The San Diego County Office of Education’s Golden Bell Award-winning Policy to Practice: Suicide Intervention Toolkit provides local schools with protocols to support students experiencing suicidal ideation, and since its launch in 2019, has likely saved many lives.
San Diego COE’s 16 school districts, 11 single-site charter schools and four multi-charter school organizations across the county have implemented the toolkit to develop or enhance their unique district suicide intervention protocols. In that time, nearly 1,500 suicide-risk screenings have been conducted, with schools using the toolkit reporting an increased comfort level, confidence and capability among staff when talking with students about suicide risk, explained Heather Nemour, coordinator of student wellness and school culture for the county.
“Schools now have a uniform approach in using an evidence-based screening tool to determine better the level of suicidal ideation the student is experiencing and a protocol to respond to based on severity level,” she said. “The toolkit indirectly contributes to the school climate by creating an environment where students feel safe to express themselves and share how bad they may be feeling. Implementing the toolkit has also resulted in parents getting information to increase their understanding of supporting their children at home.”
Suicide is the second leading cause of death for young people ages 10-24, according to the Centers for Disease Control and Prevention. The California Department of Public Health recently reported almost all age groups saw a decline in suicide rates between 2019 and 2020, except for youth aged 10-18 years, which saw an increase of 20 percent in suicide rates for 2020.
In a COE press release announcing the toolkit as an award recipient, two school administrators sang its praises. One noted that it provided a “strong procedural way to work through crisis response that is consistent across all campuses in our district,” while the other said that “if it were not for the toolkit, I would not have been able to hold an appropriate re-entry meeting for a student who was hospitalized this year.”
Helping students transition back into school after a suicide attempt or hospitalization is one of the critical pieces that result in comprehensive suicide intervention, Nemour said, noting that survey results show 73 percent of local educational agencies do not have a system to notify schools when a student is released from the hospital.
“The re-entry plan was created and added to the toolkit in response to a lack of communication between the education, behavioral health and/or medical sectors when a student is hospitalized for suicide ideation,” she said. “Most often, students will re-enter the school community after this traumatic event, and staff have no idea what the student has experienced.”
The re-entry form provides schools with the information, tools and procedures for holding a re-entry meeting once the student returns to school. The form is intentionally embedded throughout the toolkit to ensure it becomes a consistent procedure for suicide intervention, Nemour explained. The re-entry form also contains references to specific items in the toolkit, including the relationship mapping tool or developing a self-care plan to reinforce using these tools as a part of the re-entry process.
The checklist section of the re-entry plan offers schools best practice suggestions for accommodations that can be put in place to ensure the students are safe and supported as they reintegrate back into the school community.
“Having a re-entry plan helps the school identify a lead person responsible for the aftercare of the student and providing check-ins,” Nemour said. “Most importantly, the form gives students a voice in creating their re-entry plan, including choosing the accommodations that will make them feel most comfortable when returning to school.”
In addition to the collaborative and comprehensive re-entry plan, what sets San Diego COE’s toolkit apart is the ease of use, as well as the fact that most toolkits are for suicide prevention or postvention but not for suicide intervention, Nemour said.
“The existing toolkits are lengthy, with lots of impractical reading content to use during a potential crisis. The Policy to Practice Toolkit is designed to be easy to use as it is sequential in laying out the best practice steps and protocols for effective suicide intervention,” she explained. “Additionally, the tools and forms within the toolkit can be downloaded and modified — including LEAs adding their logo — to fit the unique needs of districts and schools. It is never easy to conduct a suicide risk screening with a student, no matter how much experience you have doing it. This toolkit is a mechanism promoting a systematic approach to suicide intervention that prepares school staff to have these difficult conversations with students that ultimately can be lifesaving.”