
                                                                  
           HIGH SCHOOL SUICIDE CRISIS INTERVENTION                           

                             By

                       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
