N.E.A.T. TEAM PROVIDES ASSISTANCE TO NEBRASKA SCHOOL
DISTRICT EXPERIENCING MULTIPLE SUICIDES

By Scott Poland

The Millard School District located in suburban Omaha unfortunately has experienced multiple suicides of high school students during the 2003-2004 school year.  Liz Carey, school psychologist and member of the district’s crisis team in Millard, recommended that the district contact N.E.A.T. Team member Scott Poland for advice and direction. 

In addition to providing extensive phone consultation, Scott inquired at the U.S. Department of Education’s Office of Safe Schools about the availability of Project S.E.R.V. funds for the beleaguered district.  Project S.E.R.V. is an acronym for schools emergency response to violence and has previously provided funds to schools affected by school shootings or terrorist attacks such as 9-11-01.  Assistant Secretary of Education Bill Modzeleski encouraged Millard Schools to apply for a $50,000 short-term assistance grant, which they have done, and if approved will provide the following:

·        Cover expenses for N.E.A.T. Team members to provide onsite assistance.

·        Purchase S.O.S. (Signs of Suicide) materials for use in the district.

·        Employ part-time counselors to provide additional services to students.

·        Conduct a community-wide suicide prevention presentation.

N.E.A.T. Team members Scott Poland and Richard Lieberman provided extensive phone and e-mail consultation and then conducted training and planning meetings in Omaha on January 19-20, 2004.  Both Scott and Rich have provided guidance to a number of school systems that have experienced suicide contagion or suicide clusters.  They are the authors of “Best Practices in Suicide Intervention” in NASP Best Practices IV, and they have authored numerous other publications, provided hundreds of presentations on this topic, and worked in many postvention situations.  Scott’s first book, Suicide Intervention in the Schools, was published in 1989 and has been translated into several languages.

The crisis response conducted by the Nebraska school district subsequent to each suicide was a best practices approach that modeled NASP and American Association of Suicidology guidelines, with the district being very careful not to glorify the actions of the suicide victim(s) in any way.  Crisis team members immediately reached out to the victims’ close friends and family members and this included working over the weekends on several occasions.  The deaths were acknowledged as suicides without further explanation of why they occurred.  In addition, it was emphasized that no one was to blame nor were there simple explanations for the tragedies.  Emphasis was placed on helping students to cope with the loss and to know the warning signs as well as the importance of seeking adult help to prevent further suicides.  A wallet-sized card containing these points and the local crisis hotline number was developed and distributed to all secondary students.

Scott and Rich were kept very busy during their stay in Omaha January 18-20, 2004, beginning with a planning meeting with key Millard staff members that was held Sunday night, January 18.  On Monday, a scheduled inservice day for Millard staff members, they presented to approximately 1800 employees in 1½-hour sessions that focused on:

·        Warning signs of youth suicide, including precipitating events.

·        The importance of working as a team.

·        Helping students cope with grief.

·        Building resiliency skills.

·        Increasing positive connections between students and the adults in their lives.

·        Reducing gun access to troubled teens.

·        Protective factors that reduce youth suicide.

·        Reducing substance abuse problems in teenagers.

Scott and Rich also provided an intensive three-hour session for school district crisis team members on Monday afternoon.  On Monday evening they led a session that was attended by nearly 400 parents and that covered many of the points listed above.  Tuesday consisted of two half-day presentations for building administrators and school support personnel such as counselors, nurses, school psychologists and social workers.  In addition, the district crisis team held a planning meeting and raised a number of questions which were addressed in the large group with all administrators and support staff.  All sessions were evaluated, and positive feedback was received from the participants. 

The Center for Disease Control (CDC 1997) has been studying suicide clusters or contagion since four teens died as a result of a suicide pact in Bergenfield NJ in 1988.  Cluster or contagion is defined as more suicides or suicide attempts than are to be expected in a community.  Well documented in the research is the fact that teenagers are the most susceptible to suicide contagion.  The American Association of Suicidology (1998) and the Center for Disease Control (1997) have both emphasized that media coverage -- especially front-page coverage -- of a youth suicide, details of the method used, simplistic explanations of the cause of suicide, and printing a photo of the suicide victim are key contributors to contagion.  The literature also contains numerous references that once a community has experienced one youth suicide that the chances of a second occurrence increase greatly.  The following is information that has been summarized (Poland & McCormick, 1999) about communities that have previously experienced suicide clusters:

·        Little community awareness of youth suicide.

·        Rapid growth in the community.

·        Substance abuse problems.

·        Massive schools.

·        Lack of a sense of belonging.

·        Material emphasis.

·        No crisis center and limited community mental health resources.

Important research continues in the area of suicide contagion.  There are unfortunately several thousand youth suicides per year in our country and some of them will be close in either proximity, time or physical location.  A recent study found that adolescent boys and girls are both very affected by the suicide of a friend or classmate, and girls are especially prone to suicide if isolated from peers.

The risk factors that might cause a young person to imitate another person who died by suicide were outlined by Brock (2002).  Young people who experienced the following are increasingly at risk:

·        Facilitated the suicide.

·        Failed to recognize warning signs.

·        Close relationship with suicide victim.

·        Viewed suicide victim as role model with parallel circumstances to their own life.

·        Previous history of suicide attempts or psychopathology.

·        Have suffered significant losses.

The suicide of a young person has been compared to a rock being thrown into a pond with a ripple effect in the schools, churches and community.  Being personally acquainted with the suicide victim is not necessarily a prerequisite for a young person to become more suicidal.  Poland (1989) emphasized that postvention activities designed to prevent further suicides cannot concentrate only on the close friends of the suicide victim but must also include other students either known to be suicidal or to have their own tragic life circumstances.

One very promising preventive strategy that is especially important in a contagion situation is the SOS -- Signs of Suicide -- screening program which is designed for secondary students.  Its two main components are:

1.      A 30-minute educational video that emphasizes the warning signs of suicide and stresses to students the importance of getting adult help and utilizing local and national crisis hotlines.

2.      A short screening questionnaire for completion by the students themselves and/or their parents.  This questionnaire identifies students who are potentially at risk for suicide and therefore must be considered candidates for a thorough assessment and intervention.

With suicide being the third leading cause of death for teenagers, the SOS program is being recommended for regular use in all secondary schools.  NASP and the National Association of Secondary School Principals are sponsors of the program and are encouraging that more schools use it on a regular basis.  However, there are three major barriers to its usage in schools being more widespread:  Denial of the problem of youth suicide, taking away from academic instruction time, and cost.  Information about the program is available at www.mentalhealthscreening.org.

Scott and Rich will return to Omaha to present at a community-wide forum on March 12, 2004.  Members of the Millard district crisis team will also present important information concerning the lack of mental health resources in their community.  Like many states, Nebraska has experienced budgetary problems and has closed some mental health facilities including one in Omaha that provided needed services to Millard students and their families.  The focus of this community presentation will also be to share CDC postvention recommendations that emphasize the following:

·        Planning must involve all aspects of the community including hospital and emergency personnel, community mental health, local and state agencies, clergy, school leaders, parent groups, survivor groups, police, media and crisis hotline personnel.

·        A public response must minimize sensationalism, avoid glorification but include prevention information and community resources.

·        Evaluating and counseling close friends of the victims and those known to be suicidal.

·        Restricting young people’s access to lethal means in the community.

The Millard school district is to be highly commended for all their efforts to assist staff and students to cope with the multiple suicides that plagued their community.  The school district is determined to get the best possible advice to do whatever it takes to prevent additional tragedies.  They are to be complimented in particular for their willingness to share their tragic experiences so that others may learn. 

The most common factors in youth suicide are depression or some other form of mental illness, substance abuse, gun access, and a precipitating event such as a severe argument with a loved one or loss of a relationship.  Greater awareness of the warning signs is the key to prevention along with increased availability of mental health services for young people.  Important research on the problem of suicide contagion also continues.  There is a great deal of information about suicide prevention on the NASP website at www.naspweb.org Youth suicide is no one’s fault, but it is everyone’s fault.  If you have thoughts about this article, please contact Scott Poland at PolandNASP@aol.com

 REFERENCES

American Association of Suicidology. (1998). Suicide postvention guidelines. Suggestions for dealing with the aftermath of suicide in the schools. Washington, DC: Author.

Brock, S. (2002).  School suicide postvention. In S.E.Brock, P.J. Lazarus, & S.R. Jimerson, Best practices in school crisis prevention and intervention. Bethesda, MD: National Association of School Psychologists.

CDC (1997). Youth suicide resource guide. Available at www.cdc.gov .

Poland, S. (1989).  Suicide intervention in the schools.  New York: Guilford Press.

Poland, S., & Lieberman, R. (2002). Best practices in suicide intervention.  In  A. Thomas, & J. Grimes (Eds.), Best practices in school psychology IV, pp.1151-1166).  Bethesda, MD: National Association of School Psychologists.

Poland, S., & McCormick, J.S. (1999). Coping with crisis: Lessons learned. Longmont, CO: Sopris West.