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