from the school psychologist from the school psychologist

t is among a principal’s worst fears: a student has committed . Bullying and In the hours that followed the call from local law enforcement officials, IPrincipal Green reviewed his crisis plan and prepared to summon his Youth Suicide: team and inform his staff members, students, and parents. But nothing had prepared him for the second call when police informed him they were about Breaking the to arrest five of his students. The deceased student had left a note indicat- ing that she had been a victim of prolonged, torturous cyberbullying. Her text Connection messages, e-mail, and social network postings strongly implicate the five students facing arrest. Now what?

How school leaders respond to the suicide The suicide of a student is one of the the fourth leading cause of death for most tragic—albeit rare—events to middle school youth (ages 10–14) of a student will help which a school administrator must in the (Xu, Kochanek, determine the depth and respond. It requires balancing the Murphy, & Tejada-Vera, 2010). duration of its impact on grief of students and staff members Bullying is predatory and antago- the school community. and their desire to remember the nistic behavior that contributes to the deceased with the risks of contagion silent misery of millions of students that can result from paying a suicide and puts some at increased risk for too much attention. The challenges suicidal thoughts and behaviors (Cen- By Richard Lieberman and are greatly compounded when the ters for Disease Control and Preven- Katherine C. Cowan student’s death is linked to bullying tion, n.d.; Hinduja, & Patchin, 2010). by fellow students. Concern about Bullying also undermines the quality Richard Lieberman is a school psychologist and the prevalence of bullying behavior of the learning environment for all suicide expert with Los Angeles Unified Public among students and the responsibil- students. Anyone can be a target of Schools. ity of the school to prevent or stop it bullying, but certain populations Katherine C. Cowan is director of communications can collide with postvention efforts to of students are especially vulner- for the National Association of School Psychologists. support students in need and maintain able to developing a positive learning environment. and behaviors as a result of bullying: A principal can greatly mitigate students who are being cyberbullied; the potential negative consequences students with disabilities and mental of in his or her health problems; and students who school by understanding the behav- are , , bisexual, transgender, iors; how they are linked; and most and questioning (LGBTQ). importantly, the role of the school in Cyberbullying victims are almost preventing both. twice as likely to attempt suicide as youth who have not experienced be- Context ing bullied online (Hinduja & Patchin, Created in collaboration with the Although recent headlines suggest 2010). LGBTQ youth often face par- National Association of School that youth suicide is epidemic, the ticularly intense pressures, including Psychologists (NASP) to facilitate reality is that the suicide rate for family rejection (Ryan, Huebner, Diaz, partnerships between principals youth in the United States has steadily & Sanchez, 2009), that put them at and school psychologists and declined over the last two decades. risk for increased suicidal ideation to remove barriers to learning. efforts have and attempts and are bullied at school Additional resources are available at www.nasponline.org/resources/ proven successful, but suicide remains at a higher rate than their peers. In principals. the third leading cause of death for the 2009 National School Climate high school youth (ages 15–19) and Survey (Kosciw, Greytak, Diaz, &

12 z Principal Leadership z october 2011 Bartkiewicz, 2010), 84.6% of LGBTQ victimization increases risk of ideation students reported being verbally ha- but not attempts. rassed, 40.1% reported being physi- All evidence asserts that children cally harassed, and 18.8% reported and teens who are frequently involved that they were physically assaulted in bullying behavior either as victims at school in the past year because of or as perpetrators should be actively their sexual orientation. screened for mental health problems (Klomek et al., 2009), and school The Link Between Bullying mental health professionals should and Suicide collaborate with district and com- The sheer number of students who munity mental health professionals to report being bullied compared with ensure follow-up treatment. those who actually die by suicide im- plies a correlation, rather than a direct Prevention causal relationship, but the difference Just as the risks of bullying and suicide in terms of concern for schools is ir- are intertwined, prevention of both relevant. Research strongly supports behaviors involves many related prin- the view that all forms of bullying ciples and strategies. and peer victimization are clear risk Establish a positive, supportive factors for depression and suicidal school culture in which bullying and thinking. harassment of any type is unac- Bullying is predatory Adolescents frequently cite in- ceptable. This should include stated and antagonistic behavior terpersonal problems as a precipitant policies and positive affirmations of of suicidal behavior and, relevant to respect, caring, and inclusion of all that contributes to the the issue of loss as a trigger, bullying students. Policies should be devel- silent misery of millions of causes a substantial loss of dignity and oped by students, staff members, and humanity. The likelihood of suicidal parents and should include expected students and puts some at ideation or behavior goes up when behaviors and consequences as well as increased risk for suicidal there are co-existing risk factors. Girls specific policies that address cyberbul- are particularly at risk if they are lying. Adults should model appropri- thoughts and behaviors. suffering depression and are self-med- ate behaviors and intervene immedi- icating with alcohol, drugs, or other ately when they see bullying behavior. substances. Boys are at greater risk if Strengthen connections between they are depressed and have a conduct students and adults. Ensuring that ev- disorder (Lieberman, Poland, & Cassel, ery student is intentionally connected 2008). to at least one trusted adult in the Bullies and victims demonstrate building is paramount. Adults must higher levels of suicidal ideation and emphasize that no student should attempts in all settings (e.g., home and suffer unnecessarily and that students school) and all ages. Overall, adoles- should feel safe seeking help if they cents are at greater risk for suicidal feel that they are at risk from others, thoughts and behaviors if they have are depressed, or have thoughts of been both bullies and victims. Girls suicide. and boys have markedly different risk Train staff members. Staff mem- profiles. For girls, risk of ideation and bers should be trained to recognize attempts increases with frequency and respond to students who indicate of victimization; for boys, frequent that they are struggling. Training

october 2011 z Principal Leadership z 13 from the school psychologist from the school psychologist

Prevalence in School- should include learning clear protocols referrals to community mental health Age Children and Youth for reporting bullying behavior and providers. The school-based providers how and when to refer students who also help link mental health supports Bullying exhibit suicide risk to school mental to improved school engagement and n 7%–28% of students engaged health staff members or designated learning and facilitate collaboration in bullying behavior (Hinduja & administrators. between the school, the family, and Patchin, 2010) Educate and empower students. private mental health providers. n 11%–33% were victimized by Key messages should be framed in the Protect particularly vulnerable stu- bullies (Hinduja & Patchin, 2010) context of how students contribute to dent populations. Students with spe- n 19.9% felt bullied on school a safe and caring school community. cial needs and LGBTQ students need campus (Centers for Disease Information should address both bul- additional protection. Students with Control, n.d) lying and suicide prevention strate- special needs should be receiving sup- n 9.8% were hit or physically hurt gies as well reinforce tolerance for port through their IEPs that includes by a boy- or girlfriend (Centers diversity and individual differences. adult mentorship and skills building. for Disease Control, n.d) All students should understand the LGBTQ students may not have this difference between reporting and rat- structured support and might ben- Suicide ting and have an anonymous means of efit from belonging to a gay-straight n 1,661 10- to 19-year-olds reporting their concerns if they don’t alliance or similar clubs. Schools can died by suicide in 2007 (Xu, feel comfortable going directly to an contact the Gay, Lesbian, Straight Kochanek, Murphy, & Tejada- adult. Education Network (www.glsen.org) Vera, 2010) Reinforce positive behaviors to to obtain Safe Space Kits, which help n 100–200 estimated youth replace bullying behaviors. Bully- educate school staff members and in- suicide attempts are made per ing is a learned behavior that can be clude resources to ­visibly demonstrate completion (Xu et al., 2010) unlearned. Using positive behavior support for ­LGBTQ students. n 13.8% seriously considered supports to teach appropriate replace- Improve school, family, and com- suicide in past year (Xu et al., ment behaviors has proven to decrease munity collaboration. Because bully- 2010) bullying and other negative behaviors ing is associated with many other risk n 6.3% reported one or more in students. Some specific strategies, factors, including exposure to suicide attempts in past year (Xu such as positive behavior interventions outside of the school setting, compre- et al., 2010) and supports (www.pbis.org), include hensive strategies that encompass the References establishing a positive, predictable school, the family, and the commu- n Centers for Disease Control and school culture for all students across nity are most likely to be effective. Prevention. (n.d.). 1991–2009 high all settings; teaching social skills that The Centers for Disease Control has school youth risk behavior survey data. work as well as or better than problem launched Striving To Reduce Youth Retrieved from http://apps.nccd.cdc behaviors; reinforcing the positive Violence Everywhere (STRYVE), a .gov/youthonline behavior of bystanders; and actively national initiative to promote in- n Hinduja, S., & Patchin, J. W. (2010). supervising students and individual- creased awareness that youth violence Bullying, cyberbullying and suicide. izing support systems. can be prevented and provide an Suicide Research, 14(3), 206–221. Ensure access to mental health array of evidence-based strategies for n Xu, J. A., Kochanek, K. D., Murphy, S. L., & Tejada-Vera, B. (2010, May). services and supports. School-based schools and communities (www.cdc Deaths: Final data for 2007. National mental health services provided by .gov/violenceprevention/stryve). Vital Statistics Reports, 58(19). Retrieved school psychologists, school counsel- Create a specific plan for suicide from www.cdc.gov/nchs/data/nvsr/ ors, and school social workers are the prevention, intervention, and postven- nvsr58/nvsr58_19.pdf front line of support for students who tion. Being prepared for the worst are at risk of suicidal ideation and is essential. Any plan should include attempts. Services include assessment creating a suicide task force; provid- and identification, counseling, and ing gatekeeper training for all school

14 z Principal Leadership z october 2011 What Causes Suicide?

No one factor or event causes suicide, but schools play a thinking about suicide to attempting suicide in less than vital role in identifying students who are at risk. Imagine the four minutes, especially if there is a gun or rope around seven risk factors—history of substance abuse, conduct (Shenassa, Rogers, Spalding, & Roberts, 2004). Because disorder or depression, access to such items as firearms accurately predicting exactly when all the lights will turn or ropes, internal and external protective factors and green for any particular adolescent is nearly impossible, vulnerabilities, hopelessness, and impulsiveness—as being schools must be able to identify all potential risk factors seven traffic lights. For an adolescent to go from thinking and be vigilant about responding to all students, even about suicide to attempting suicide, all of the lights must those who have been assessed to be low risk. turn green at the same time. References Usually, it takes a trigger or a precipitating event to flip the n Kalafat, J., & Lazarus, P. J. (2002). Suicide prevention in schools. In S. E. Brock, P. J. Lazarus, & S. R. Jimerson (Eds.), switch, which is often mistakenly labeled the “cause” of Best practices in school crisis prevention and intervention the suicide. Research indicates numerous precipitating (pp. 211–224). Bethesda, MD: National Association of School events that could spark suicidal ideation, but for youth, Psychologists. triggers most often involve a loss of some kind, such n Shenassa, E. E., Rogers, M. L., Spalding, K. L., & Roberts, M. as the death of a loved one, a romantic breakup, or an B. (2004). Safer storage of firearms at home and risk of suicide: A academic or disciplinary crisis at school (Kalafat & Lazarus, study of protective factors in a nationally representative sample. 2002). Once all the lights turn green, a youth can go from Journal of Epidemiology & Community Health, 58(10), 841–848.

staff members; proactively identify- impact on the school community ing depressed students through such (including staff members and screening programs as the SOS (Signs parents). of Suicide) Program (www.mental n If possible, inform staff members healthscreening.org) or TeenScreen personally in a staff meeting be- (www.teenscreen.org); developing fore informing students. clear procedures for intervening with n Contact the victim’s family to suicidal students; improving collabora- offer support and determine their tion with law enforcement officials preferences for students’ outreach, Because bullying is and community agencies; and plan- expressions of grief, and funeral associated with many other ning procedures for the aftermath of arrangements and attendance. a suicide. n Determine what and how infor- risk factors…comprehensive mation is to be shared, conferring strategies that encompass The Unthinkable with the family and law enforce- Even the most comprehensive and ment officials. Never speculate. the school, the family, and the caring bullying and suicide prevention Always tell the truth. community are most likely to plan may not prevent a tragedy. The n Inform students through discus- following steps can serve as a check- sions in classrooms and smaller be effective. list for schools when the unthinkable venues, not assemblies or school- happens: wide announcements. n Activate the school crisis team. n Identify youth who are at risk of Verify the death and assess its suicidal behavior. The suicide of

october 2011 z Principal Leadership z 15 from the school psychologist from the school psychologist

What Next? n Memorials are not recommended of the case (e.g., where the bullying for deaths due to suicide, but if took place and whether or not school To foster an increased awareness there is strong consensus to do so, officials were made aware of it). In of the link between bullying and advocate for appropriate expres- addition to cooperating with law suicide, every principal should work sions of remembrance. Do not enforcement officials, school leaders with staff members to answer the dedicate a memorial (e.g., a tree, should follow school policies related following questions: a plaque, or a yearbook). Do con- to bullying. School leaders should tribute to a suicide prevention ef- meet with and listen to the accused n Are we doing enough to prevent fort in the community or establish students and their families; reinforce bullying among our students? a living memorial (e.g., a student behavior expectations and policies; n Do our students genuinely assistance program). and if out-of-school suspension is believe that bullying is wrong and n Excessive media coverage of warranted, work with their school adults care enough to stop it? a suicide can lead to copycat psychologist to ensure that students How do we find out? behaviors. Reporters should be have access to continued education in n Do staff members fully encouraged to follow the advice an alternative setting. understand the risks of a student in Recommendations for Reporting Members of the school crisis team suicide and how to respond on Suicide, which was developed should broaden the scope of students appropriately to facilitate healing by the American Association of they think may be at risk to include and reduce copycat behavior? , the American Foun- those who are friends of the accused dation for Suicide Prevention students and those who might have n Are we communicating effectively (AFSP), and the Annnenberg been involved bystanders. School lead- about bullying and suicide Public Policy Center, among oth- ers must be willing to take an honest to students, staff members, ers (http://www.afsp.org/files/ look the school climate and the effec- families, and the community? Misc_/recommendations.pdf). tiveness of bullying policies. In addi- n Am I prepared to communicate The recommendations include tion, school leaders are responsible for with the school community when not making the suicide front-page communicating with the school com- these two issues collide? news or publishing a picture of the munity. Rumors, misinformation, and deceased, but instead emphasizing blame are a serious risk in the already suicide prevention, recognition of emotionally fraught aftermath of a warning signs, and where to go for student’s death. (See Talking Points at peer can trigger other . help. www.nassp.org/pl1011Lieberman Work with mental health staff n Evaluate the crisis response. _talkingpoints.) members to identify students A toolkit is available from the AFSP There is no easy answer when a who may be at risk. At particular and the Suicide Prevention Resource student dies by suicide, particularly if risk are students who might have Center that will help schools in the bullying by fellow students plays a role. facilitated the suicide, who failed aftermath of a suicide. It includes an Prevention should always be a prior- to recognize or ignored warn- overview of key considerations; general ity. If a tragedy occurs, however, how ing signs, or who had a relation- guidelines for action, both what to do school leaders respond can make the ship or identify with the victim. and what not to do; and templates and difference between limiting the scope Provide support and referral when sample materials (www.sprc.org/after and duration of the crisis and allowing ­appropriate. asuicideforschools.asp). it to put additional students and the n Focus on survivor coping and ef- entire school environment at risk. PL forts to prevent further suicides. When Bullying Is Involved This is a time for key prevention A confluence of challenges will arise References information. Emphasize that no if bullying is suspected of contribut- n Centers for Disease Control and Preven- one thing or person is to blame ing to a student suicide. Potential tion. (n.d.). 1991–2009 high school youth and that help is available. legal issues depend on the specifics risk behavior survey data. Retrieved from

16 z Principal Leadership z october 2011 Resources

Center for Safe and Responsible Internet Use http://cyberbully.org/

Engaging the Media After a Suicide www.sprc.org/library/media http://apps.nccd.cdc.gov/youthonline tion. In A. Thomas & J. Grimes (Eds.), _guide.pdf n Hinduja, S., & Patchin, J. W. (2010). Best practices in school psychology V: Vol. IV. Los Angeles County Suicide ­Bullying, cyberbullying and suicide. Suicide Enhancing the development of wellness, social Prevention Project Research, 14(3), 206–221. skills, and life competencies (Section V, pp. http://preventsuicide.lacoe.edu n Klomek, A. B., Sourander, A., Niemela, 1457–1473). Bethesda, MD: National As- National Association of School S., Kumpulainen, K., Pima, J., Tamminen, sociation of School Psychologists. Psychologists T.,...Gould, M. S. (2009). Childhood bully- n Ryan, C., Huebner, D., Diaz, R. M., & http://nasponline.org ing behaviors as a risk for suicide attempts Sanchez, J. (2009). Family rejection as a National Suicide Prevention Lifeline and completed suicides: A population- predictor of negative health outcomes in 800-273-TALK (8255) based birth cohort study. Journal of the White and Latino lesbian, gay, and bisexual Stop Bullying Now American Academy of Child & Adolescent young adults. Pediatrics, 123, 346–352. http://stopbullyingnow.hrsa.gov/ Psychiatry 48(3), 254–261. n Xu, J. A., Kochanek, K. D., Murphy, S. index.html n Kosciw, J. G., Greytak, E. A., Diaz, E. L., & Tejada-Vera, B. (2010, May). Deaths: M., & Bartkiewicz, M. J. (2010). The 2009 Final data for 2007. National Vital Statistics Suicide Prevention Resource Center http://sprc.org national school climate survey: The experi- Reports, 58(19). Retrieved from www.cdc ences of lesbian, gay, bisexual and transgen- .gov/nchs/data/nvsr/nvsr58/nvsr58_19.pdf Suicide Prevention Resource der youth in our nation’s schools. New York, Center: Best Practices Registry Editor’s note: Additional Principal Leadership NY: GLSEN. www2.sprc.org/bpr/index articles that were developed with NASP on suicide n Lieberman, R., Poland, S., & Cassel, R. and bullying are available at www.nassp.org/ Trevor Project (2008). Best practices in suicide interven- pl1011Lieberman_links www.thetrevorproject.org

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