Suicide Prevention and School

*Content Notice: This post discusses suicide among children and adults.

One evening in October of 1995, my family and I visited my parents. My sons were playing with grandpa downstairs while my mother, wife and I were in the kitchen talking. Eventually, dad came upstairs and asked mom for a stamp. She gave him one, and without a word, he affixed it to an envelope which he then put in his planner.

The next day, mom called saying dad was late coming home from work. Minutes turned into hours, and we grew more concerned. We searched the rural roads of northern Utah for his little pick-up truck all night with no success. Emotionally and physically exhausted, we returned to mom’s house. The next morning, my father’s letter was delivered through the post. It was a suicide note. Shortly after, two police officers arrived telling us they had located my father’s body. Our fears were confirmed.

Over the next few days, I learned a lot about my dad. He struggled with depression throughout his life, but my parents handled it the way many people of their generation dealt with difficult and sensitive issues, and my siblings and I assumed all was well. In retrospect, I felt something was different with dad, but as a family, we never discussed it. Even now, I often wonder how things might be different if the clues dad provided throughout his life had been recognised and addressed.

After his death, I learned he struggled to make friends as a child and spent a lot of time alone. He would often go to primary school before it opened, sometimes as early as 6 am, because he didn’t want to be alone in the house. He’d sit outside on the front step until the custodian arrived and together they would open the building and get it ready for the day. The custodian was my father’s best friend at school.

Schools are places of academic learning, but they are also complex, socio-cultural environments intersected by the particularities of individuals’ personalities and the consequences and outcomes of their everyday lived experiences. In 2014-2015, my colleagues and I working on the WISERDEducation Multicohort study surveyed 376 Year 8 pupils in Wales using questions derived from the Moods & Feeling Questionnaire (MFQ). Analyses illuminated many of the struggles young people in school face. For example, 66 (17.5%) agreed with ALL of the “low-mood” constructs in our questionnaire. For some positively oriented items (“I am a person of value, “I am accepted for who I am,” and “I feel I belong at school”), 75% or more pupils disagreed.

Additionally, girls were far more likely to be unhappy at school and agreed (34.4%) with ALL of the “low mood” constructs from the MFQ more often than boys (21.7%). We also asked pupils to rank how happy they were on six different measures (school work, appearance, friends, family, school overall and life as a whole). Again, girls (23.6%) were more likely to be unhappy on ALL 6 of our measures than the boys (10.2%).

These findings highlight a growing problem. Suicide rates among young people in the US (also here and here) and the UK (also here and here) have increased to epidemic proportions (Bender et al, 1999), with suicide rates among boys being higher than girls, but instances of suicide increasing with both groups. Unfortunately, teachers – who are often overloaded – lack confidence in supporting pupils considering suicide.

September 10^th is World Suicide Prevention Day, and the International Association for Suicide Prevention (IASP) provides a number of resources on how we can collectively work to identify signs leading to suicide and prevent it. According to King and Vidourek (2012), the majority of young people who consider suicide display clues or warning signs to others, including friends, parents, mentors and role models, but these signs are not always easily identifiable.

Research suggests school-wide strategies for suicide prevention are more effective than targeting specific pupils (Bauman et al, 2013; King and Vidourek, 2012; Speaker & Petersen, 2000). With the national curriculum framework for Wales requiring schools to develop their own curricula, it is important that reliable guidance on suicide prevention, founded on the best research evidence available, is provided to schools as they engage in their curricular work.

As schools in Wales aspire to develop as “learning organisations,” let us ensure, as an explicit mandate, a commitment to creating safe environments that challenge mental health stigma and devise school-wide approaches for understanding, identifying and responding to the clues and warning-signs provided by pupils. This way, everyone in school may have a chance to get the help they deserve – from the pupils in school classrooms and corridors, to the lonely child on the front step.

Resources

Typically, each 800 word blog is followed by “reflective questions.” However, for this post, I’d like to list some possible resources for people working in schools. If you have more resources you’d like to share, feel free to tweet them and (and to tag me @dr_KevinSmith) in the tweet.

Six questions you can ask a loved one to help screen for suicide risk

Teacher guidance: teaching about mental health and emotional wellbeing

Model guidance for schools responding to incidents of self-harm

References

Bauman, S., Toomey, R. B., and Walker, J. L. (2013). Associations among bullying, cyberbullying, and suicide in high school students. Journal of Adolescence, 36(2), 341-350. doi:10.1016/j.adolescence.2012.12.001

Bender, W. N., Rosenkrans, C. B., and Crane, M. (1999). Stress, depression, and suicide among students with learning disabilities: Assessing the risk. Learning Disability Quarterly, 22(2), 143-156.doi:10.2307/1511272

King, K. A., and Vidourek, R. A. (2012). Teen depression and suicide: Effective prevention and intervention strategies. PsycEXTRA Dataset. doi:10.1037/e535022013-005

Speaker, K. & Petersen, G. (2000). School Violence and Adolescent Suicide: strategies for effective intervention. Educational Review (52)1, pps.65-73.