Suicide risk assessment in schools

Article in Review: Erps, K. Ochs, S., & Myers, C. (2020) School psychologist and suicide risk assessment: Role perception and competency. Psychology in the Schools, DOI: 10.1002/pits.22367

Summary: There are a range of challenges experienced within the school environment, where school psychologists can support effective and appropriate responses. So how do we effectively support school psychologists? In the area of suicide prevention, many school psychologists feel they were ‘lacking adequate graduate preparation’. The following offers some valuable insights.

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Research undertaken in the US during 2017 found that 17.2% of high-school students seriously considered attempting suicide, and 7.4% had attempted suicide. Children aged 10-14 years have shown a 200% increase in suicide rates over the last twenty years. Particular contributing factors to these statistics among children and young people include depression, poor or fractured social relationships, bullying or teasing, family discord and academic concerns. LGBTQ+ youth are at a particularly higher risk of death by suicide.

Children and young people may not have a fully accurate understanding of the finality of suicide. The notion that that death is not inevitable or universal, and is actually reversible is presentfor many children aged 12 and under.In films and TV shows death and suicide are sometimes depicted as non-permanent. In video games, characters die only to come back to life with ease or are available to be selected again for game play. Suicide is a taboo topic in many families, and when death is spoken about it may be primarily described using euphemisms.

Suicide Risk assessment
The term Suicide Risk Assessment is used to describe any measures taken in prevention, intervention or post-intervention for suicide. There are particular suicide risk assessment activities that are useful in the school setting.

The role of schools and school psychologists
Children and young people spend around 1200 hours in school each year.  It makes sense for schools to play a role in supporting and addressing suicide risks for their students. Educators and other staff that are spending time with students have some responsibility to be aware of and recognise risk signs for suicide. Suicide is certainly of concern for educators and school staff, and many schools are taking an action to address the rising rates. In school districts in America where there are suicide risk assessment strategies in place, there appears to be a lower suicide completion rate. As research emerges showing how schools can provide a positive support and influence for at-risk students, there is more and more pressure on schools to provide suicide training for staff and deliver suicide awareness programs for students.

School psychologist services
Within the school setting, school psychologists are identified as the best places to assist with suicide prevention efforts. Their competency in mental health and services make them “uniquely positioned” to drive prevention programs, given their main role is to improve student mental health and well being. School psychologists may provide suicide risk support in three types of Suicide Risk Assessment models which are detailed as being universal (for example, school-wide screening), targeted (for example, targeting act risk students) and tertiary(working with students who require intervention).

Suicide risk assessment competency
A recent study sought to better understand exactly what school psychologists consider their role in suicide risk assessment to be, and their confidence and competency in supporting children and youth with suicidal ideation and behaviors. The voluntary study involved 92 current or previously practicing school psychologists from 28 American states, who were questioned about their role in suicide risk assessment in educational settings. The respondents were primarily early career professionals (58.7%) working in public elementary schools.

Respondents agreed with the notion that school psychologists are best placed to deliver suicide risk assessment activities. However many professions feel inadequately prepared to intervene with students in crisis. The research finds in part that this is due to a gap in graduate education. The study results found that only 46% of school psychologist reported receiving some type of graduate training in suicide, a figure that is up only around 10% in twenty years.

This study found that many professionals are going into work in schools without formal suicide risk assessment training. Findings reinforced other research to conclude that there is a lack of preparedness in crisis intervention and suicide risk assessment amongst school psychologists. While providing mental health support may be a school psychologist’s primary role, this may not be recognised as extending into crisis and suicide risk scenarios, as these may be seen as beyond core services. One factor that we specifically were curious about in reading this article related to school based interventions also pertained to the intersectionality of trauma informed approaches as supporting effective suicide risk assessment practice and intervention. We know how critical this is across all areas of practice.

It is critical to increase awareness of and new approaches for addressing suicide rates among young people. Suicide risk assessment should be mandatory in graduate curricular. Findings might also be able to influence the development of policies and procedures that seek to support the development of suicide risk assessment skills for those who will likely have a career in the school setting.

If you are interested in understanding suicide risk in children and adolescents, consider our Children, Adolescents & Suicidal Behaviour blended learning workshop.