Content Warning: The following post contains sensitive content about suicide and self-harm. If you or a loved one expresses suicidal thoughts, please call the National Suicide Prevention Lifeline at 1–800–273–TALK (8255).
Last week, The New York Times highlighted student mental health and the unprecedented challenges kids have been facing during the pandemic. Separated from friends, teachers, activities, and the emotional support system of in-person schooling, many students are struggling with emotions that can lead to suicidal thoughts and possible self-harm. The Times article sheds light on this topic in a way not previously explored at the national level, creating a global discussion about student mental health and how we can better support kids who are struggling.
As an educator or parent, you may have read the article and wondered, “This affects my classroom” or “I see this in my child or someone I know,” followed by, “What can I do next?” We’ve asked suicide prevention experts Dr. Jonathan Singer, Dr. Terri Erbacher, and licensed professional counselor Tracy Clements, LPC, to offer their advice in the videos below.
About the Speakers:
Dr. Terri A. Erbacher, Ph.D.
Certified School Psychologist, Licensed Psychologist, Crisis Committee Chairperson for the Association of School Psychologists of Pennsylvania, speaker, and consultant.
Dr. Jonathan Singer, Ph.D., LCSW
Licensed Clinical Social Worker, Associate Professor at Loyola University Chicago, President of American Association of Suicidology (AAS), author, speaker, and podcast host.
Tracy Clements, LPC
Licensed Professional Counselor, Professional School Counselor, Director of Counseling Services at Neosho School District in Missouri.
A CALL TO ACTION FROM DR. TERRI ERBACHER
Dr. Terri Erbacher: Today, we want to talk just a little bit about COVID-19 and suicide risk. I know many of us in schools are worried about our students, especially if we remain on hybrid or virtual models and we just can't lay eyes on them.
In terms of a call to action, there's a few things I want to think about. One, what are the warning signs of suicide? Many of us are afraid our children are isolated. We're afraid about what might be going on at home, family stress, the secondary aspects of COVID-19, financial loss. What about child abuse? We know in past pandemics, child abuse rates have increased, as has domestic violence. But if we can't see our children every day in school, who are they reporting this to?
I make sure my school staff knows that they talk to kids privately on chat and to let the students know they can chat anything privately that might be hard to say in person. And maybe that's going to be a hidden benefit of this. Also, schools must make sure—aside from making sure school staff know the warning signs—that we have procedures in place for screening suicide risk, suicide risk assessment, suicide risk monitoring, as well as safety planning.
We also engage in early detection: How are we going to identify those students who are of most concern? First and foremost, making sure other students know the warning signs, making sure parents know the warning signs, maybe post them on your website. But then we also have early detection through third-party technology systems, like GoGuardian. I'm a past user of GoGuardian, and I have more than one example where a student wrote a concerning statement on a school computer—and it was flagged and saved a life. So I believe strongly in that any way we can find out a child might be at risk, the better. Because nothing is more important than saving a life.
And then we have to have, again, procedures in place to screen the risk, conduct suicide risk assessments, including how to do those virtually. And we're finding through a lot of my trainings that staff are reporting that students are opening up as well as, if not better, on technology than they did in person. I think our youth are used to talking on computers more than maybe we are. So we're meeting them more on their level. And there are some hidden gifts through all of this that maybe we can take with us forever.
With that, my final point is we have to all take care of each other. Nothing is more important than our school staff who have given their all during this time, along with our students, our families, and our stakeholders. We have to look out for each other, know the warning signs of suicide across the ages, and hopefully we’ll begin to feel some relief with COVID-19.
"Nothing is more important than saving a life." ~ Dr. Terri Erbacher
MENTAL HEALTH ISSUES CONTINUE TO ESCALATE
Dr. Singer: In terms of the crisis stuff, I'm seeing more family members—older family members—in crisis, which has some trickle-down for kids. Particularly when kids have parents who are our essential workers, there is really a sense that “my parents or one of my parents or my only parent is not available...literally has to go out. And when they go out, I'm afraid they're going to die.” And that is an incredibly stressful time for kids.
If you look at the stats from the crisis text line, which is 741741, you see that the number of adults that are texting in for crisis help has increased significantly since pre-COVID times. You also see that more kids are talking about things like essential workers and stress and things like that.
Tracy: There's a big difference between mental health and mental illness. And I think most people, when you say anything about mental health, they automatically think mental illness. So we have been working a lot with our district wellness coordinator, and she usually provides a lot of information about healthy eating and exercising.
We've been working together a lot and trying to group mental health in with physical health. So there are things you can do to keep your body and your mind healthy. And your brain is really just an organ in your body. We're trying to package the two together so that people can understand that health is not just physical health; it's mental and emotional health as well.
ACKNOWLEDGING SHARED TRAUMA BUILDS COMMUNITY
Dr. Singer: There's a third kind of trauma, which we call shared trauma. And I think this concept is particularly important right now because a shared trauma is when the provider—the professional—is experiencing the same traumatic thing as the person that they're supposed to be providing services to. Famously in the United States, we think about teachers and therapists and emergency workers in Manhattan on 9/11. They literally experienced the same traumatic event as the people that they were supposed to be helping. Same thing with Hurricane Katrina and New Orleans. There are a lot of other examples, but for the first time in our lifetime, we are all experiencing the same event.
Now, just to be clear, this is not a trauma in the sense of a capital “T” trauma, like you're being physically abused. This kind of trauma is lower “t” trauma, right, where there's this ongoing sense of the world is unsafe. And, so what we need to do is we need to remember that we are sharing an experience. And when providers, when teachers, when mental health workers are able to acknowledge with the people that they're supposed to be helping—students, parents—that they are affected by it too, it actually improves the relationship. So, whereas we usually don't have teachers just sort of spilling about their days to their students—you don't have therapists who are like, “Oh my God, let me tell you what's going on.” That's just not appropriate. In what's going on today, it is actually appropriate to acknowledge what we are sharing, because it helps to build that sense of community.
LEVERAGING THE PRINCIPLES OF TRAUMA TRAINING
Tracy: We did a district-wide basic trauma training earlier in the year, which I'm so thankful that we had that done, because I've been able to remind them of those principles and kind of just remind them of the basic impacts of trauma and how it impacts your sleep and your ability to focus and concentrate. And I'm asking them to acknowledge those things in themselves and manage their level of trauma—and then help students, because if they are still experiencing their own trauma to a certain degree, they're not much help for the students. If they can manage it themselves and see what works, then they can basically give a testimonial to their students.
I was having a hard time sleeping, and this is what helped me. I was able to do some deep breathing exercises or go running and do a little bit of mindfulness. Hopefully they are using those principles and then sharing them with their students.
HOW TO BUILD AND STRENGTHEN CONNECTIONS BETWEEN STUDENTS, TEACHERS, AND PARENTS
Tracy: Connection is the foundation of building resilience, and right now, all of us need resilience. Connection is so very important, not just for kids, but for adults and administrators. If you're human, you need connection.
Most of our teachers are making contact with their students at least weekly. They're doing Zoom sessions and phone calls, and the counselors are reaching out to students they were working with before the shutdown. And they're maintaining those contacts either through video calls or telephone calls and emails where we're still making sure we're touching base with kids at least weekly. Our district office sends out updates that impact the whole district, so good communication there. Those come via email, text, and phone call. They're on our website, and we're also still delivering meals daily.
I think we need to encourage them to continue to interact with each other. All of our students have access to a Chromebook, so they have the chat features through the Chromebook, and we are seeing more and more students setting up their own Zoom accounts and having Zoom hangouts. Several of them will get on a Zoom meeting and get together virtually.
SUICIDE PREVENTION PROGRAMS: ADAPTING PROTOCOLS DURING DISTANCE LEARNING
Tracy: To begin with, when we were developing our suicide prevention plan, it started with support from the upper administration and the school board. So that was key. And once we had their support, I began looking for resources and, believe it or not, my favorite resource I've found is Dr. Singer's book. So I developed our suicide prevention plan based on his book.
Once we had the plan written, then we started training the various people. We had to train administrators, counselors, nurses, teachers, and then we've implemented an ongoing training each year for all school staff. And then we utilize signs of suicide for student suicide prevention training each year.
So we had all of that in place, and we utilized Dr. Singer's suicide risk assessment resources, which are wonderful. And we have been able to adapt those...kind of just hit the high points with those through virtual learning. We utilize Beacon, and so we get Beacon alerts. When we call and talk to a parent, we can do those risk assessments online, or we can do a Zoom meeting, or we can just do them over the phone. So we've had to adapt a little. But overall, we're still basically using the same suicide plan, just in a little different way.
HOW SCHOOLS CAN REMOTELY SUPPORT THE MENTAL HEALTH AND WELLNESS OF THEIR STAFF
Dr. Singer: This is such a challenging time because we're all making it up. First of all, administrators are kind of figuring out how to remotely support staff, and staff are having to figure out what their limits are. I think a lot of well-being happens during the school day because people see each other, they hear things that other people are saying, they walk down the hall to just catch a couple of minutes with their colleague—and you can't do that when you're stuck at home.
Another thing that you can't do is you can't walk. Teachers are used to wandering around the classroom. They're used to being active on their feet all the time. They want to get off their feet usually. But these days, folks are sitting all day, and that in and of itself is a stressor. And so I think that you're really finding different things for different stuff, which is the technical way of saying, “We're just kind of making it up as we go along.”
I think one of the things that school administrators can do is to make sure that there is a pipeline of information. Do teachers and staff know who to reach out to? Is there a way that they can do it in a confidential, supportive way so that if somebody says, “I'm really having a hard time,” it's not interpreted as, “You're not doing your job.” It's just, “Okay, so this is another learning opportunity for us here.” The idea that there are no mistakes; there are just learning opportunities. And so I would say that be gentle and forgiving, and make sure that folks are being creative with what they do and honest with each other. I think those are some good places to start.
CONNECTIONS CREATE HOPE
Dr. Singer: The flip side of the things that I'm seeing is that adolescents are having an opportunity to connect with their parents in a way that was hard before the shutdown. And there are a small subset of adolescents that are in dangerous home situations, so I'm not talking about those kids. Those kids we believe are in greater danger because of the shutdown because there's less monitoring by other adults, there's less ability to get support. But for the majority of kids who have been busy either because they were working after school, caring for their siblings, doing other activities, extracurriculars—they didn't have the informal opportunity to kind of hang out with their parents.
One of the things that we always say about supporting adolescents is that you want to be there when the adolescent is ready to talk to you. And if everybody's busy and everybody is going off and doing their own thing, they can't do that. But this shutdown has made it possible for kids and parents to have that unstructured time together. So one of the other things that we've seen is when kids talk about things that are supportive, things that are meaningful to them, they're increasingly using the word mom. They're increasingly using the phrase parents—not friends, not YouTube. They're talking about their family. And this is an amazing, totally unintended consequence of the shutdown.
HOW TO REACH OUT FOR HELP
Dr. Singer: There are a couple of things that you can do. First of all, you can always call, you can text crisis text line, you can call the national suicide prevention lifeline. You can go to places like on auntbertha.com and search your zip code, and it'll give you a list of resources in your area. I think a lot of places have 311 set up where you can call to get information about resources.
So there are lots of different ways that you can find that out. If you have insurance, look at the back of your insurance card, and call that 800 number or 888 number, and say, “I need to talk to somebody.” What's true is that third-party payers would much rather have you be involved in online or telehealth than end up at a hospital. And that's always true, but it's definitely true right now. So people are particularly motivated to get people hooked up.
Visit our channel to see the full conversation with Dr. Jonathan Singer and Tracy Clements.
Suicide in Schools: A Practitioner's Guide to Multi-level Prevention, Assessment, Intervention, and Postvention by Terri A. Erbacher, Jonathan B. Singer, Scott Poland