What if the unthinkable happens?

Even after my long flight yesterday I’m not prepared to say the ‘j’ word… Let’s just say I’m feeling a little tired 🙂 (weary? exhausted? zonked?) However, I couldn’t go to bed tonight without writing about the two incredible meetings I had today here in Los Angeles – making that long flight oh so worth it.

The first meeting was with Richard ‘Rich’ Lieberman, Coordinator of the Suicide Prevention Unit for the Los Angeles Unified School District. In short, when it comes to anything suicide related in LA schools, Rich is the go-to man, and has been for many years, pioneering the strategies that have been implemented in all areas of youth suicide prevention, intervention and postvention. This is no small feat – the district of California is the second largest in the US (New York being the biggest) and has over 800000 students. Rich has been on several steering committees (including the committee for the SPRC – Suicide Prevention Resource Centre) and done a range of consultancy work in other districts, assisting them to improve their strategies. He has also contributed chapters to a range of publications, documents and resources on several topics including crisis management and a Toolkit for use in schools in the unfortunate circumstance where a student chooses to end their life. Much of his recent time and energy has been dedicated to developing the content for the Los Angeles County Youth Suicide Prevention Project. This website contains a range of useful resources for administrators, teachers and parents. I urge you, take a look.

We spent a solid block of time together, discussing everything from preventative strategies including Gatekeeper training, risk assessment screening, hotlines, means reduction – right through clusters, contagion, media intervention and how best to support those students and families bereaved by suicide. Some clear points for consideration:

– A planned and collaborative approach is necessary when dealing with the issue of suicide with students.

– Schools should have a clear and well defined crisis management plan, so that all staff know protocols and appropriate response should the community be bereaved by suicide

– Research shows that those exposed to suicide are more likely to engage in suicidal ideation later in life. In the event of suicide, support must be appropriate, timely and consistent for all members of the community – including staff.

– Recent trends in the way of approaching suicide is shifting – the need for us to be mindful of the language we use around suicide prevention is becoming more evident. Messages should be focussed on the idea that suicide is preventable, that everyone can play a role in prevention and that there are evidence based treatments for all of the risk factors that come with suicidal thoughts and behaviours.

– The need for some level of Gatekeeper training for staff working with young people is obvious and essential. In New Jersey, teachers are required to do a minimum two-hour training course every five years on suicide prevention in order to maintain their licence to teach. New Jersey has one of the lowest suicide rates for young people in the US.

– It is evidentially clear now that talking about suicide appropriately with young people does not increase the likelihood of suicidal behaviour – this is a myth and the taboo and stigma around youth mental health and suicide is very damaging. Where possible, teachers need to feel confident to be able to speak to young people about this topic – appropriate training is needed in order to improve teacher confidence in this taboo area.

– in the event that suicide does occur it is important to acknowledge that there is never one definitive cause for suicide and it is not a matter of laying ‘blame’ or directing ‘responsibility’. The causal factors are always complex and interconnected. A collaborative approach is certainly best when dealing with intervention and postvention. Never make a decision in isolation without consulting with other members of the case management team and never give out any information unless you are certain that it is 100% accurate.

In summary, schools need to have a clear ‘prevention’ strategy and then a clear ‘intervention/postvention’ strategy that is known by all staff and part of ongoing training and discussion. Rich provided me with a range of resources and training modules that have been implemented and rolled out to a number of staff in the LA United District Schools – much of which could be adapted to the Australian context for use in NSW Schools.

Aside from his incredible depth of knowledge stemming from his years of experience, Rich is warm, inviting and he acts as a mentor to principals, school psychologists and teachers. One primary example is Lea Howell, who I visited after meeting with Rich. Lea is the School Psychologist at Crescenta Valley High School, which is situated just north of Los Angeles. This comprehensive High School is home to approximately 2800 students from the local surrounding suberbs. Walking through the corridors today after the final bell, it struck me how similar young people are. As I caught snippets of conversations from groups of teens as they made their way to the distinct yellow school buses and the pick up zone out front, I could have easily been mistaken for thinking I was back home at John Therry CHS – if it wasn’t for the American accents and the absent uniform requirement (it’s hard to get used to seeing students in casual clothing at school – I’m too used to saying ‘tuck your shirt in mister!’). Intrinsically, in my experience from Sydney to Dubai to London to Los Angeles, young people and schools are so very similar in so many different ways, despite the contextual differences.

I put the very distressing question out there – how would you respond if a suicide happened during school hours at your school? What would you do? Who would you turn to? How would you inform parents? What would you tell the student body? How would you memoralise that student’s passing? Would you memoralise it? How would you determine the impact on students? How would you provide ongoing support? Who would lead this process? These are quite challenging and distressing questions to consider, but the reality is, we need to have answers for these questions so that we are prepared should the potential, unthinkable scenario play out on our campus.

Lea Howell contacted Rich eighteen months ago in this exact circumstance, directly after a terrible incident at her school where a student ended his life on the campus by jumping to his death, from a third story building, in front of a large group of students. You can read a news report from the time of this incident here. Lea explained the extremely difficult task of dealing with the immediate aftermath of this terrible tragedy, likening it to the heightened emotional trauma of a school shooting incident. I can hardly fathom how difficult it must have been to stay calm and focussed in those circumstances, to provide appropriate support and assistance to those who needed it so abruptly and who were experiencing the full spectrum of shock and grief.

The trauma from this incident and the direct and heightened impact on the entire school community was immediate and is certainly ongoing. It was exceptionally informative to learn from Lea how the school responded during this crisis and how they have continued to show ongoing support for members of the school community who were impacted by this event. Lea shared the strategies implemented from the Toolkit and how the ongoing support of students has been a considered and evaluated process. As the School Psychologist, Lea is still seeing the roll on effect of this tragedy eighteen months later and providing ongoing support to both staff and students alike. Much of the weight of mental ill-health is shouldered by the school counsellors here in America as, in most cases, access to external service providers and clinicians is out of the reach of many parents unless they are able to afford their own insurance. This has been a real barrier in ensuring that students are linked in with the specialist assistance they need and an ongoing concern for school counsellors all over the USA.

The direct toll of an incident such as this is very difficult to measure and there are clear lessons that we can learn in terms of how best to respond to a crisis such as this. The key piece of information I took away from this meeting is the importance of being proactive, not only in your suicide prevention strategies, but also in having a school plan in place should a tragic incident like this occur. It is a scenario that is certainly difficult to think about and one that is uncomfortable to plan for – no one would ever want to acknowledge that this could happen – not in our school – and heaven forbid that it ever does, but in the event of a tragedy such as this it is so very important that school leadership teams know exactly what needs to be done, how, when and by whom, to lessen the initial impact and ongoing burden of the trauma and to best support all members of the community who are affected and potentially traumatised by the event. This is an absolute necessity. Lea provided me with some excellent resources that were developed specifically during that crisis and which could be easily adapted to suit the NSW schools context. A collaborative approach is needed to ensure that the best possible crisis plan is designed and implemented in a circumstance such as this one, where the potential for clustering and contagion is of major concern.

There is some great work being done already, but I feel that there is certainly potential for improvement in our practice. I have a huge collection of resources now that I need to read and categorise before I compile my final report.

More on this tomorrow – I really need to get some sleep so I’m refreshed for my 8am meeting at Clarke Magnet HS tomorrow morning. I’m hoping you’re finding these blogs helpful and useful for your practice.

Thanks, Donna 🙂

2 thoughts on “What if the unthinkable happens?

  1. Sharyn D'Souza says:

    how do I *like” this post???
    I have to deal with crisis intervention on a large scale before. When you get back I can explain what the process was at that school in terms of informing staff and students, extra counsellors, self care, etc.
    That process can probably be adapted for cases of support after suicide. Headspace also do work in this area.

  2. Gail Tarrant says:

    Hi globetrotter!
    Thank you for your insights and resources- I am keenly reading and downloading at every opportunity.
    Jane Thomas and I have developed a Diocesan Pre/Intervention/Postvention Suicide kit (which is in draft format atm) but when you’re back (which is soon?) I’d love you to put over this resource, the lens of wisdom and expertise gained from this amazing PD tour.
    If you are interested could you please let me know if/when this might suit?
    Take care-
    Gail.

Leave a Reply