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