School Personnel Perspectives on their School’s Implementation of a School-Based Suicide Prevention Program

Abstract

Youth suicide is a national public health priority, with policymakers highlighting schools as an ideal setting in which to deliver suicide prevention programs. Over the past decade, the number of schools implementing such programs has grown substantially, yet little is known about how successfully such programs are being implemented. This study examines the implementation of a district-wide suicide prevention program through key informant interviews with school personnel. Schools with higher rates of implementing district protocols for at-risk students had an organized system to respond to at-risk students, a process for effectively responding to students who were at-risk for suicide, and strong administrative support. In contrast, schools that had lower rates of implementing district protocols relied on a handful of individuals for suicide prevention activities and had limited administrative support. Attention to organizational factors leading to successful implementation of school-based suicide prevention programs may enhance schools’ role in national adolescent suicide prevention efforts.

A Review and Application of Suicide Prevention Programs in High School Settings

“…Gatekeepers are the adults, such as teachers and school counselors, who are in a position to observe and intervene with at-risk adolescents. Gatekeeper training focuses on increasing the identification and response skills of these professionals; subsequent self-reports from those who have received training indicate using the new skills and an increase in referrals (Stein et al, 2010). According to Kalafat (2006), there are several gatekeeper training programs available such as Question Persuade Refer (QPR), Living Works, and Suicide Options and Relief (SOAR).…”

“…The authors concluded that the program was effective in equipping these individuals with the necessary skills when refresher courses were utilized and when there were legislative mandates, proper infrastructure, and administrative capacity to sustain the program. Stein et al (2010) evaluated the Los Angeles Unified School District's Youth Suicide Prevention Program (LAUSD) and concluded similarly that excellent administration and communication from the district down to the school, support of leadership (especially the principal), and established resources and channels for referrals were essential to successful training in this gatekeeper program servicing over 740,000 students.…”

“…Stein et al (2010) found that the LAUSD program required specific protocols, adequate training, accessible support materi-als and personnel, excellent communication, vigilant oversight, and flexibility to maintain the program. These authors also noted there was no evidence this program actually reduced the incidence of adolescent suicide in this school district.…”

“…A critical component of this program is the idea that suicidal thoughts are not normal, are the result of mental illness or other psychosocial crises, and should be regarded as an emergency that needs to be addressed. This critical component is a development in the science addressing an old methodology that taught suicide was a normal response to stress, thereby normalizing it (Stein et al, 2010). Students are taught to acknowledge the signs in themselves and others, let others know they care, and tell a responsible adult.…”

System constraints on efficacious teacher behaviours in school-based suicide prevention initiatives; a qualitative study of teacher views and experiences

“…Whereas in a study of health education teachers only a quarter felt that if they talked to parents it would reduce the risk of suicide (27%) (King et al 1999). Conversely, where staff are informed about and have access to an organized system with transparent processes for responding effectively to a student who is at risk, self-efficacy of staff has been found to be higher (Anderson 2004;King et al 1999) and more effective responses have been demonstrated (Stein, Kataoka, Hamilton, Schultz, Ryan, Vona & Wong 2010). However, it is known that in many contexts, there is a lack of readily available, responsive mental health Other contextual factors may differ, such as protocols for communication between schools and families.…”