By Dr. Kimberlee Ratliff, Program Director for M.Ed. School Counseling at American Public University

According to the American Association of Suicidology, suicide is the third leading cause of death in young people between the ages of 15-24. As a counselor educator, that statistic leads me to the conclusion that prevention efforts need immediate attention. A collaborative effort between schools, parents, and the community can make a difference and, in my opinion, should be mandated in all states. 

One of the reasons for not implementing a prevention program is based on the fear that talking about suicide will increase suicidal thoughts and possibly attempts. This fear is based on a myth. Research conducted by Gould, Marrocco,  Kleinman, Thomas, Mostkoff, Cote, and Davies in 2005 demonstrated that discussing suicide and opening dialogue on feelings associated with suicide actually lessened the chance for teenagers to consider suicide.

Schools are an excellent place to implement suicide prevention programs. The effort should begin with training for staff on how to identify warning signs, how to respond, and particular interventions to address specific needs of students at-risk. Currently, 12 states require educators to be trained in suicide prevention: Tennessee, Louisiana, California, Mississippi, Illinois, Arkansas, West Virginia, Utah, Alaska, South Carolina, Ohio, and North Dakota.

Peers play a significant role in prevention of suicide. We know that teenagers are more likely to tell a friend about their suicidal thoughts and intentions rather than sharing them with an adult. The American Association or Suicidology recommends educating students on warning signs, how to provide a supportive response, and how to seek out adult assistance. Teaching students how to respond to their peers with empathy and take signs seriously may help prevent a tragedy.

As a former middle school counselor, I often asked language arts teachers to monitor journal writings for warning signs. This led to several suicide assessments, which indicates that we need to be diligent in reviewing student journals and artwork that could be a cry for help.  During a 2013 presentation to the Association for Counselor Education and Supervision Conference, counselor educators D. Granello and P. Granello offered these signs that a student may be considering suicide:

• Hopelessness
• Comments such as “I won’t be here much longer”; “Everyone would be better off if I wasn’t here”; “I can’t do this anymore”; “I wish I were dead” to name a few
• Depression (consider changes in sleeping and eating habits)
• Withdrawing from social circles and activities previously enjoyed
• No interest in planning for the future
• Risky behavior
• Giving away possessions
• Decline in academic achievement
• Changes in personality
• Being preoccupied with death

If this is too much to remember, the American Association of Suicidology created a mnemonic to highlight some warning signs: IS PATH WARM? This stands for Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, and Mood Changes. 

In their presentation, Granello and Granello also outlined factors that may help prevent suicide. These include:

• Family support
• Academic achievement
• Positive relationships with peers
• Feeling connected to school
• Social involvement
• Impulse control, coping skills, problem solving skills, and conflict resolution skills
• Self-confidence
• Access to mental health support

School counselors can create peer training programs to help students understand how to respond.Training would include recognizing the warning signs, responding with empathy, and notifying a trusted adult when a classmate exhibits the warning signs.  With statistics indicating that 90 percent of those considering suicide tell someone, these efforts could have a significant impact on prevention.

School counselors can also provide group counseling and individual counseling to support personal or social concerns. Teaching problem solving skills, conflict resolution, coping skills, and impulse control falls within the realm of expertise of the school counselor and can also be incorporated into the school curriculum. 

Providing additional support to those identified at greater risk is an important consideration in suicide prevention. We now know that students identifying as LGBTQQIA and students who are bullied are at a higher risk of suicide. Walls, Wisneski, and Kane explored how school-based Gay-Straight Alliance groups have been shown to decrease suicide risk. 

Suicide is currently one of the leading causes of death among our youth, but it is also preventable.  Schools can play a tremendous role in providing protective factors to students through training, programs, and positive school climate. Students and staff can also be instrumental in recognizing students exhibiting warning signs and provide an access to mental health support that is needed.   

References

• Gould, M. S., Marrocco, F. A., Kleinman, M., Thomas, J. G., Mostkoff, K., Cote, J., & Davies, M. (2005). Evaluation iatrogenic risk of youth suicide screening programs: A randomized controlled trial. Journal of the American Medical Association, 293(13), 1635-1643.
• Granello, D. H., & Granello, P. G. (2013). Training school counselor to conduct suicide prevention gatekeeper trainings in their schools. Association for Counselor Education and Supervision Conference, Denver, CO.
• Walls, N. E., Wisneski, H., Kane, S.  (2013). School climate, individual support, or both? Gay straight alliances and the mental health of sexual minority youth. School Social Work Journal, 37(2), 88–111.

About the Author

Dr. Kimberlee Ratliff is a National Certified Counselor (NCC), National Certified School Counselor (NCSC), and Trauma and Loss School Specialist (TLC Institute). She is currently the Program Director and Associate Professor of the M.Ed. School Counseling Program at American Public University System (APUS). Prior to her career at APUS, Dr. Ratliff worked as an elementary and middle school counselor in North Carolina and Northern Virginia in addition to teaching at George Mason University. She received several awards including the Virginia Counselors Association Counselor of the Year Award, Prince William County Schools (PWCS) Above and Beyond Award, Prince William County Education Foundation Hero in Education Award, and the APUS Teaching Excellence Award for the School of Education. Dr. Ratliff has held previous leadership positions in the Prince William County Regional Counselors Association (PWRCA), Virginia Counselors Association (VCA), and Virginia School Counselor Association (VSCA). She is also a member of the American School Counselor Association and American Counseling Association. Dr. Ratliff has presented on the local, state, and national levels on bully prevention and counseling multiracial children.