Assessing School-Based Suicide Prevention and Intervention Capacity

Background:

Suicide is a leading cause of death for adolescents in the United States and is a growing issue among children under twelve years of age. Patterns of suicidal ideation and behaviors by children and adolescents vary by ethnicity and socioeconomic status. As children and adolescents spend most of their time at school, school staffs are at the frontlines of suicide intervention and prevention.

Despite a plethora of school suicide-related initiatives, there is a minimal research on the implementation capacity of schools. School-based implementation capacity involves the resources, policy, and staff with the awareness, skills, and knowledge to identify, intervene, and monitor students at-risk for suicide. This study present early estimates on the implementation capacity of schools for suicide prevention and intervention by the socioeconomic status and ethnicity of school student.

Methods:

This study is part of statewide project to examine schools’ suicide intervention and prevention initiatives and resources and was conducted in the Midwest in 2018. School staff members and affiliates were recruited via convenience sampling and provided written consent to complete an on-line survey. The final sample (N=166) included employees of predominantly urban schools. The authors selected items specific to school capacity for suicide prevention and intervention for descriptive and chi-square analyses.

Results:

Most respondents were school counselors (99, 59.64%) who worked at the elementary school level (57, 44.53%), and at school were the students were predominantly White (78, 53.79%), but of lower income (96, 67.13%). Approximately 53% (85) of respondents’ schools did not have in-house mental health services, while nearly 73% (61) had a school resource officer (SRO). More respondents reported that their school had policy for suicide intervention (80, 63.49%) than prevention (61, 54.95%). Fewer respondents reported that their school monitored at-risk students (22, 53.66%), peers (11, 18.97%) and staff (24, 42.11%) trained as gatekeepers (a first line of intervention), and suicide trends on campus (16, 28.07%).

Chi-square results yielded predominantly ethnic minority schools were significantly more likely to report having in-house mental health services than predominantly White schools (χ ²(1) =7.939, p <.01). Predominantly White schools were significantly more likely to have an SRO (χ ²(1) =10.375, p <.01) and an SRO trained in suicide intervention (χ ²(1) =7.323, p <.01). Participants from predominantly White schools were more likely to agree that their school had a suicide prevention policy (χ ²(2) =6.681, p <.05). We found no significant differences in suicide prevention capacity by the school’s socioeconomic status. 

Conclusions:

The results demonstrate variability in schools’ current capacity to implement suicide prevention and intervention, especially by the predominant ethnic composition of students at the school. Gaps in access and knowledge of training, monitoring, and policy suggests that staff are poorly equipped to address student's suicidality. The results also suggest that schools serving predominantly ethnic minorities may have less capacity than White schools to support suicidal students. Given the recent increases in suicide among ethnic minority children and adolescent, future research should focus on the capacity for suicide intervention and prevention within schools that serve vulnerable youth.