicide is suspected, the only appropriate action is to advise
|
|||
|
|
parents to seek medical attention for their teen immediately.
|
|||
|
|
|
|||
|
|
The main operating principle of the suicide crisis
|
|||
|
|
intervention team is to LISTEN, EVALUATE, AND GET HELP. The
|
|||
|
|
evaluation is not intended to be clinical in nature, but to
|
|||
|
|
assist in determining appropriate help options.
|
|||
|
|
|
|||
|
|
SUICIDE ATTEMPTS
|
|||
|
|
|
|||
|
|
During an attempted suicide at school or a barricaded
|
|||
|
|
situation that may result in suicide, the SRO is the one who
|
|||
|
|
takes the necessary steps to ensure safety. This includes trying
|
|||
|
|
to locate and secure weapons and drugs from the student, trying
|
|||
|
|
to coax the student into a secure area, such as an office, and
|
|||
|
|
removing onlookers as quickly as possible from the scene. School
|
|||
|
|
administrators or backup officers may assist as needed.
|
|||
|
|
|
|||
|
|
If a firearm is involved, the SRO does not approach the
|
|||
|
|
student directly, but maintains cover while communicating with
|
|||
|
|
the potential victim. Because of the possibility of a hostage
|
|||
|
|
situation, school personnel are instructed not to get involved.
|
|||
|
|
The SRO handles the situation alone until the weapon is secured.
|
|||
|
|
|
|||
|
|
As soon as possible, the SRO begins communicating with the
|
|||
|
|
individual by asking the student's name. All conversation is
|
|||
|
|
conducted in a calm, casual manner, during which the SRO
|
|||
|
|
expresses concern for the student's well-being and indicates a
|
|||
|
|
willingness to help. Once the student is identified, pertinent
|
|||
|
|
background data are obtained from school records and family
|
|||
|
|
members are notified, even though they are kept from the scene
|
|||
|
|
and are not allowed to converse with the student.
|
|||
|
|
|
|||
|
|
Of course, in the case of serious injury or drug overdose,
|
|||
|
|
getting medical assistance is the overriding consideration. The
|
|||
|
|
SRO takes custody of the individual by any means necessary and as
|
|||
|
|
soon as possible, while ensuring officer safety, and arranges for
|
|||
|
|
medical transport. The SRO should be aware of local medical
|
|||
|
|
facilities that accept psychiatric patients.
|
|||
|
|
|
|||
|
|
FOLLOWUP CARE
|
|||
|
|
|
|||
|
|
Followup care could possibly be the most important part of
|
|||
|
|
suicide crisis intervention. Even though the crisis may appear
|
|||
|
|
to be over, and the individual appears to be recovering, there is
|
|||
|
|
the chance the teen is simply regaining energy to complete the
|
|||
|
|
suicide. Visits by a team member to the student in treatment
|
|||
|
|
keeps the student from feeling forgotten, isolated, or betrayed.
|
|||
|
|
|
|||
|
|
Once the student returns to school, there is a critical
|
|||
|
|
phase of readjustment, and periodic visits with a team member are
|
|||
|
|
encouraged. The student still needs to know that someone cares
|
|||
|
|
and that help is available by only asking for it.
|
|||
|
|
|
|||
|
|
Helping the student develop and maintain positive
|
|||
|
|
involvement in school and community activities is also essential
|
|||
|
|
during followup care. Programs involving other students have
|
|||
|
|
been successfully used, and working with organizations having
|
|||
|
|
service-oriented goals gives teens a sense of purpose and directs
|
|||
|
|
their energy and focus outward.
|
|||
|
|
|
|||
|
|
CONCLUSION
|
|||
|
|
|
|||
|
|
Members of the suicide crisis intervention team are not
|
|||
|
|
certified mental health professionals. However, they are capable
|
|||
|
|
of evaluating the needs of a troubled student and getting the
|
|||
|
|
proper help in a timely manner.
|
|||
|
|
|
|||
|
|
By using such strategies as quick response intervention,
|
|||
|
|
building positive relationships with students, learning basic
|
|||
|
|
alert and assessment techniques, and being aware of available
|
|||
|
|
resources, the suicide crisis intervention team has been able to
|
|||
|
|
help students. Since the inception of the team program in 1987,
|
|||
|
|
there have been no completed or life-threatening suicide attempts
|
|||
|
|
among the Dixie Hollins High School student population.
|
|||
|
|
|
|||
|
|
FOOTNOTE
|
|||
|
|
|
|||
|
|
(1) Richard H. Schwartz, M.D., Teenage Suicide: Symptom or
|
|||
|
|
Disease (Springfield, Virginia: Straight, Inc., 1987), p. 4.
|
|||
|
|
|
|||
|
|
|
|||
|
|
|
|||
|
|
Appendix
|
|||
|
|
|
|||
|
|
KEY RISK SUICIDE INDICATORS
|
|||
|
|
|
|||
|
|
High Priority Indicators
|
|||
|
|
* Active attempt or threat
|
|||
|
|
* Direct statements of suicidal intent
|
|||
|
|
* Recent attempts or self-inflicted injury
|
|||
|
|
* Making final arrangements, such as making a will or giving
|
|||
|
|
away items of personal value
|
|||
|
|
* Specific method or plan for suicide already chosen
|
|||
|
|
|
|||
|
|
Other Indicators
|
|||
|
|
* Feelings of hopelessness or helplessness
|
|||
|
|
* Loss of interest in friends or activities
|
|||
|
|
* Depression/aggression (sometimes masked as vandalism or
|
|||
|
|
poor behavior)
|
|||
|
|
* Drug and/or alcohol abuse
|
|||
|
|
* Preoccupation with ``heavy metal'' music, morbidity,
|
|||
|
|
satanism or the occult
|
|||
|
|
* Friend or relative who committed suicide
|
|||
|
|
* Previous suicide attempts
|
|||
|
|
* Excessive risk-taking
|
|||
|
|
* Recurrent or uncontrolled death thoughts or fantasies
|
|||
|
|
* Low self-esteem
|
|||
|
|
* Loss of a family member or relationship, particularly by
|
|||
|
|
death or rejection
|
|||
|
|
* Frequent mood swings/self-imposed isolation
|
|||
|
|
* History of child abuse (physical or sexual)
|
|||
|
|
* Chronic physical complaints or eating disorders
|
|||
|
|
* Sexual identity conflicts
|
|||
|
|
* Unreasonably high expectations for academic or athletic
|
|||
|
|
performance
|
|||
|
|
|
|||
|
|
|
|||
|
|
SRO PROCEDURES TO FOLLOW DURING SUICIDE ATTEMPTS
|
|||
|
|
|
|||
|
|
* Ensure backup and emergency service units are out of sight
|
|||
|
|
of the suicidal teen
|
|||
|
|
* Listen attentively and patiently, responding with
|
|||
|
|
understanding and empathy
|
|||
|
|
* Ask questions that encourage the teen to express feelings
|
|||
|
|
or events leading to the crisis
|
|||
|
|
* Be nonjudgmental
|
|||
|
|
* Do not oversimplify solutions or make statements that
|
|||
|
|
trivialize the situation
|
|||
|
|
* Avoid threatening gestures or flippant comments
|
|||
|
|
* Call in mental health professionals, clergy, or any one
|
|||
|
|
else who could possibly reach the troubled teen
|
|||
|
|
* Suggest alternatives to suicide that can be made available
|
|||
|
|
to the teen
|
|||
|
|
* Do not rush--take whatever time or steps necessary to get
|
|||
|
|
help for the troubled teen
|
|||
|
|
|
|||
|
|
|
|||
|
|
HELP OPTIONS
|
|||
|
|
|
|||
|
|
* Counseling
|
|||
|
|
* Contact parents
|
|||
|
|
* Peer support
|
|||
|
|
* Community resources, such as family counseling centers,
|
|||
|
|
licensed private agencies, hospital outpatient services,
|
|||
|
|
government agencies
|
|||
|
|
* Voluntary emergency mental health examination at a licensed
|
|||
|
|
facility
|
|||
|
|
* Involuntary examination and admission at an approved mental
|
|||
|
|
health facility
|
|||
|
|
|