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There are situations when confidentiality must NOT BE MAINTAINED; if at any time, a student has shared information that indicates the student is in imminent risk of harm/danger to self or others, that information MUST BE shared. The details regarding the student can be discussed with those who need to intervene to keep the student safe. This is in compliance with the spirit of FERPA and HIPAA known as “minimum necessary disclosure”.

Exceptions to Parental/Caregiver Notification

Abuse or Neglect Parents/Caregivers need to know about a student’s suicidal ideation unless a result of parental abuse or neglect is possible. The counselor or staff suicide contact person is in the best position to make the determination. The school staff will need to let the student know that other people would need to get involved on a need-to- know basis. If a student makes a statement such as “My dad/mom would kill me” as a reason to refuse, the school staff can ask questions to determine if parental/caregiver abuse or neglect is involved. If there is no indication that abuse or neglect is involved, compassionately disclose that the parent/caregiver needs to be involved.

●      School staff are frequently considered the first line of contact with potentially suicidal students.

●      Most school personnel are neither qualified, nor expected, to provide the in-depth assessment or counseling necessary for treating a suicidal student. They are responsible for taking reasonable and prudent actions to help at-risk students, such as notifying parents, making appropriate referrals, and securing outside assistance when needed.

●      All school personnel need to know that protocols exist to refer at-risk students to trained professionals so that the burden of responsibility does not rest solely with the individual “on the scene”.

●      Research has shown talking about suicide, or asking someone if they are feeling suicidal, will not put the idea in their head or cause them to kill themselves.

●      School personnel, parents/guardians, and students need to be confident that help is available when they raise concerns regarding suicidal behavior. Students often know, but do not tell adults, about suicidal peers. Having support in place may lessen this reluctance to speak up when students are concerned about a peer.

●      Advanced planning is critical to providing an effective crisis response. Internal and external resources must be in place to address student issues and to normalize the learning environment for everyone.

Suicide can be prevented. Following these simple steps will help ensure a comprehensive school based approach to suicide prevention for students and staff.

STAFF

All staff receive training (or a refresher) once a year on the policies and procedures and best practices for intervening with student and/or staff at risk of suicide. The A.C.T. curriculum provides staff in-service training on best practices. All staff participate in Safe Schools Suicide Prevention Training in the Fall of every school year.

STUDENTS

Students receive information about suicide in health or by counselor classroom lessons. The purpose of this curriculum is to teach students how to access help at their schools for themselves, their peers, or others in the community.

• RECOMMENDATIONS: (1) Use curriculum in line with Oregon State Standards for health such as Sources of Strength for elementary and Signs of Suicide for middle and high school. Students should be made aware each year of the staff that have received specialized training to help students at risk for suicide. (2) Consider engaging students to help increase awareness of resources.

COMMUNITY PARTNERS

Depending on the role of the community partner (CP), they may complete a Suicide Assessment if contracted to do so or will refer student to the lead school counselor. CP's will notify administration and either contact parents themselves or ask the school counselor to.

• RECOMMENDATIONS: Understand roles of community partners and schools in relation to suicide prevention and intervention before working in the schools.

PARENTS/COMMUNITY

Provide parents with informational materials to help them identify whether their child or another person is at risk for suicide. Information should include how to access school and community resources to support students or others in their community that may be at risk for suicide.

• RECOMMENDATIONS: (1) List resources in the school handbook or newsletter. Partner with community agencies to ofter parent information nights using research based programs such as Sources of Strength or Signs of Suicide. (2) Ensure cross communication between community agencies and schools within bounds of confidentiality.

RESOURCES

For emergencies:

• 911

• Local emergency rooms

• Multnomah County Crisis Line, 503-988-4888

• Clackamas County Crisis Line, 503-655-8585

To speak with a counselor or schedule an appointment:

• Care Solace, 888-515-0595

Other resources:

• National Suicide Prevention Lifeline, 800-273-TALK,

• The Trevor Project, 866-488- 7386

Elementary School

Sources of Strength is a radically Strength based, upstream prevention program that employs a strength-based wellness approach to improving the health and wellbeing of individuals and communities. The model moves to increase health and wellness through the empowerment of individuals and communities working together to increase connection, increase early help-seeking, and build belonging to help people live healthy, thriving lives. The lessons are designed to give students and adults opportunities and tools to develop Strengths and healthy coping strategies leading to resilience in the face of life's ups and downs. Everyone is invited to explore eight protective factors represented in the Sources of Strength Wheel: Family Support, Positive Friends, Mentors, Healthy Activities, Generosity, Spirituality, Physical Health, and Mental Health.

Middle and High School

SOS Signs of Suicide (SOS) is a universal, school-based prevention program designed for middle school (ages 11-13) and high school (ages 13-17) students.

The goals of this program are:

• Decrease suicide and suicide attempts by increasing student knowledge and adaptive attitudes about depression

• Encourage personal help-seeking and/or help-seeking on behalf of a friend

• Reduce the stigma of mental illness and acknowledge the importance of seeking help or treatment

• Engage parents and school staff as partners in prevention through "gatekeeper" education

• Encourage schools to develop community-based partnerships to support student mental health

Through a video and guided discussion, students learn to identify warning signs of suicide and depression in a single class period. At the end of the session, students complete a seven-question screening for depression (anonymous or signed - the school can decide) to further encourage help-seeking and connect students at risk with trusted adults. The curriculum raises awareness about behavioral health and encourages students to ACT (Acknowledge, Care, Tell) when worried about themselves or their peers. Schools can purchase a program license through MindWise Innovations (formerly Screening for Mental Health, Inc.).

The Suicide Intervention process should be initiated when a student is exhibiting any of the following behaviors: gestures, talk of suicide (including those thoughts expressed in writing, art, or other forms), or suicide attempts. The purpose of the suicide protocol is to assess immediate risk and to inform a plan of action. To initiate the protocol school staff will immediately notify the counselor or social worker AND administrator who form the decision making team and who will initiate the Suicide Prevention Protocol.

Intervention Suicide/Crisis Intervention is the intentional steps that our district takes in the event of a student mental health crisis. It includes:

● Safety planning

● Family involvement

● Suicide assessments

● Emergency services

When a student is identified by a peer, educator or other source as potentially suicidal — i.e., verbalizes thoughts about suicide, presents overt risk factors such as agitation or intoxication, an act of self-harm occurs, or expresses or otherwise shows signs of suicidal ideation — the student shall be seen by a school counselor or school social worker within the same school day to assess risk and facilitate referral necessary.

Family Notification and Involvement

The principal, designee, or school mental health professional shall inform the student’s family or guardian on the same school day, or as soon as possible, any time a student is identified as having any level of risk for suicide or if the student has made a suicide attempt (pursuant to school/state codes, unless notifying the family will put the student at increased risk of harm). Following family notification and based on initial risk screening, the principal, designee, or school counselor/social worker may offer recommendations for next steps based on perceived student need. These can include, but are not limited to, an external mental health evaluation conducted by a qualified health professional or emergency service provider.

If school staff are unable to reach the student’s family or guardian, they should consider any of the following in consultation with the building administration:

• Contact with the student’s emergency contacts (informing them they need to speak to the student’s family)
• A home visit
• A call to DHS Hotline : 1-855-503-SAFE (7233) or student’s DHS case manager, (if applicable) In cases of emergency, contact Multnomah County Crisis Line (503- 988-4888) and/or the Police and ask for mental health support.

Based on information the student provides during the screening process, school staff may need to provide families with the following information regarding “lethal means counseling”.

Lethal means counseling shall include discussing the following:

Ensuring Student Safety

Firearms

• Inquire of the family or guardian if firearms are kept in the home or are otherwise accessible to the student
• Recommend that the family store all guns away from home while the student is struggling — e.g., following state laws, store their guns with a relative, gun shop, or police.
• Discuss the family’s’ concerns and help problem-solve around offsite storage, and avoid a negative attitude about guns — accept where they are, but let them know offsite storage is an effective, immediate way to protect the student.
• Explain that in-home locking is not as safe as offsite storage, as children and adolescents sometimes find the keys or get past the locks.
• If there are no guns at home, ask about guns in other residences (e.g., joint custody situation, access to guns in the homes of friends or other family members).
• If the family won’t or can’t store offsite, the next safest option is to unload guns, lock them in a gun safe, and lock ammunition separately (or don’t keep ammunition at home for now).
• If guns are already locked, ask the family to consider changing the combination or key location.

Medications

• Recommend the family or guardian lock up all medications (except rescue meds like inhalers), either with a traditional lock box or a daily pill dispenser. Recommend disposing of expired and unneeded medications, especially prescription pain pills
• Recommend the family maintain possession of the student’s medication, only dispensing one dose at a time under supervision.
  • If the family won’t or can’t lock medication, advise they prioritize and seek specific guidance from a doctor or pharmacist regarding the following:
    • Prescriptions, especially for pain, anxiety or insomnia
    • Over-the-counter pain pills
    • Over-the-counter sleeping pills
• Staff will also seek the families’ permission, in the form of a Release of Information form, to communicate with outside mental health care providers regarding the student’s safety plan and access to lethal means.

Additional Resources:

All supporting documents can be found on the district Counseling website

Schools must be prepared to act and provide postvention support and action in the event of a suicide attempt or completed suicide. Suicide Postvention has been defined as “the provision of crisis intervention, support, and assistance for those affected by a suicide” (American Association of Suicidology). Postvention strategies after a suicide attempt or completion is very important. Schools should be aware that youth and others associated with the event are vulnerable to suicide contagion or, in other words, at increased risk for suicide. Families and communities can be especially sensitive after a suicide event. The school’s primary responsibility in these cases is to respond to the suicide attempt or completion in a manner which appropriately supports students and the school community impacted. This includes having a system in place to work with the multitude of groups that may eventually be involved, such as students, staff and faculty, parents/guardians, community, media, law enforcement, etc.

After a Suicide Attempt

Re-Entry Procedure

The transition back to school after a suicide attempt and psychiatric hospitalization can be a difficult one, especially if the attempt was very public. The student's privacy going forward is critical and the student and their family need to be an integral part of the decisions that get made in the re-entry plan. Prior to Return

• Safety and Supervision Plan
  • If not done by the mental health provider at the parent’s request already, obtain releases of information from the parent so the mental health provider, inpatient, or outpatient team can talk to the school counselor. This will ensure that pertinent information is shared, and there is a smooth transition throughout the levels of care.
  • Meet with the student and his or her parents/guardians before the return to school, plan together what information they want shared and with whom.
  • Practice role-playing so that the student can try out different responses to different situations (peer-to-peer & staff-student) that may arise to help lower anxiety.
  • Ask how school staff can best support recovery.
  • Refer to and update the student’s safety plan as needed.
  • Work out an agreement with the student to not share details of the attempt including the method, with other students to avoid the potential of increasing self-harm risks with other students, including by social media. Explain that peers talking to peers about the details of an attempt may give ideas to other students who are struggling with their own thoughts of suicide to make an attempt. However, do let the student know that it is an important part of the healing process to talk about the attempt with trusted adults and the student's therapist. Explain that talking about the attempt and what led to it in a safe environment can help the student avoid an attempt in the future.
  • Reassure the student and family that sharing information with school personnel will be done on a need to know basis. Faculty and staff that have direct contact should be informed so they can actively assist the student academically. Identify the staff that will need to know by name and role.
  • Reassure the student that staff will be available to help the student with any academic issues, and that it will be important for the student to reach out if he or she is feeling worried about their schoolwork.

After Return to School

• Treat the student's return to school as you would had the student been out sick for a few days. Let the student know you are glad he or she is back, "Good to see you."
• Be aware that the student may still be dealing with symptoms of depression which can affect concentration and motivation.
• Be aware that the student may be adjusting to medication and may be dealing with side effects including fatigue, or jitteriness.
• Accommodations may need to be made such as an extended time to turn in assignments, or additional time for testing. Some students with concentration issues may find it easier to take a test alone. Some students dealing with anxiety may find it helpful to be able to leave class a little early to avoid the crowds and noise in the hallways when changing classes.
• Monitor social interactions. Meet with the student, and if they agree, their friends, in the days and weeks following the transition back to school to check in and see how things are going with peers. Quickly address any bullying behaviors that are occurring.
• Have regular contact with the student's parents and therapist to provide feedback and to garner information that will help to further support the student's recovery.

A student returns to school without meeting prior to return

• Meet with students and parents/guardians as soon as practical in order to develop a safety plan and identify necessary supports for the student and family.

In-School Suicide Attempts

In the case of an in-school suicide attempt, the physical, mental health and safety of the student are paramount. In these situations:

• First aid shall be rendered until professional medical services and/or transportation can be received, following district emergency medical procedures, including calling 9-1-1. Inform building administrator.
• School staff shall supervise the student to ensure their safety.
• Staff shall move all other students out of the immediate area as soon as possible.
• Staff shall immediately notify the principal or school suicide prevention coordinator regarding the incident of in-school suicide attempt.
• The school counselor/social worker or building administrator shall contact the student’s family or guardian. (Note: See Family Notification and Involvement section of this document).
• The school shall engage the Flight Team as necessary to assess whether additional steps should be taken to ensure student safety and well-being, including those students who may have had emotional or physical proximity to the victim.
• Inform the Executive Director of Student Support Services and Program Director.
• Staff shall request a mental health assessment for the student as soon as possible.
• If the student does not currently have a mental health provider, a referral will be made.
• Building team will debrief with the Executive Director of Student Support Services and Program Director within 24 hours.
• Building team should plan for the student’s re-entry (See Re-Entry Procedure).

Out-of-School Suicide Attempts

If a staff member becomes aware of a suicide attempt by a student that is in progress in an out-of-school location, the staff member shall:

• If the student contacts the staff member and expresses suicidal ideation, the staff member shall maintain contact with the student (either in person, online, or on the phone).
• Enlist the assistance of another person to contact the police or Project Respond while maintaining engagement with the student.
• Call 911 (police and/or emergency medical services) and provide as much information as possible, including address, age, etc.
• Inform the student’s family or guardian.
• Inform the school suicide prevention coordinator and building administrator.
• Follow re-entry processes prior to the student's return to school.

Link to FAQ for Suicide Response Protocol

After a Suicide Death

Flight Team

The Flight Team, led by a designated Flight Team coordinator, shall develop a crisis response plan to guide school response following a death by suicide. This plan may be applicable to all school community related suicides whether it be student (past or present), staff, or other prominentschool community member(s).

Once school personnel has been notified of a death by suicide, the district Flight Team procedures will be followed. The building administrator will contact the Executive Director of K-12 Schools and Executive Director of Student Support Services. Additional considerations the Flight Team will take in the instance of death by suicide include:

• A designated school contact shall confirm the death and determine the cause of death through communication with the student’s family or guardian, the coroner’s office, local hospital, or police department.
• The Flight Team shall meet to prepare the postvention response according to the crisis response plan. The team shall consider how the death is likely to affect other students and staff, and determine which students are most likely to be affected.
• The Flight Team shall also consider how recently other traumatic events have occurred within the school community and the time of year of the suicide. The team and principal shall triage staff first, and all teachers directly involved with the victim shall be notified in person and offered the opportunity for support. Based on the information gathered and buildings’ current context, the District Flight Team Coordinator may contact district Mental Health Partners, neighbor district Flight Team Coordinators, Project Respond, and/or Trauma Intervention Programs, NW (TIP).
• The Flight Team will be available to provide a written statement for staff members to share with students and also assess staff’s readiness to provide this message in the event a designee is needed.
• Actively triage particular risk factors for contagion, including emotional proximity (e.g., siblings, friends, or teammates), physical proximity (witness, neighbor) and pre-existing mental health issues or trauma.
• The Flight Team coordinator will contact the Suicide Prevention Program Specialist with Multnomah County.

Response Checklist:

-Receive information regarding death involving of student or alumna or traumatic event

-Police Department or Principal contacts Deputy Superintendent who will assume lead with partnership with Multnomah County Health Department

-Deputy Superintendent contacts Flight Team Coordinator

-Flight Team Coordinator contacts Counselors on Special Assignment to convene Flight Team response (with consideration for feeder schools and potential impact in those buildings)

-Flight Team Coordinator contacts Flight Team Members and creates a response plan

-Flight Team Coordinator connects with building principal and reviews the building needs and plan in place for support 

-Flight Team Coordinator communicates with all counselors and social workers in the district about the implementation of flight team, so that they can be aware of potential impact in their schools

During The Flight Team

-Convene Flight Team and Staff to announce the reason for being there and the support available.

-Flight Team Coordinator ensures that flight team members sign the confidentiality agreement

-Flight Team members create scripts for teachers to share announcement during class for students and drafts a letter home to be sent to families

-Flight Team create space in the building for a student centered “care room” as well as a staff centered space for support

-Flight Team member attends the school schedule of the student that passed away in order to provide extra comfort and support for the classes impacted

-Flight Team members manage the Care Room and students coming in and out through a sign in and sing out process

-Flight Team Coordinator coordinates with Instructional Coaches to offer breaks for teachers throughout the day

-Flight Team communicates with Principal and Flight Team Coordinator throughout the day regarding student/staff needs

-Flight Team convenes at the end of the day to debrief and plan accordinglyfor additional days of support if needed

-Principal schedules short debrief with all staff at the end of the day

After the Flight Team

-Flight Team Coordinator works with building administrator to determine if Lines for Life is needed for staff support

-Flight Team Coordinator reviews the notes from the staff debrief

-Flight Team Coordinator communicates with the principal to determine what further support is needed either in the building or for the family impacted, including plans for memorials

-Flight team members replenish supplies in the flight team boxes

-Flight Team Coordinator documents members that responded, so that new members can be prioritized during the next flight team response.

What is a Care Room?

Care rooms provide a space for students to grieve in community, process the traumatic event or other events that have been triggered by the current tragedy and care for one another while being supported by mental health professionals.

• Elements of a Care Room
• Sign In Sheet
• Water & healthy snacks available
• Activities
  • Cards for Family
  • Memory Cards
  • Banner to hang in hall or somewhere visible (optional)
• Connection
• Counselor check ins
• Behavior
  • It is important to keep the room safe for everyone. Creating a space for all kids to share and be respectful of each other. If a student needs to leave (could be because behavior is very disruptive or because they have spent much of their day in the room, consider finding an adult to meet with them 1- 1 to assess causes of behavior and possible support needed. This is not a time for discipline but rather talking through issues and drawing boundaries.

The guiding principle is that all deaths should be treated the same way.

Memorials:

District Crisis Response Leaders and School Administrators will address the content and timing of memorializing the event. Immediate issues, such as how to formally convey condolences to family survivors on behalf of the school, are appropriately addressed after receiving input from the school community.

Spontaneous memorials may be created by students. These memorials often are set up by a locker and/or school rock or such. Sometimes memorials are set up at the site where the death occurred. The school’s goals should be to balance the students’ needs to grieve with the goal of limiting the risk of inadvertently glamorizing the death. In all cases, memorializing will be considered equally among all sudden deaths.

Cultural / linguistic appropriateness:

■ Cultural considerations should be accepted and responders need to accommodate requests to the best of their ability.

Location:

■ Discourage requests to create and distribute t-shirts, buttons, etc. that bear the image of the deceased, this includes numbers on helmets or jerseys. This memorialization behavior glamorizes the sudden death.

■ Don’t sponsor vigils or permanent memorials on campus. Students may hold spontaneous gatherings or candlelight service. This would be a great role for any community clergy members who are part of the community crisis team.

■ Internal and external Mental Health professionals and/or law enforcement should be a supportive presence for individuals and groups.

■ Avoid locations such as cafeteria and entry ways - so that those who don’t wish to participate don’t have to. Oftentimes lockers are the key area for such memorialization but should not be cordon off which would merely draw excessive attention to it. Also consider students whose lockers are nearby, suggesting moving to a temporary locker elsewhere if needed. Preferably located close to the counselor’s office.

■ Emptiness of the deceased student’s chair can be unsettling and evocative, after approximately 5 days (or after the funeral), at that point it is suggested to set up a new seating arrangement to create a new environment. Teachers should always explain in advance that the intention is to strike a balance between compassionately honoring the student who has died while at the same time returning the focus back to the classroom curriculum.

Timing

■ Leave memorials in place until after the funeral or memorial service, up to approximately 5 school days. Items should then be removed and offered to the family after the district Crisis Response Team has read all items for appropriateness and to consider students at risk.

■ Avoid flying the flag at half-mass.

■ School assemblies solely for the purpose of suicide prevention, sudden death notification, or sudden death memorialization is not permissible due to the risk of increasing contagion.

Permanent Memorials and Scholarships

■ Some families and/or communities wish to establish a permanent memorial, sometimes physical, such as planting a tree or installing a bench or plaque; sometimes commemorative, such as a scholarship. All memorials are established off school grounds.

■ The school will not install a memorial. As difficult as this can be, schools can play an important role in channeling the energy and passion of the students and greater community in a positive direction, balancing the need to grieve with the impact that the proposed activity will likely have on students, particularly those who were closest to the student or staff member who died.

Safe memorialization ideas

■ Holding a day of community service or creating a school-based community service program in honor of the deceased. (great suggestion for athletic teams or other extracurricular groups)

■ Gifting the family with memories - Have students write down memories of the deceased and hand it into the school counseling office. School counselors will review the memories before giving them to the family.

■ Putting together a team to participate in an awareness or fundraising event sponsored by one of the national mental health or suicide prevention organizations; ie. Out of the darkness walks, or holding a local fundraising event to support a local crisis hotline or other suicide prevention program.

○ Sponsoring a mental health awareness day

○ Purchasing books on mental health for the school or local library

Funerals and Memorial Services:

■ When possible, services should occur at a location outside of the school. If that is not possible, hold the service outside of school hours. Encourage services to occur at a time when parents/guardians can accompany youth. Do not close school for a memorial service and it is encouraged to have additional counselors or crisis team members attend if possible.

■ Administration should ensure that there is school staff representation at all memorial services.

School Newspapers and Yearbooks:

■ So if there is a history of dedicating the yearbook (or a page of the yearbooks) to students who have died, that policy is equally applicable to a student who has died by suicide, provided that the final decisions are made by a school administrator.

■ Coverage of the student’s death in a school newspaper may be seen as a kind of memorial; also articles can be used to educate students about suicide warnings signs and available resources. All articles should be reviewed by a school administrator with the considerations of safe messaging practices. (see safe messaging document)

Events:

■ The student’s family or classmates may wish to dedicate an event (such as a dance, performance, concert, or sporting event) to the deceased. All deaths should be treated the same way.

■ Do not use the aftermath of a suicide death as a time to promote suicide prevention. Having speakers present to students about suicide actually puts high risk students at a higher risk of acting on their own suicidal thoughts.

Graduation:

■ Include the name of the deceased in the graduation program, along with the dates of his/her life. During the opening remarks by the administrator, a brief statement can be made acknowledging students who have died. All deaths should be treated the same way.

■ Empty chairs and portraits and tributes should not be part of the graduation ceremony.If it is customary to hang student collages during a celebratory event it is acceptable to have one of a deceased student as long as there is no reference to suicide or cause of death.

The guiding principle is that all deaths should be treated the same way.

At-risk: A student who is defined as high risk for suicide is one who has made a suicide attempt, has the intent to die by suicide or has displayed a significant change in behavior suggesting the onset or deterioration of a mental health condition. The student may have thought about suicide including potential means of death and may have a plan. In addition, the student may exhibit feelings of isolation, hopelessness, helplessness, and the inability to tolerate any more pain. This situation would necessitate a referral, as documented in the following procedures.

Flight Team/Crisis Team: A multidisciplinary team of primarily administrative, mental health, safety professionals, and support staff whose primary focus is to address crisis preparedness, intervention/response, and recovery. These professionals have been specifically trained in crisis preparedness through recovery and take a leadership role in developing crisis plans, ensuring school staff can effectively execute various crisis protocols and may provide mental health services for effective crisis interventions and recovery supports.

Mental Health: Someone’s state of being in regard to their emotions and feelings. Everyone has mental health! Mental health is a spectrum and can present strengths and challenges at all stages of life. The Oregon Department of Education specifies that “mental health is grounded in four, interconnected pillars of practice: Trauma Informed Care, Social Emotional Learning, Racial Equity, and Strengths-Focused, Evidence-Based or Field Tested Prevention and Intervention programs.”

Protective Factors: Parts of someone’s life experience that might increase their ability to cope with stressors. Examples of protective factors are a stable home environment, presence of supportive adults, and financial stability.

Risk Factors: Parts of someone’s life stressors or the oppression experienced by a part of their identity that might increase their likelihood of thinking about suicide. Examples of risk factors may include trauma exposure, being LGBTQ+, and experiencing a recent loss.

Safe Reporting: The way that media outlets, reporters, and others can safely share news that someone has died by suicide. Safe reporting can help reduce the risk of suicide contagion and/or cluster in a community. Examples of safe reporting practices include not sharing the means of death, avoiding sensationalizing the death, and including resources for community members to get help if needed.

Self-Harm: Behavior that is self-directed and deliberately results in injury or the potential for injury to oneself. It can be categorized as either nonsuicidal or suicidal. Although selfharm often lacks suicidal intent, youth who engage in self-harm are more likely to attempt suicide.

Stigma: A mark of shame or a negative perception of a societal topic due to a combination of lived experience, culture, and belief systems in communities. Mental health topics are stigmatized, with societal messages such as those that live with mental illness are weak, dangerous, or unstable.

Suicide: Death caused by self-directed injurious behavior with any intent to die as a result of the behavior. Note: The coroner’s or medical examiner’s office must first confirm that the death was a suicide before any school official may state this as the cause of death.

Suicide Attempt: A self-injurious behavior for which there is evidence that the person had at least some intent to kill himself or herself. A suicide attempt may result in death, injuries, or no injuries. A mixture of ambivalent feelings such as wish to die and desire to live is a common experience with most suicide attempts. Therefore, ambivalence is not a sign of a less serious or less dangerous suicide attempt.

Suicidal Behavior: Suicide attempts, intentional injury to self, associated with at least some level of intent, developing a plan or strategy for suicide, gathering the means for a suicide plan, or any other overt action or thought indicating intent to end one’s life.

Suicide Contagion/Clusters: The process by which suicidal behavior or a suicide influences an increase in the suicidal thoughts or behaviors of others. Guilt, identification, and modeling are each thought to play a role in contagion. Although rare, suicide contagion can result in a cluster of suicides.

Suicidal Ideation: Thinking about, considering, or planning for self-injurious behavior which may result in death. A desire to be dead without a plan or intent to end one’s life is still considered suicidal ideation and should be taken seriously.

Suicide Prevention: The intentional steps that your school takes to create a school culture that encourages positive coping skills, reaching out for help with mental health, and talking about suicide in a safe and healthy way. Examples of suicide prevention include mental health education, staff training, and mental health awareness campaigns.

Suicide Intervention: The intentional steps that your school and its staff take in the event of a student mental health crisis. Examples include written procedures, safety planning, parental involvement, and emergency services. Suicide Postvention: Suicide postvention is a crisis intervention strategy designed to reduce the risk of suicide and suicide contagion, provide the support needed to help survivors cope with a suicide death, address the social stigma associated with suicide, and disseminate factual information on the suicide death of a member of the school community.

Suicide Screen/Risk Assessment: An evaluation of a student who may be at risk for suicide, conducted by the appropriate school staff (e.g. school counselor, or school social worker). This assessment is designed to elicit information regarding the student’s intent to die by suicide, previous history of suicide attempts, presence of a suicide plan and its level of lethality and availability, presence of support systems, and level of hopelessness and helplessness, mental status, and other relevant risk factors.