Preventing and responding to suicide

Resource kit for schools

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Preventing and responding to suicide – Resource kit for schools

Contents

Preventing and responding to suicide: Resource kit for schools 1

Whakataukï 4

Introduction 5

HowtousePreventing and responding to suicide: Resource kit for schools 6

Section 1 – Quick reference checklists and tools 7

Introduction 8

Emergencychecklist:intheeventofasuicideorseriousattempt 9

Emergencychecklist:ifthereisathreatofimminentsuicide 10

Assessmentofstudentsatriskofsuicide:forschoolcounsellors 11

Managementofstudentsatriskofsuicide:forschoolcounsellors 14

Section 2 – Guidelines for prevention 16

Introduction 17

Awhole-schoolapproachtopromotingstudentwellbeing 18

Toolstopromotestudentwellbeing 19

Teacherandcounsellordevelopmentandsupport 21

Classroompractices:dealingwiththeissueofsuicideifitarises 22

Section 3 – Guidelines for responding to suicidal behaviours 24

Part1–Respondingtostudentsatriskofsuicide 25

Recognisingsuicidalbehaviours 26

Self-harmandsuicide 27

Respondingtostudentsatrisk:roleoftheleadershipteam 28

Respondingtostudentsatrisk:roleoftheteacher 29

Respondingtostudentsatrisk:roleoftheschoolcounsellor 31

Part2–Respondingtoasuicideandmanagingtheconsequences 37

Schoolsneedtoplanhowtheywillrespondtoasuicide 38

DevelopingaSuicideResponsePlan 38

Managingtheaftermathofadeathbysuicide 39

Thispublicationwasupdatedin2019.ItwillcontinuetoundergofurtherreviewsanddevelopmenttoalignwithEvery Life Matters – He Tapu te Oranga o ia

Tangata: Suicide Prevention Strategy 2019-2029.ThisresourcewasfirstdevelopedbytheMinistryofEducationProfessionalPracticeUnit,basedonareview

undertakenbyProfessorSunnyCollingsandBarryTaylor,UniversityofOtagoWellington,ofthe1997guidelinesforschools.ThereviewwascommissionedbyTe

PouundercontracttotheMinistryofHealth.

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Part3–Respondingtoasuicide:templates 43

Introduction 44

Templateforstatementtostudents 45

Templateforalettertofamiliesandwhänau 47

Templatefortalkingtostudentsaboutsuicideloss 49

Templateforthemedia 51

Sampleagendaforafamilyandwhänaumeeting 52

Templateforinformingfamiliesandwhänauabout‘chokinggames’ 55

Section 4 – Prompts for developing policies and procedures to prevent suicidal behaviours and promote wellbeing 57

Introduction 58

Promptsforschoolleaders 59

Promptsforschoolcounsellors 64

Section 5 – Scenarios 69

Scenariosfordiscussion 70

Scenario1:Suicidepreventionprogrammes 70

Scenario2:Suicidethemes 70

Scenario3:Dangerousgames 71

Scenario4:Topicsfordiscussionorstudy 71

Scenario5:Suicidalthoughtsdisclosed 72

Scenario6:Breakingconfidences 72

Scenario7:Communicatingnewsofasuicide 73

Scenario8:Managingstudentsupport 73

Section 6 – Support services and information about self-harm 74

Supportservices 75

Informationaboutself-harm 75

Acknowledgements 76

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Preventing and responding to suicide – Resource kit for schools

Whakataukı

Ma te whakaatu, ka möhio. Ma te möhio, ka märama. Ma te märama, ka mätau. Ma te mätau, ka ora.

By discussion comes understanding. By understanding comes light. By light comes wisdom. By wisdom, comes wellbeing.

Tënä koutou, tënä koutou, tënä rä tätou katoa.

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Introduction

ThemajorityofstudentsinNewZealandenjoypositivewellbeingmostofthetime.However,somestudentswillexperienceemotionaldistressandmayattemptsuicide.

• About1percentofsecondaryschoolstudentsattemptsuicideandrequiretreatmentbyadoctorornurse.Mostoftheseattemptsdonotrequirefurtherhospitaltreatmentorresultindeath(Youth12’PrevalenceTables,2013).

• Suicidewastheleadingcauseofdeathinadolescentsintheperiod2002to2016andaccountedforthirty-sixpercentofalldeathsinthoseaged15to24years.(ChildandYouthMortalityReviewCommittee13thdatareport2012–2016).

• Mäoriyouthsuicideratesarehigherthanthosefornon-Mäoriyouth–forty-ninepercentofdeathsbysuicideofstudentsaged10to19yearsin2017and2018werestudentswhoidentifiedasMäori(accordingtoprovisionalstatisticsfromthecoroner).

• Whiletherehasbeenanoverallreductionintheratesofsuicideinyoungpeoplesince1998,theratesforyoungMäorihavenotdeclinedtothesameextentasnon-Mäori.

“We need to keep talking about how to recognise the signs that someone may want to take their own life. If someone expresses thoughts and feelings about suicide, take them seriously.”

Suicides are preventable

Schoolshaveavital,albeitchallengingroletoplayinthewellbeingofstudentsandthepreventionofsuicide.Creatingapositive,culturallyinclusivelearningenvironmentthatisfreeofdiscrimination,enables

studentstofeelphysicallyandemotionallysafe,whichsupportstheirwellbeingandacademicachievement.Schoolscanprovidesocialsupporttovulnerablestudentsandprovideappropriatereferralsforthoseinneedofassistance,sothathelp-seekingisnolongertabooandsafedialogueisencouraged.Developingtheseenvironmentshelpsenhancethewellbeingandresilienceofallstudents.

Thisresourcekitprovidesinformationforcreatingpositive,safeenvironmentsinschools.Itisanupdateandsynthesisoftwopreviousguidesforschoolsonsuicideprevention:

• Young People at Risk of Suicide: A guide for Schools (1998).

• Youth Suicide Prevention in Schools: A Practical Guide (2003).

Theadviceprovidedinthisresourcekitisbasedonthebestresearchevidenceavailable.

Someelementsofthiskithavebeenupdatedsince2013,asaninterimmeasure.NowthatEvery Life Matters – He Tapu te Oranga o ia Tangata: Suicide Prevention Strategy 2019-2029hasbeenactioned,wewillcontinuetoupdatethiskittoreflecttheresourcesandsupportsdevelopedthroughtheSuicidePreventionActionPlan2019–2024forAotearoaNewZealandinconsultationwiththeMinistryofHealth,theOfficeoftheChildren’sCommissionerandotherkeystakeholders.

ThefullevidencereviewandreferencesarepublishedintheUpdated evidence and guidance supporting suicide prevention activity in New Zealand Schools.

Seewww.tepou.co.nz(intheResourcecentresearch:suicidepreventionforschools).ThisreviewcombinesmaterialfromtwoearlierevidencereviewsandselectivelyupdatestheevidencerelevanttoNewZealandschools.

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Preventing and responding to suicide – Resource kit for schools

How to use Preventing and responding to suicide: Resource kit for schools

Usethesectionsthataremostrelevanttoyourroleinyourschool,addingfurtherinformationfromothersectionsasyouneedit.Dependingonyourrole,youmaywishtomakecopiesofsomesections(suchastheassessmentcharts)touseforreference.

Thisguidehasseveralinterrelatedcomponents:

1 – Quick reference checklists and tools

• Emergencychecklist:intheeventofasuicideorseriousattempt.

• Emergencychecklist:ifthereisathreatofimminentsuicide.

• Assessmentchart(forusebyschoolcounsellors).

• Managementchart(forusebyschoolcounsellors).

2 – Guidelines for prevention

• Awhole-schoolapproachtopromotingstudentwellbeing.

• Toolstopromotestudentwellbeing.

• Teacherandcounsellordevelopmentandsupport.

• Classroompractices:dealingwiththeissueofsuicideifitarises.

3 – Guidelines for responding to suicidal behaviours

• Respondingtostudentsatriskofsuicide.

• Respondingtoasuicideandmanagingtheconsequences.

• Respondingtoasuicide–templates:statementforstudents,lettertofamiliesandwhänau,talkingtostudentsaboutsuicideloss,mediaresponses,sampleagendaforfamilyandwhänaumeeting,informingfamiliesandwhänauabout‘chokinggames’.

4 – Prompts for developing policies and procedures to prevent suicidal behaviours and promote wellbeing

• Promptsforschoolleaders:fourkeyguidelinesforboardsoftrustees,principalsandseniormanagement.

• Promptsforschoolcounsellors:fourkeyguidelinesforschoolcounsellors,deans,schoolsocialworkersandotherspeciallytrainedstaff.

5 – Scenarios

• Scenarios:examplesofpossiblesituationswhichcanbeusedtofocusdiscussionforprofessionaldevelopment.

6 – Contacts and information

• Supportservices.

• Informationaboutself-harm.

» Introduction

» Emergencychecklist:intheeventofasuicideorseriousattempt

» Emergencychecklist:ifthereisathreatofimminentsuicide

» Assessmentofstudentsatriskofsuicide:forschoolcounsellors

» Managementofstudentsatriskofsuicide:forschoolcounsellors

Section 1 – Quick reference checklists and tools

Introduction

Thesequickreferencechecklistsaredesignedforuseinrapid-responsesituations.Furtherinformationabouthowtopreventandrespondtosuicideisavailableintheothersectionsofthistoolkit.Werecommendyoubecomefamiliarwiththedetailedcontentinthosesectionsaswell.

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Emergency checklist: in the event of a suicide or serious attempt

• Informtheschoolprincipal.

• Checktheaccuracyoftheinformation.

• ConvenetheTraumaticIncidentResponsePlan(TIRP)teamandassignroles.

• ContactMinistryofEducationTraumaticIncidents(TI)team,phone0800TITeam(0800848326).

• Sharefacts(when,where,how,whathasbeenconfirmed)withTIRPteam.

• Determinetherolesofeachpersoninyourschoolandconfirmwiththemthattheyunderstandwhatisexpected.

• Contactotherschoolsthatmaybeaffected.

• Contactthefamilyandwhänau(agreewhatinformationcanbediscussedwithstudents,community,ifappropriateoffercondolencesanddiscussfuneralarrangements).

• Determinetheneedforadditionalsupportservices,supportroomsandreliefstaff.

• Assignphonesformedia,familiesandwhänau,outsidephonecalls.

• Determinehow,whenandwhatinformationtoreleasetoteachers(usuallyatastaffbriefing).

• Determinehow,whenandwhatinformationtoreleasetostudents(usuallyinclassgroups,withfamiliarteachersandpeers).

• Writeastatementforteacherstoreadouttostudents.(See Statement to students template in Section 3, part 3)

• Prepareamediastatementincaseyouareapproachedbythemedia.(See template in Section 3, part 3)

• Writealetterforfamiliesandwhänauandthewidercommunity,includinginformationonrecognisingrisk,wheretoseekadditionalsupportandhowtotalkwithastudentiftheyhavequestionsaboutsuicide.(See Letter to families and whänau template in Section 3, part 3)

• Closelymonitorschoolgroundsandattendanceoverthenextweek.

• Setupsystemsforteachers,familiesandwhänauandstudentstouseoverthenextfourtosixweeks,toidentifystudentswhomaybeatrisk(includingknownstudentswithpreviousadverselifeevents).

• Determinetheneedforoutsidesupportfromculturalorreligiousadvisers,otherschools,andmentalhealthservices.

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Emergency checklist: if there is a threat of imminent suicide

• Staffmemberswhoarepresentwiththestudentsupportthestudentuntiltheyareablehandovertoacounsellor,familyorwhänaumemberorahealthprofessional.

• Ensurethestudent’simmediatesafety:donotleavethestudentaloneandremoveallpossiblemeansofharm.

• Ifnecessary,call111emergencyservicesforhelp.

• Consultwiththeprincipalwhowilltheninformappropriatestaff.

• Theprincipalinformsthestudent’sfamilyandwhänauoftheriskandtheproposedsafetyplan.

• TheschoolcounsellormakesimmediatecontactwiththelocalCrisisAssessmentTeam,andhandsoverresponsibilitytoanappropriatehealthprofessional.YoucancontacttheMentalHealthCrisisAssessmentTeaminyourareaatanytime.FurtherinformationbefoundontheMinistryofHealth’swebsite(www.health.govt.nz)bysearching‘crisisassessmentteams’.

• Whentheimmediatethreatisover,thecounsellorinformstheprincipalofactionstaken.

• Theschoolfollowsupwithfamily,whänauandhealthservices.

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Assessment of students at risk of suicide: for school counsellors

Duringaninterviewwiththestudentatrisk,investigateeachoftheareasinthecolumnontheleftandcategorisetheresponseaslow,moderateorhighrisk.Ininvestigatinganysuicideplan(1:Suicidalthinking–Plandetails,availabilityofmeans,time,lethalityofmethod,chanceofintervention)itisimportanttousedirectquestions,asthestudentislikelytobereluctanttovolunteertheinformation.Directquestioningwillnotaggravatetheriskofsuicidebutfailuretofullyinvestigate,categorisetheriskandrespondappropriatelymayresultinasuicidethatcouldhavebeenprevented.Finally,onthebasisofthestudent’sresponses,determinewhichofthethreerisklevels,low,moderateorhigh,bestdescribesthesituationandproceedwiththemanagementplanforthatlevelofrisk.

Areas to Consider Low Risk Moderate Risk High Risk

1:Suicidalthinking

Thoughts • Occasionalsuicidalthoughts

• Suicidalthoughtsonmostdays

• Frequentorpersistentsuicidalthoughtseachday

Intent • Cannotseeanswerstotheircurrentissues

• Seessuicideastheonlyoption

• Seesnoreasonsforliving

• Believesnothingwouldchangetheirmindorstopthem

• Thedesiretodieornotbehereisverystrong

Plandetails,availabilityofmeans,time,chanceofintervention

• Vague

• Meansaren’tavailable,willhavetogetthemeans

• Nospecifictime,orinthefuture

• Otherpeoplearepresentmostofthetimeorhighlylikelytodiscover/interrupt

• Somespecifics

• Availablemeans,hascloseby

• Planstoactwithinafewhours

• Otherpeopleareavailableifcalledupon

• Wellthoughtout;knowswhen,where,how

• Hasthemeansinhand

• Planstoactimmediately

• Noonenearby;isolated

Moodstate • Mildlydepressed;feelsslightlydown

• Moderatelydepressed;somemoodiness,sadness,irritability,lonelinessanddecreaseinenergy

• Presenceofadditionalmentalhealthconcerns,suchasPTSD,Anxiety,ADHDetc

• Overwhelmedwithhopelessness,sadnessoranger

• Feelingsofworthlessness;self-neglect

• Extrememoodchanges

• Anewlypresentingcalm,contentednesswhichmaybeduetodecisionaboutsuicide

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AdaptedfromMinistryofEducation1997Young people at risk of suicide – a guide for schools.

Areas to Consider Low Risk Moderate Risk High Risk

Hopelessness • Hassomeplanforfuture

• Thinksthingsmightpossiblygetbetter

• Asenseofbeing‘trapped’

• Defeatandhumiliation

• Futurebleakandempty

• Hasconvictionthatthingscanneverimprove

Communication • Sharingdirectexpressionofthoughtsandfeelingsofdistress

• Keepinginformationtothemselves,reluctanttosharetheircurrentthinkingordistress,suchas“I’ll be fine”,“Just leave me alone”,“I don’t need anyone”

• Unwillingtodiscusstheiremotionaldistressatall

• Becomesangrywhenconcernisshown

2:Riskbehaviours

Previoussuicideattempt

• None • Oneormoreattempts • Oneofhighlethalityormultipleattemptsofmoderatelethality

• Severalattemptsoverpastweeks,ofanylethality

Previousorcurrentself-harm

• None • Multipleorongoingself-harm

• Self-harmusedtocontrolormanagedistressedemotions

• Lackofalternativeoptionstomanagedistressedemotions

• Multipleorongoingself-harm,withincreasingrangeofmethodsorlethality

• Self-harmusedtocontrolormanagedistressedemotions

• Lackofalternativeoptionstomanagedistressedemotions

• Knownhistoryofadversechildhoodexperiences(butnotappropriatetoassessatthistimeifnotknown)

Otherriskybehaviours • Doesnotorveryrarelyengagesinriskybehaviours

• Occasionalriskybehaviourssuchasoccasionalillegalsubstanceuse

• Increaseduseofalcoholordrugsasmethodsofcopingwithemotionaldistress

• Difficultywithemotionalself-regulation

• Multipleorfrequentriskybehaviourssuchasillegalsubstanceuse

• Increasinghigh-riskbehaviours,suchasdrivingatexcessivespeedwithoutaseatbelt,uncaringaboutpotentialconsequences

• Increasingimpulsivity

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AdaptedfromMinistryofEducation1997Young people at risk of suicide – a guide for schools.

Preventing and responding to suicide – Resource kit for schools

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Areas to Consider Low Risk Moderate Risk High Risk

3:Stressors/context • Nosignificantstressors • Experiencingoccasionalbullyingordiscrimination

• Moderatereactiontoalossorsocialcontextchange

• Bereavementinwiderfamily,whänau,socialorschoolcircle

• Recentschooldisciplinaryaction

• Experiencingongoingbullyingordiscrimination

• Severereactiontolossorsocialcontextchange

• Manyrecentsocialorpersonalcrises

• Bereavementincloserfamily,whänau,socialorschoolcircle,especiallyifsudden

• Recentschooldisciplinaryaction,especiallystand-downorexclusion

4:Self-management • Maintainingdaily/socialactivitieswithlittlechangeinleveloffunctioning

• Communicatingopenlyaboutissuesbeingfacedandworkingthroughthem

• Candrawonseveralproblem-solvingstrategies

• Willingtoseekandaccepthelp/support

• Stablerelationshipsandschoolacademicperformance

• Someactivitiesdisrupted,withdisturbanceinsleep,eating,schoolwork

• Communicatesfromtimetotime,orpartialcommunication

• Oneortwoapproachestosolvingproblems,somedifficultycarryingthemthrough

• Ambivalentaboutreceivinghelporsupport

• Challengingauthoritysuchasparents,teachers,family,whänauorcommunityinawaywhichisdetrimental

• Substanceabusetomanageemotions

• Significantdisturbancesindailyfunctioning

• Nocommunicationaboutproblems

• Unabletoeffectivelyapproachproblem-solving

• Significantself-neglect

• Repeateddifficultywithpeers,familyandwhänau,andteachers

• Challengingauthoritysuchasparents,teachers,family,whänauorcommunityinawaywhichisdetrimental

5:Positiveresources • Multiplestrongfamily,whänauandcommunityconnections

• Significantothersconcernedandwillingtohelp

• Otherhelpavailable,inparticular,aconcernedandtrustedadult

• Lackoffamily,whänauandcommunityconnections

• Family,whänauorfriendsavailablebutunwillingtohelpconsistently,orneededucationtodoso

• Poororharmfulfamily,whänauandcommunityconnections

• Family,whänauorfriendsnotavailableorarehostile,exhausted,injurious

• Family,whänauorfriendsareabusive

AdaptedfromMinistryofEducation1997Young people at risk of suicide – a guide for schools.

Management of students at risk of suicide: for school counsellors

Action Low Risk Moderate Risk High Risk

Immediateintervention

• Establishanappropriateplantomonitorthestudent’ssuiciderisk

• Checkonfamilyorwhänauandothersupportavailableand,asappropriate,involvethem

• Takeateamapproachtoensurethesafetyofthestudentwhileatschool

• Principaltoinformthefamilyandwhänau,asappropriate,anddiscussstrategiesappropriatetothelevelofrisk

• Establishappropriateregimetomonitorthestudent’ssuiciderisk

• Arrangeforthestudenttogetaccesstotheappropriatelevelofcounselling/treatment

• Consultwiththeprincipalwhowilltheninformtheappropriatestafftominimiseanyimmediaterisk.Principaltoinformthefamilyandwhänauoftheriskandproposedmanagementasappropriate

• Counsellortoensurethestudent’simmediatesafety,arrangeforanyhandoverofresponsibility(includinginformingfamilyandwhänauofsafetyprecautions)tofamily,whänauorahealthprofessional

Consultation • Consultasappropriatewithschoolstaffandfamilyorwhänau

• Counsellortoconsultwithsupervisorasnecessary

• Checkifotherservicesareinvolvedandcoordinate;clarifywhoisleadingclinicalmanagementplanning

• Counsellortoconsultwithhealthprofessionals(GP,CrisisAssessmentTeamorifappropriate,mentalhealthservices)todiscussactionsrequired

• Fornewcases,immediatereferralforassessmentbyGPormentalhealthservicesisdesirable

• Counsellortoconsultwithsupervisorasnecessary

• Checkifotherservicesareinvolvedandcoordinate;clarifywhoisleadingmanagementplanning

• Continuecontactwiththestudentandtheirfamilyandwhänautoensuretherequiredlevelofserviceisbeingprovidedandtofacilitateasmoothreturntonormalinvolvementintheschool

• Consultwithhealthprofessionalsinvolvedtoensuretheyknowofthecurrentlevelofrisk,anybehavioursseenatschoolandthattheappropriateservicesarebeingaccessed

• Counsellortoconsultwithsupervisor,asnecessary

AdaptedfromMinistryofEducation1997Young people at risk of suicide – a guide for schools.

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AdaptedfromMinistryofEducation1997Young people at risk of suicide – a guide for schools.

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Action Low Risk Moderate Risk High Risk

Referral/clinicalmanagement

• Provideinformationtothestudent(andthefamilyandwhänau)onresourcesavailabletoassistthem

• Provideongoingclinicalmanagementaspartofschoolcounsellingservice

• ReferraltoGPwithconfirmedappointmentwithin24-48hours

• Activelymanagewithself-managementstrategies,asappropriate,andweeklymonitoring

• Educatefamilyandwhänauonsignsofdistressandappropriateemergencycontacts

• Counsellortomakeareferraltoanappropriatehealthprofessional-GPorCrisisAssessmentTeams(ormentalhealthservicesifstudentisalreadyengagedwithservices)forfurtherassessmentandprimarymanagement

• Ensurecommunicationaboutprimarymanagementwithmentalhealthservicesisclearsorolescanbeestablished

• Educatefamilyandwhänauonsignsofdistressandappropriateemergencycontacts

Follow-up • Regularreviewofthestudenttoidentifyanychangesinrisk

• Iftherehasbeennoimprovementinfourtosixweeks,thentreatasiftheriskweremoderateandseekadditionalassistance

• Ensurestudenthasconnectionandaccesstoanadultoftheirchoosingtosupportthemifneeded

• Checkoutcomeofanyreferralwiththehealthprofessionalandfamilyandwhänau

• Monitorriskandbehaviourswithintheschoolenvironmentandtakeactionasappropriate

• Appropriatelyandsafelymanagestudentexperiencesofbullyingordiscrimination

• Ensureallstaffinvolvedwiththestudentreportallincidentsthatcauseconcern(riskfactors:unexpectedreductioninacademicperformance,ideasandthemesofdepression,death,suicide,changesinmood,grief,withdrawal,physicalsymptoms,high-riskbehaviours)

• Ensurestudenthasconnectionandaccesstoanadultoftheirchoosingtosupportthemifneeded

• Checkoutcomeofanyreferralwiththehealthprofessionalandfamilyandwhänau

• Ensureallstaffinvolvedwiththestudentreportallincidentsthatcauseconcern(riskfactors:unexpectedreductioninacademicperformance,ideasandthemesofdepression,deathandsuicide,changesinmood,withdrawal,physicalsymptoms,high-riskbehaviours)

• Appropriatelyandsafelymanagestudentexperiencesofbullyingordiscrimination

• Liaisewithfamilyandwhänautoensuretheyhavesupportandthatthestudent’senvironmentissafe(ie,removalofmeansofsuicideandclosemonitoringandsupport)

• Priortothestudentreturningtoschool,establishthenecessarymonitoringandsupportsystems

• Ensurestudenthasconnectionandaccesstoanadultoftheirchoosingtosupportthemifneeded

Section 2 – Guidelines for prevention

» Introduction

» Awhole-schoolapproachtopromotingstudentwellbeing

» Toolstopromotestudentwellbeing

» Teacherandcounsellordevelopmentandsupport

» Classroompractices:dealingwiththeissueofsuicideifitarises

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Introduction

Researchidentifiesanumberoffactorsthatsupportstudents’wellbeing.A2000studyof9,699NewZealandsecondaryschoolstudentsfoundthatstudentswhoreporthavingcaringparentsandotherfamilymembers,‘fair’teachers,andfeelingsafeatschool,havelowerratesofsuicideattempts1.Personalattributesthatincreasethelikelihoodofpositivewellbeingoutcomesinclude:

• goodself-regulationskills

• healthyfamilyandwhänaufunctioning

• culturalengagement

• strongsenseofpositiveidentity

• family,whänau,schoolandcommunityconnectedness.

Inparticular,closeandcaringfamilyandwhänaurelationshipsareassociatedwithreducedyouthparticipationinanumberofpotentiallyriskybehaviours,includingsuicidalbehaviours.

ManyschoolsinNewZealandareusingtheMinistryofEducation’sPositiveBehaviourforLearning(PB4L)frameworkandinitiativestobuildpositiveschoolculturesthatenablestudentstofeelsafeandsupported.Buildingpositive,inclusiveculturesisanextremelyimportantroleforschoolsinhelpingtopreventsuicide.

See Tools for change and support page 19.

Forsomestudents,thepresenceofpsychologicaldistressorsocialstressorsmayhavesuchanegativeimpactthatnotonlyistheirabilitytolearnadverselyaffectedbutalsotheirmentalhealth.Thismayresultinanincreasedriskforphysicalorpsychologicalharm,includingself-harmingorsuicidalbehaviour2.

• Suicidalbehavioursincludesuicide,attemptedsuicideandsuicidalideation(thoughts).

• Suicideisanyself-injuriousactintendedtoendone’slifeandwhichresultsindeath.

• Attemptedsuicideisanypotentiallyself-injuriousactintendedtoendone’slifebutwhichdoesnotresultindeath.

• Suicidalideationisthinkingaboutengaginginsuicidalbehaviour,withorwithoutaspecificsuicideplan.

• Self-harmingisthedirect,deliberateactofhurtingorinjuringyourbody,butwithoutnecessarilywantingtodie.It’sawaysomepeoplecopewithintenseorverydifficultemotions,oroverwhelmingsituationsandlifeevents.

• Self-harmdoesnotalwaysdictatesuicidalthinkingoranintenttodie,howevertheongoingpresenceofself-harmisconsideredariskfactorforsuicide.

Itisimportanttonotethatwhilemostpeoplewhothinkaboutsuicidedonotcompletesuicide,somedogoontomakeattemptsontheirownlives.

Additionally,thepresenceofsuicidalthinkingdoesnotindicatethepresenceofamentalillness.Suicidalthinkingishoweveraclearsignofemotionaldistressandtheneedforcompassionate,non-judgementalsupport.

1Respondingtopeopleatriskofsuicide–SuicidePreventionInformationNewZealand(SPINZ),2010,atwww.spinz.org.nz.2AdolescentHealthResearchGroup.NewZealandYouth:Aprofileoftheirhealthandwellbeing.Auckland:UniversityofAuckland;2003.

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A whole-school approach to promoting student wellbeing

Thefirstlineinpreventingsuicideisthepromotionofstudentwellbeingandresiliencewithinapositiveschoolculture.Thisisawhole-schoolapproach–everyonehasaroletoplay.

• TheBoardofTrusteeshasaresponsibilitytoensuretheschoolprovidesasafeandprotectivelearningenvironment.Itmustalsoensurethatschoolpersonnelhaveaccesstothenecessaryresources,supportandskillstoimplementawhole-schoolapproachtostudentwellbeing.

• PrincipalandSeniorLeadershipTeamareresponsiblefordevelopingandimplementingpoliciesandprocedures,andprovidingleadershiptoensurethattheschoolimplementspracticesthatpromotepositivebehaviourandenhancestudentwellbeingandcompetence.Thisincludesbeingabletoappropriatelyandsafelyrespondtoanat-riskstudentortothesuicideofamemberoftheschoolcommunity.Schoolleadersrecognisethatthepromotionofwellbeingandsuicidepreventionarenotjusttheresponsibilityoftheguidancestaff–allstaffhavearoletoplay.

• Teachersandotherstaffarealladultswhocomeintocontactwithstudentsandneedtobeawareofwaystorecognisestudentswhomaybedistressedandknowhowtoobtainsupport.

Promoting resilience

Emotionalwellbeingandgoodmentalhealtharealsostronglyassociatedwithresilience.Resiliencemeansbeingabletocopeandadaptdespitesetbacksanddisappointments,andisakeyfactorindeterminingtheabilitytomovepastadversity.Resilientstudentsareusuallycharacterisedbytheirabilityto:

• reflectontheirownthoughts,feelingsandmotivations,andtounderstandtheyhavetheabilitytorespondandchangenegativethoughts

• believetheycaninterveneeffectivelyintheirownlives,eveninadversesituations,andtotrynewsolutions

• engageandinteractpositivelywithothers,leadingtomeaningfulrelationships.

Resilienceisacompetencethatcanbedevelopedbyschoolswithinthecontextofthelearningenvironment.Thereisafocusonlearnerwellbeinginourcurricula.Qualityeducationsupportsandincreasesthewellbeingofstudents.Educationequipslearnerswiththeknowledge,skills,competenciesandexperiencestheyneedtoprogressthroughlifeandsucceedinwaysthataremeaningfultothem.Effectiveevidence-basedteachingpractices,strongpartnershipsbetweenfamily,whänauandcommunity,andqualityenvironmentsthatrecognise,respectandvalueeverylearner’slanguagecultureandidentify,allcontributesignificantlytowellbeing.

Tools to promote student wellbeing

Schoolscandevelopschool-widepoliciesandpracticesthatpromotesocialbehaviour,equalityandfairness,andthatdecreasebullying,anti-socialbehaviourandviolence.PositiveBehaviourforLearning(PB4L)supportsschoolstodothis.(Gotohttps://www.education.govt.nz/school/student-support/special-education/pb4l/).

Safeandhealthyschoolenvironmentsstrengthenandmaximisestudentparticipationandconnectiontoschool,andalsocontributetostudentwellbeing.

Tools for change and support

TheMinistryofEducationandotherorganisationsprovidetoolsandinformationonthedifferentsupportsavailabletohelpschoolsplanandimplementchange.

• TheWellbeing@schoolwebsite,whichschoolscanusefreeofcharge,includesastudentsurveyandaschoolself-reviewtooltohelpgatherinformationfromstudentsandteachersabouthowsafetheirschoolenvironmentis.Thisinformationandtheonlineresourcesandtoolscanhelpschoolboardsandleadershipteamstoidentifywaysofreducinganti-socialbehavioursintheschool.Moreinformationisavailableatwww.wellbeingatschool.org.nz

• TheEducationReviewOfficeprovidesschoolswithindicatorstohelpthemtoevaluateandmeasuretheirsuccessinareasofinterest.Forexample,educationandlearningoutcomes,studentengagementandparticipation,familyandcommunityengagement,andresourcing.(Gotohttps://www.ero.govt.nz/publications/school-evaluation-indicators/purpose-of-indicators/#indicators-in-education.)

• Wellbeing for success:aresourceforschoolshasalsobeendevelopedtohelpschoolsevaluateandimprovestudentwellbeing.(Gotohttps://www.ero.govt.nz/publications/wellbeing-for-success-a-resource-for-schools/.)

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• Positive Behaviour for Learning School-Wideisaframeworkthatsupportsschoolstocreateaculturewherepositivebehaviourandlearningthrive.Aschoolenvironmentthatislessreactive,aversiveandexclusionaryhasmoreengaging,responsiveandproductiverelationshipsbetweenstaff,students,familiesandwhänau,andsupportslearners’wellbeing.ContactyournearestMinistryofEducationdistrictofficeifyou’reinterestedinmoreinformationaboutthisframework(Gotohttps://www.education.govt.nz/our-work/contact-us/regional-ministry-contacts/learning-support-services/)

• The New Zealand Health and Physical Education Curriculumsupportsstudentwellbeingbyraisingtheawarenessofmentalhealthissuesamongstudentsbydestigmatisingmentalillness,encouragingstudentstorecognisementalhealthproblemsinthemselvesandtheirfriends,facilitatingprocessesforappropriatehelp-seekingforstudentsandtheirpeers,andteachingself-awareness,problem-solvingandcopingskills,andsocialskills.Thementalhealthcomponentcanbefoundathttp://health.tki.org.nz/Teaching-in-HPE/Health-and-PE-in-the-NZC/Health-and-PE-in-the-NZC-1999/Key-areas-of-learning/Mental-health

• NewZealandCouncilforEducationalResearch’s(NZCER’s)studentengagementsurvey,Me and My Schoolmeasures,amongstotherthings,howconnectedstudentsfeeltotheirschool,andhowtheyviewthemselvesaslearners.Informationfromthesurveycanhelpschoolsunderstandhowtheirstudentsperceivetheirschool’sclimate.Gotohttps://www.nzcer.org.nz/tests/me-and-my-school

SomesuicidepreventionprogrammeshaveraisedsafetyconcernsforstudentsinNewZealandandoverseas.Yourschoolmaybeapproachedbyanorganisationorindividualwhoofferstoprovideaprogrammeonsuicidepreventionforstudents,ortalkatyourschoolassemblyortoclasses.Theevidencereviewsuggeststhatprogrammesorindividualswhopromoteawarenessaboutsuicideorfocusonsuicidecanincreasetheriskofsuicidalbehavioursinstudents.ContactyourlocalregionalMinistryofEducationofficetodiscussanysuicidepreventionprogrammes.Yourlocalofficecanoffersupportandguidanceforyourschoolonthesafetyand/orappropriatenessofthesetypeofprogrammes.See Section 5, Scenario 1: Suicide prevention programmes (page 70)

Peer support, peer support programmes, and friendships

Peer-basedsupportcanprovideanopportunitytoengagewithstudentswhoareatrisk,offeringanon-judgmental,understandingandsupportiveenvironmentamongstlike-mindedpeers,tohelpthemcopewithstressfullifeeventsandimproveresilience.Creatingasupportiveschoolclimatethatsupportshelp-seekingandmeetsdifferingyouthneedsandinterestsinyouthfriendlyspaceshasbeenshowntoreducesuiciderisk.

Peerswilloftendiscusspersonalissuesamongstthemselvesratherthanwithfamilyandwhänauorotheradults.Environmentsthatencouragestudentstoseekhelpfromtheirpeerscanempowerthemtoimprovetheirhealthandwellbeing.

Peersandfriendsareoftenthefirsttonoticewhensomeoneisindistressorhavingdifficultycoping.Allstudentsneedtounderstandtheimportanceofpassingontheirconcernstoateacher,counsellororotheradultwhocanarrangeforappropriatesupport.Teacherscanletstudentsknowthisbyconveyingpositivemessagesaboutfriendship:

• Gettinghelpforafriendisnotabreachofloyalty.

• Someproblemsshouldnotbebornealoneandit’sokaytoseekhelpfromanadult.

• Agoodfriendcaresandsupports,butalwaysseekshelpfromanadultinsituationswhereself-harm,depressionorsuicidemayoccur.

• Free,confidentialandtextorweb-basedhelpandinformationisavailableforanyoneworriedaboutthemselvesorafriendbytexting5626.

• Travellersisasmallgroupprogrammeforat-riskstudentstobuildresilienceandkeylifeskills.Itisdesignedforstudentsintheirfirstyearofsecondaryschool(Year9).Travellersenablesstudentstolearnskillstocopewithchange,lossandtransition,andtobuildself-esteemandconfidence.Findoutmoreathttps://www.skylight.org.nz/build-resilience/travellers

Teacher and counsellor development and support

Professional development

Recognisingstudentswhoseemtobedistressedisdependentontheknowledgeandskillofstaffandreferringthemtoacounsellor.Theextenttowhichstaffareabletoidentifyat-riskstudentswilldependonaschoolenvironmentwherementalhealthproblemsareconsideredimportantinthelifeofastudent.

Schoolstaffshouldbeencouragedtotakepartinregularandongoingtraining,including:

• increasingknowledgeofthesymptomsofdistressandriskofsuicide

• increasingstaffmembers’confidenceandcompetencetoreferandsupportdistressedstudents

• inductionfornewstafftoincludefamiliarisationwithschoolpoliciesandproceduresrelatingtoprevention,managementofat-riskstudentsandactionstobetakenafteranevent

• increasingstaffmembers’willingnessandcompetencetoworkinthesesituations.

See Section 3, Guidelines for responding to suicidal behaviours page 24. See Section 6, Contacts and information page 74.

Trained staff

Theschoolneedstoidentifywhoisbestplacedwithintheschooltosupportstudentswhoareatriskofsuicideorwhoaredeliberatelyharmingthemselves.Thisisusuallytheguidancecounsellorbutinsomeschoolsthismay,forexample,betheschoolsocialworker,schoolnurse,Deanorspecialeducationneedscoordinator(SENCO).Thepersoninthisrole,isreferredtoastheschoolcounsellorinthisguide.

Procedures for support

Schoolleadersandtheguidancecounsellorneedtoensureteachersandstudentsknowtherangeofsupportsystemsavailablethroughtheschoolandinthecommunity.Studentsidentifiedasatriskshouldhaveaccesstoqualifiedcounsellors,eitherwithintheschoolorifthisisnotpossible,inthecommunity.

Schoolsneedestablishedproceduresfor:

• appropriatelymanagingthemesofsuicideifandwhentheyappearthroughworkinthecurriculumorelsewhereinthelearningenvironment

• respondingtodistressedstudents

• notificationprocessesfortheprincipal,otheraffectedstaff,andfamilyandwhänauwhenastudentisassessedatmoderateorhighriskofsuicide

• referralprocesseswithexternalagenciesforstudentsassessedathighriskofsuicide,includingreferralprotocolsandeligibilitycriteriafortheagencies

• responseprocessesintheeventofasuicide.

Theseproceduresshouldbereviewedannuallyandallstaffmadeawareoftherequirementsthroughthestafforientationandprofessionaldevelopmentprogrammes.

Pastoral care and partnerships with family, whanau and external agencies

Speedyaccesstoone-to-onepastoralsupportwhenastudentisexperiencingproblemsisimportant.Theschoolcounsellorneedstohaveestablishedworkingrelationshipswithexternalagenciesthatcanprovideadviceorsupporttoeitherstudentsandtheirfamiliesandwhänauandtheschool.

Clearreferralprotocolsandstronglinkswithmentalhealthservicesandotherkeyagenciesareessential.Theschoolcounsellorwillneedtoknowhowtosupportthestudentwithintheirfamilyandwhänaucontextandworkwithexternalagencies.Aschoolcounsellorshouldneverworkinisolationwithastudentatriskofsuicideandshouldseekexternalsupportfrommentalhealthproviders.

Eachschoolshoulddevelopitsownplanfortheprovisionofpastoralcare,guidanceandcounsellinginawaythatisconsistentwithitsculture.TheguidelineTe Pakiaka Tangata Strengthening Student Wellbeing for Successoutlinespracticeprinciples,ethicsandvaluestosupportschoolstoprovidesafe,highqualitypastoralcare,guidanceandcounsellingforsecondaryschoolstudents.

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Preventing and responding to suicide – Resource kit for schools

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Classroom practices: dealing with the issue of suicide if it arises

Attentioninclasstotheissueofsuicide,whilepotentiallyinterestingformanystudents,canbedistressingforthosewithsuicidalthoughtsandmaymaketheoptionseemmoreacceptableforthesevulnerablestudents.Often,thesestudentswillnothavetoldanyoneabouttheirdistress.

Suicide and the selection of teaching materials

Themajorityofstudentswatchtelevisionormoviesandwillreadbooksaboutsuicideandwithsuicidethemes.Inaddition,theinternethasfastbecomeaworldwidephenomenonforcommunicating,informationgatheringandentertainmentforstudentsinparticular.Careneedstobetakeninconsideringtheselectionofnovels,filmsorplaysthathavesuicidethemesandthewaywediscussthisinclassroomcontexts.

See Section 5, Scenario 2: Suicide themes page 70.

Whenselectingmaterial,teachers(andlibrarians)shouldconsider:

• Issuicideportrayedasromantic,tragicorheroic?

• Doesthesuicideresultinpositiveattentionfromothers?

• Isinformationprovidedthatdirectlyorindirectlyreferstothemethodorplaceofsuicide?

• Willstudentsbeabletoidentifywiththepersonwhodiedbysuicide?

Ifthematerialmeetsoneormoreofthesecriteriacouldtheeducationalreasonsforstudyingthetextbeachievedbystudyinganotherbook?

Suicide and topics of student discussions or research

Ifsuicideoraself-harminggameorbehaviourcomesupasatopicofdiscussionoraspartofastudent’sresearch,takingopportunitiestoengagewithstudentswhentheyraisetheseissueshelpsbuildtheirunderstanding,confidenceandresilience.ForguidanceabouthowtohavetheseconversationsseeTalking with students, if students

raise the issue of suicide(Gotohttp://education.govt.nz/assets/Documents/School/Traumatic-incidents-and-emergencies/Talking-with-students-if-students-raise-the-issue-of-suicide.pdf)anddiscussing'13ReasonsWhy'withstudents(Gotohttp://education.govt.nz/assets/Documents/School/Traumatic-incidents-and-emergencies/13-Reasons-Why-season-three.pdf)

See Section 5, Scenario 3: Dangerous games and Scenario 4: Topics for discussion or study page 71.

• Talkinafactualmannerabouttherisksinvolvedinanygamethatharmsorcouldresultindeath.

• Provideinformationonwhatyouknowtobetrueaboutanygameorsituationinvolvingthedeathofyoungpeople.Ifyoudonotknow,saysoandworkthroughschoolmanagementtoprovideaccurateinformationtotheschoolcommunity.

• Promotepositiveattitudes,copingstrategiesandhealthyoptions.

• Promotewaysstudentscanhavefuntogetherinnon-riskyways.

• Promotehelp-seekingbehaviour.Informstudentsaboutthetypesofsupportservicesavailableandhowtoaccessthese.

• Remindstudentsthatchallengingsituationsinourlivesareoftentemporaryandwillpass.

• Teachaboutrisk-takingbehaviour,depressionandmentalillnessaspartoftheHealthandPhysicalEducationCurriculumandemphasisethecomponentsthatsupportwellbeing.

• Talkaboutthethingsthatmakepeoplefeelhappy,suchasgivingtoothers,listeningtomusic,playingsportortalkingwithfriends.

Ifteachershaveanyconcernsaboutdiscussionsinclassaboutsuicideordangerousgamesthatcouldleadtodeath,theyneedtotalktotheschoolcounsellingstaffordeans.Schoolsshouldhavepoliciestoguideteachersinthisarea.

Whenappropriate,discussioncanbeshiftedtorelatedtopicssuchas:

• youthhealthissues,includingdepression

• mentalhealthandwellbeing

• mentalillnessandwaysofseekinghelp,usinglocalcontacts

• dealingwithgriefandlossandrecognisingourfeelings;changingourthoughtsandfocus

• howphysicalactivityhelps

• copingwithchangeorlossofrelationshipsandproblem-solving.

Ifsuicideispartofatopicstudiedorastudent’sresearchfocus,teacherscanlimitthescopebysuggestingrelatedaspects,suchasratesofsuicideanddepression,governmentpolicies,supportprogrammesorsuggestionsonhowtohelpafriend.Itwouldobviouslybeirresponsibletoallowstudiesthatincreasestudents’knowledgeaboutthemethodsofsuicideandtheirlethality.

Cultural views about wellbeing and mental health

Viewsabouthealth,includingmentalhealth,areculturallybasedandmentalhealthissuesandemotionaldistressmaymanifestthemselvesindifferentwaysindifferentculturalgroups.Schoolsshouldbemindfulofculturalvariationsinthewaysuicideandself-harmareviewed.Whenindoubt,seekrelevantlocaladviceaboutculturalbeliefsaboutillness,deathandthesanctityoflife.Activitiesthatpromotewellbeingamongstparticulargroupsarealsoimportant.Notethattheremaybevariationsinattitudesandbeliefsaboutthesewithinculturalgroups.

Maori students' wellbeing and mental health

SuicideratesforMäoriyouth(35.5per100,000)arehigherthanthosefornon-Mäoriyouth(17.7per100,000)3.

SchoolsareincreasinglyawareoftheimportanceofrecognisingMäoriidentity,languageandculturetoimprovetheachievementofMäoristudents,inlinewiththeMäoriEducationStrategy2013–2017,Ka Hikitia – Accelerating Success

Thisrecognitionappliesequallytoissuesofhealthandwellbeing.Ensuringthatstudentshaveastrongsenseofculturalidentitywithinasupportivecommunityandinaschoolthatvaluestheirculture,canhelpsupportthewellbeingofMäoristudents.

ThereisanincreasingrangeofresourcesavailabletoschoolstosupportthebuildingofsupportforMäoristudentsandfordevelopingtheculturalcompetenceofteachers.

For more information on resources available see:

https://www.education.govt.nz/assets/Documents/Ministry/Strategies-and-policies/Ka-Hikitia/KaHikitiaAcceleratingSuccessEnglish.pdf

www.temangoroa.tki.org.nz

https://teachingcouncil.nz/content/t%C4%81taiako-cultural-competencies-teachers-m%C4%81ori-learners-0

3MinistryofHealth.Suicide facts: Deaths and intentional self-harm hospitalisations 2010.Wellington:MinistryofHealth;2012. Page 23

Section 3 – Guidelines for responding to suicidal behaviours

Part1–Respondingtostudentsatriskofsuicide

» Recognisingsuicidalbehaviours

» Self-harmandsuicide

» Respondingtostudentsatrisk:roleoftheleadershipteam

» Respondingtostudentsatrisk:roleoftheteacher

» Respondingtostudentsatrisk:roleoftheschoolcounsellor

Part2–Respondingtoasuicideandmanagingtheconsequences

» Schoolsneedtoplanhowtheywillrespondtoasuicide

» DevelopingaSuicideResponsePlan

» Managingtheaftermathofadeathbysuicide

Part3–Respondingtoasuicide:templates

» Introduction

» Templateforstatementtostudents

» Templateforalettertofamiliesandwhänau

» Templatefortalkingtostudentsaboutsuicideloss

» Templatesforthemedia

–Samplemediastatements

–Keymessagesinresponsetomediaqueries

» Sampleagendaforfamiliesandwhänaumeeting

» Templateforinformingfamiliesandwhänauabout‘chokinggames’

Part 1

Responding to students at risk of suicide

Preventing and responding to suicide – Resource kit for schools

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School-basedrecognitionofstudentsindistresshasbeenshowntobeeffectiveinprovidingassistanceforstudentswhoareatriskofsuicidalbehaviours.

Allstaffneedtoknowhowtorecogniseandsupportat-riskstudents.Thisinvolves:

• noticingself-harmandsuicidalbehaviours

• communicatingandrespondinginage-andculturally-appropriatewaystosupportstudentsandtheirfamilyandwhänauwhoareexperiencingsuicidalbehaviours

• identifyingthosewhoneedfurthersupportasaresultofsuicidalbehavioursandthenseekingappropriatesupportandcareforstudentsorstaff.

Common signs of distress

Commonsignsofdistresswhichschoolstaffwillnoticeandwhichshouldbecheckedbyacounsellorinclude:

• UnexpectedreductionofacademicperformanceThestudentshowsout-of-characterbehavioursuchasfailuretocompleteassignments,apatheticinclass,verymuchlowerthanexpectedgrades,extremedisappointmentatbeingrejectedforacourse,ordemonstratesabruptchangesinattendance,suchasincreasedabsences,tardiness,ortruancy.

• Ideasandthemesofdepression,deathandsuicideThestudent’sreadingselections,writtenessays,conversation,orartworkcontainthemesofdepression,deathandsuicide.Thestudentsuggeststhathe/shewouldnotbemissediftheyweregone,collectsanddiscussesinformationonsuicidemethods,beginsgivingawayprizedpossessions(possiblywithsomeelevationinmood),andhasmadepreviousdirectorindirectsuicidethreatsorattempts.

• ChangeinmoodThestudent’sbehaviourincludeswithdrawal,suddentearfulness,andremarkswhichindicateprofoundunhappiness,despair,hopelessness,helplessness.Thestudentmayshowangeratself,increasedirritability,moodinessandaggressiveness,lackofinterestinsurroundingsandactivitiesandmarkedemotionalinstability.Theymayshowanewinvolvementinhigh-riskactivities.

• GriefaboutasignificantlossThestudentmayhaveexperiencedstressduetotherecentdisintegrationoftheirfamilyorwhänau,orarecentdeathorsuicideinthefamilyorwhänau,

orthelossofafriendthroughdeathorsuicide,orabreak-upwithaboyfriendorgirlfriend.

• WithdrawalfromrelationshipsThestudentshowschangesinrelationshipswithfriendsandclassmates,losesinterestinextracurricularactivities,andmaydropoutofsportsandotherclubs.Thestudentbeginstospendlongperiodsoftimealone.

• PhysicalsymptomswithemotionalcauseThestudentmayhaveeatingdisturbancesorchronicphysicalcomplaints,suchasheadaches,stomachaches,fatigue,bodyaches,scratchingormarkingofthebody,orotherself-destructiveacts.Theymayshowreducedinterestinpersonalhygieneandself-care.

• High-riskbehavioursTheremaybeincreaseduseofalcoholanddrugstothepointofintoxication.Thestudentengagesinotherriskybehaviours(egdangerousdriving,playingwithguns).

Thethreatofsuicidalbehaviourshouldberegardedseriouslyandinvestigated.

• Whenthereareconcernsaboutsuicideriskthestudentshouldbeassessedtodeterminethedegreeofrisk.

• Ifdoubtsexistabouttheappropriatecourseofaction,thenadviceandconsultationwithmentalhealthprofessionalsshouldbesoughtpromptly.

• Inmostcasespromptandcontinuedliaisonwithfamiliesandwhänauofat-riskstudentsshouldbeinstituted.

• Anystudentwhoisconsideredtobeatriskofsuicideshouldbetreatedasbeingatriskuntilitisclearthatrisknolongerexists.

Factors that increase the risk of suicidal behaviours

Thereisusuallynosinglecauseofsuicidalbehaviour;ratheritcanbeviewedasasituationinwhichmultipleadversefactorshavecombined.Thefollowingareallknowntoincreasetheriskofsuicidalbehaviour:

• mentalillness,particularlydepression

• problematicsubstanceuse

• conductdisorders

• sexualabuseorotheradversechildhoodexperiences

Recognising suicidal behaviours

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• family,whänauorrelationshipbreakdown

• beinginthecareofthestateorunabletolivewithfamilyorwhänau

• disengagementwithschoolsandorcommunity

• suicidebereavement,particularlyamongstfamily,whänauorfriends.

Thosewhoengageinserioussuicidalbehavioursaremorelikelytocomefromsociallydisadvantagedbackgrounds

characterisedbylowsocio-economicstatus,limitededucationalachievementandmaterialandeconomicdisadvantage.

Beawarethatdisruptionsandtransitionsaretimesthatcanadverselyaffectthewellbeingofstudentswhoalreadyhaveahistoryofschoolsuspensions,OrangaTamarikicareandprotectionconcerns,and/oraretransitioningbetweenfamiliesorwhänauorschools.

Risky behaviours

Asphyxia or choking games

Attimesstudentsfromasmallnumberofschoolshaveplayedortakenpartin‘chokinggames’eitherinagrouporindividually.Thishasresultedinthedeathofstudentsorseriousinjuryfromthedeprivationofoxygentothebrain.Thestudentsinvolvedintheseactivitiesorgamesarenotnecessarilystudentswhoareexperiencingsuicidalbehavioursorself-harming.Thesearestudentswhoareseekingtohaveagoodtimeandalcoholcanalsobeinvolved.

Studentsengageinthisbehaviourinanattempttostarvetheirbrainsofoxygeninordertogetwhattheyperceiveasa‘floaty’feelingthatoccurswhentheypassoutandthenwakeup.Itappearsthatthestudentsthinkthisisnotdangerous.

This‘game’canstartasaninnocentrisk-takingexperience,butifbloodflowtothebrainiscompromised,seriousconsequencesincludingdeathcanoccur.Thedangerisincreasedifthestudentisalonewhentheydoit.

Werecommendthatallstaffremainalerttothepotentialforstudents’involvementinthesetypesofgames.Thesignsthatstudentsareengaginginthisnewtypeofbehaviourcaninclude:

• mentionofthechokinggame(orthegamebyanyothername–blackoutgame,passoutgame,scarfgame,spacemonkeyetc)

• marksorbruisesontheneck

• bloodshoteyes

• wearingclothingthatcoverstheneck,eveninwarmweather

• confusionordisorientationafterbeingaloneforaperiodoftime

• thepresenceofunusualitemssuchasdogleashes,ropes,scarves,bungeecords,andbeltsintheirroomsorbags

• severeheadaches,oftenfrequent

Self-harm and suicide

Youngpeoplewhoself-harmdosoformanyreasons.Notallyoungpeoplewhoself-harmdosobecausetheywishtodie.Nonsuicidalself-injurydescribesthedirect,deliberateandsociallyunacceptabledestructionofone’sownbodytissuedonewithoutconscioussuicidalintent.Incontrast,peopleattemptsuicidetoendtheirlives.

Nonsuicidalself-injuryiswidespreadamongyoungpeoplewithlatestfiguresshowingtwenty-fivepercentoffemalesandsixteenpercentofmalesself-injuring.Youngpersonengagementinself-injuryisusuallyduetopsychologicaldistressandpoorcopingandproblem-solvingskills.

Whetherayoungpersonintendstodieornot,self-harmingislikelytoexpressastrongsenseofdespairandneedstobetakenseriously.

Studentswhoareself-harmingshouldbetreatedasneedingimmediatesupportuntilfurtherassessmentindicatesotherwise.

Professionalsupportforstudentswhoself-harmshouldbeaccessed.Furtherinformationaboutself-harmandsupportforyoungpeoplewhoareself-harmingisavailableinSection 6 – Information about self-harm page 75.

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Responding to students at risk: role of the leadership team

Onceastaffmemberhasidentifiedastudentwhoseemstohavesuicidalthoughtsorbehaviours,theteacherwillneedtoknowwhotocontactandhowtoreferastudent.

Schoolsneedtodevelopclearprocedurestodothis.

Thisincludes:

• regularremindersandinformationaboutwarningsignsforschoolstaff

• informationsessionsforstaffonhowtodiscusswarningsignswithastudentandhowtoresponddirectlytoastudentwhohasexpressedsuicidalthoughtsorbehaviours.Thiscanbefacilitatedbytheschoolleadershipteamorschoolguidancecounsellor.Alternatively,refertoSection 6 – Contacts and informationorfindoutifthereisalocalsuicidepreventionnetworkthatcanassist

• Processestoreferstudentsthatidentify:

– whentorefer

– whotoreferto

– howtorefer

– whatwillhappennext

– whatinformationstaffcanexpecttoreceive.

Trained staff available

Theschoolneedstoidentifyschoolstaffwhoaretrainedandcanbeavailabletorespondtoareferralandattendsupportandplanningmeetingswithmentalhealthservices.

Thestaffmemberinthisrolewouldfacilitatecontactwiththestudent,theirfamilyandwhänau,andmentalhealthservices.Mentalhealthservicescanthenprovideaclinicalriskassessmentofthestudentandputasupportplaninplaceincollaborationwiththefamilyandwhänau,andtheschool.

Theschoolneedstoensurethereare:

• agreedintakeprocesseswithappropriatementalhealthprofessionalsandservices

• agreedprotocolsbetweentheagencyandtheschoolforsharinginformationanddevelopingsharedcareplansforthestudent

• asysteminplacesostudentscaneasilyaccessthecounselloreitherforthemselvesorforotherstheyareconcernedabout.

Ifastaffmemberhasidentifiedthatastudenthassignsofdistress(see page 26)andjudgestheretobesomerisk(nomatterhowsmall)thattheymayharmthemselvesorhaveanintentiontodie,thenthestaffmembermustmakeareferraltotheschoolcounsellororotherdesignatedperson.

• secretivebehaviour,irritability,hostility

• bleedingundertheskinofthefaceandeyelids

• questionsaboutstrangulation.

Ifyouheartalkaboutchokingasa‘game’,talkwithstudentsabouttherisks.The‘floaty’feeling,orthepassoutsensationisthebeginningofbraindamage–braincellsaredyingandthatcancausedeathorpermanentbraindamage.Thekeyissueistolookoutforsignsandbeabletorecogniseandrespondtostudentswhomayneedhelp.

Riskbehaviourforstudentscanchangefromday-to-daysomonitoringattendanceandsupervisionofstudentsineducationsettingsisimportant.Itisalsoimportanttosendoutmessagestofamiliesandwhänautoinformthemofthistypeofgameifitisoccurringinyourcommunity.See Template for informing families and whänau about ‘choking games’ on page 55.

Thereisariskthattalkingaboutthe‘chokinggame’mayelicitinterestandincreasestudents’involvement.However,thereisalsoanargumentthatprovidingfamiliesandwhänauwithappropriateinformationhelpsensurethatstudentsareawareoftheriskswhenandiftheissuearises.

Socialnetworkingsitesandtextingarehighlyeffectiveandstudentsarelikelytohearaboutsuch‘games’beforetheirfamiliesandwhänau.TheMinistryofEducation,afterconsultingrelevantexpertsincludingtheMinistryofHealth,andtheCoronialServicesUnit,recommendsyouprovideinformationtoyourfamiliesandwhänau.

IfyouhaveanyconcernsaboutthisissueorneedfurthersupportyoushouldringtheMinistry’sTraumaticIncidenthelplineon0800TITeam(0800848326).Ifyouaremadeawareofplanned‘chokingparties’,‘games’ortextmessagesinvolvingchokingyoushouldalsoinformthepolice.

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Responding to students at risk: role of the teacher

Teachers(includingsportsandancillarystaff)aretheadultsmostlikelytobeawareofstudentswhohaveissuesthatmayincreasetheriskofsuicidalbehaviour.Thesecanincludeissuesrelatedto:

• mentaldistressormentalillness

• lackoffamilyandwhänauinvolvement

• familiesandwhänauexperiencingdistressortransitions

• bullyinganddiscrimination

• ahistoryofOrangaTamarikiinvolvement

• sexualityandself-identity

Teacherswhoknowaboutrecognisingsuicidalbehaviouraremorelikelytoactonaconcernaboutastudentorapeerwhoexpressesconcernaboutafriend.

Theschoolhasaroletoensureallstaffhaveinformationaboutthecommonwarningsignsofsuicideandknowthatsomeonewhoisexperiencingoneormoreofthesewarningsignsisverylikelytoneedsupport.

See Section 5, Scenario 5: Suicidal thoughts disclosed page 72.

Anydisclosureaboutwantingtodieorthoughtsaboutoractualself-harmorharmingothers(includingintheabstract)ordisclosuresfromfriends,requiresseriousattentionandthisinformationneedstobecommunicatedtotheschoolcounsellor.

How teachers respond to a student at risk

Manystudentswilltalkorconfideintheirteacherorseektheirteacher’ssupport.Somestudentsfeelmorecomfortabletalkingtoateachertheyarefamiliarwithandmayneverhaveapproachedorspokentotheschoolcounsellor.Somestudentswillalsofeelthattalkingwithaschoolcounsellorisnottheirculturalnorm,ortheymayworrythatotherstudentsmayseethemtalkingwiththecounsellor.Teachersshouldfollowschoolpolicyonat-riskstudents.

Teachersarenotexpectedtobecounsellors.Ifateacherhasseensomewarningsignsofastudentfeelingsuicidal,theycanletthestudentknowtheyareconcernedaboutthemandarewillingtohelp.Itisimportantthatallconcernsarerespondedto.Onceateacherbecomesaware

ofaconcern,heorshemustrefertothecounsellororotherdesignatedperson,no matter how uncertain they are of the seriousness of the risk.

Suicideriskassessmentshouldonlybecarriedoutbythecounsellorordesignatedstaffmember.Ifnosuitablytrainedpersonisavailablewithintheschool,andthesituationisconcerning,thencontactshouldbemadewiththefamilyandwhänau,expressingtheseconcernsandsuggestingthestudentshouldbereferredtoalocalyouthserviceortheirdoctor.Theschoolshouldfollowupwiththestudenttoseewhatoutsidesupporthasbeenestablished.Ifnosupporthasbeenidentified,thentheschoolmayneedtocontacttheschoolnurseordoctorindependentlyofthefamilyandwhänau.

Referring a student to the school counsellor

• Ifateacherisconcernedaboutastudent’sbehaviour,orwhattheyhavebeensayingorwritingabout,theteacherneedstotellthestudentabouttheirconcernsandthattheycanassistthemtotalkwithsomeonewhowillhelpthem.

• Ifthestudentdoesnotwanttoreceiveanyhelp,theteachershouldreferthestudentontotheschool’ssupportservices(forexample,totheschoolcounsellor).

• Evenafterreferringon,ateachershouldcontinuetosupportthestudent,forexample,byaskingabouthowthey’regoingandremindingthemthattherearesupportsavailable.

• Anyactionstakenbytheteachershouldbeinthecontextandparametersofthesafetyplanfortheindividualstudent.

How teachers respond to a threat of imminent suicide

Whenthereisimminentriskofsuicide,itwillbenecessaryforanyadultpresenttosupervisethestudentandarrangeacleartransferofresponsibilitytoanotherprofessionalorthefamilyorwhänau.Thismaymeaninformingfamiliesandwhänauorsignificantothersevenifthestudentdoesnotagree.

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Ifateacherisinasituationwhereitisclearastudentisabouttotaketheirownlifeandimmediatehelpisnotavailable,theteacherneedsto:

• tellthestudentthatyoucareandyouwanttohelpthem

• listentothemandexpressempathyforwhattheyaregoingthrough

• tellthepersonthatthoughtsofsuicidearecommonanddonothavetobeactedon.

Ifthestudenthasamethodandaplanthismeansheorsheisactivelysuicidalandshouldnotbeleftalone.

• Ifthestudenthascontactedyoubyphone,text,emailorsimilar,establishwherethestudentisandaskifanyoneiswiththemornearby.

• Getthestudenttothinkaboutpeopleorthingsthathavesupportedtheminthepastandfindoutifthesesupportsarestillavailable.Iftheyare,encouragethestudenttoaccessthem.

• Callorhavesomeoneelsecallemergencyservices111.Telltheoperatorthereisastudentwhoissuicidal(giveaddressorlocation).Provideotherrelevantinformation,suchaswhetherthepersonhasbeendrinking.Giveyournameandcontactdetails.

• Callthestudentbackorstaywiththemandremoveaccesstomeansofsuicideuntilemergencyservicesarrive.Donotuseguiltorthreatstopreventsuicide,suchastellingthemtheywillruinotherpeople’slivesiftheydiebysuicideasthismayfurtherexacerbatethesituation.

Handing over responsibility

Assoonaspossible,teachersmustinvolvetheschoolcounsellorwhowillinformtheschoolprincipal.ThecounsellorwillimmediatelycontacttheCrisisAssessmentTeam.ThecounsellorwillalsolettheprincipalknowthattheCrisisAssessmentTeamhasbeencontacted.TheCrisisAssessmentTeammayreferthestudentthroughtotheirlocalGPorChildAdolescentMentalHealthServicesfollowinginitialdiscussionandassessment.Thecounsellorandprincipalshoulddiscusswhatinformationwillbesharedwithstaffandwhenandhowthiswillhappen.

Schoolmanagementshouldfollowupwithmentalhealthservicestodiscusstheactionstakenandthewelfareofthestudent.Counsellingstaffshouldfollowupthestudentonthenextschoolday.

Teachersshouldseekhelpandsupportfromtheirfriends,workcolleagues,familyandwhänau,andothersasneeded.Theymayneedtotaketimetolookaftertheirownsupportneedsandtorememberthatdespitetheirbestefforts,somepeoplewillstillattemptorcarryoutsuicide.

Teachers and confidentiality

Teachersandothersinvolvedwithathreatenedsuicideshouldneveragreetokeepaplanforsuicideconfidential.Ifthereisarisktoastudent’slife,immediateactionisneededandthismaymeaninformingfamiliesandwhänauorothersevenifthestudentdoesnotagree.Teacherscantalktothestudentabouttheirrespectforthestudent’srighttoprivacyandtotheirfutureinvolvementinanydecisionsaboutwhoneedstoknowwhathashappened.

See Section 5, Scenario 6: Breaking confidences page 72.

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Responding to students at risk: role of the school counsellor

Counsellors respond to an imminent threat of suicide

Whentheschoolcounselloriscontactedbecauseastudentisthreateningimminentsuicide,urgentactionsneedtobetaken.

• ImmediatecontactshouldbemadewiththeDHBMentalHealthCrisisAssessmentTeam.FurtherinformationcanbefoundontheMinistryofHealth’swebsite(www.health.govt.nz)bysearching‘crisisassessmentteams’.

• Freecallortext1737anytimeforsupportfromatrainedcounsellor.

• UntilcontactismadewiththeCrisisAssessmentTeam,explicitinstructionsshouldbegiventothoseprovidingthesupervisionabouthowtomakeanenvironmentsafe(forexample,removalofthemeansofsuicide,includingfirearms,pills,ropesandpoisons)andtoprovidesupportivesupervision.

See also Counsellors referring students at risk of suicide to other agencies, page 34.

Assessing the level of risk in referred students

Whenastudenthasbeenreferred,theschoolcounsellorwillneedtoassesstheriskofsuicideassoonasispracticableusingAssessment of students at risk of suicide: for school counsellors (page 11).Aftertheassessmenthasbeencompleted,andifthecounsellorconsidersthestudentisatriskofsuicide(low,moderateorhigh),theprincipalorotherdesignatedstaffshouldbeinformed.Fromthispointtheprincipal,inliaisonwiththecounsellor,mustconsiderif,whenandtowhatdegreeanyotherstaffshouldbeinformed.Theywillalsodecideif,whenandhowthefamilyandwhänauaretobeinformed.Theprimarygoalisthesafetyofthestudent.

Risklevelsinstudentscanchangerapidlyoverashortperiodoftime.Itisimportanttoremaininregularcontactwiththestudent.

Developing a safety plan for a student at risk

Counsellorsordesignatedstaffhavetheprimaryresponsibilitytodevelopasafetyplanbasedontheassessedriskandtoarrangeappropriateassistance

forthestudentwhileheorsheisinthecareoftheschool.Thisassistanceisoutlinedaspartofthesafetyplan.Adifferentsafetyplanforeachlevelwillbeformulated,basedontheguidelinesinManagement of students at risk of suicide: for school counsellors (page 14).

Changes in the level of risk

Studentsidentifiedasatriskshouldbesupportedintheschoolenvironmentandmanaged,togetherwithmentalhealthservicesandfamilyandwhänau,accordingtotheirsafetyplan.Moststudentswhoareidentifiedashavingmentalhealthorpersonaladjustmentproblemswillnotbepreoccupiedwiththoughtsofsuicide–mostsuicidalideasarefleeting,occurfromtimetotimeandinmostcasesarenotactioned.However,forasmallnumber,theriskofsuicideissignificantandshouldbeaddressedandcanchangefromlowtohighreasonablyquickly.Thisisnotalwaysobviousanditshouldbenotedthereareoccasionswheneventhemostexperiencedprofessionalsfailtorecogniseastudentatriskofsuicide.

Students who harm themselves

Studentscanharmthemselvesintentionallyinmanydifferentways.Researchshowsthatthemajorityofstudentswhoself-harmdosotomanageintense,negativeemotions.Self-harmisbestunderstoodasacopingstrategythatstudentsusetogainrelieffromfeelingdistressedandoverwhelmed.

Manystudentskeeptheirself-harmasecretbutsomemayuseself-harmasasupport-seekingstrategy.Self-harmcanbeawayofstudentscommunicatingtoothersthattheyarestrugglingandneedsupport.Counsellorsshouldrespondtotheseneedsandavoidescalatingasituationbyassumingitshowssuicidalintent.Intentisdifficulttoascertainandcarefulsensitiverapportbuildingandquestioningisneededtodetermineintent.Allstudentswhoreportordisplayself-harmwheresuicidalintentisestablishedshouldbetreatedasbeinginastateofpotentialemergencyuntilthecounsellororotherprofessionalsareconvincedotherwise.

Studiesshowthattheonsetforself-harmamongstudentscanbefromage12to15.See Section 6 – Contacts and information forfurtherinformationaboutself-harm.

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Establishing rapport with a student self-harming or at risk of suicide

Akeycomponenttoworkingwithanystudentwhopresentsinastateofdistressistheconsciousefforttoestablishrapportwiththem.

Rapportistheongoingdevelopmentofasenseofsafetyandrespectfromwhichapersoncanfeelincreasinglyfreetosharetheirproblems,whilegainingincreasedconfidenceinthepersontheyaretalkingto,tounderstandthem.

Rapportfacilitatesthedisclosureofinformationandintentandmayserveasaprotectivefactorbyencouragingasenseofhopefulnessandconnectedness.Theprocessesthatarecrucialtodevelopingastrongallianceareempathy,activelistening,trustandtransparency.

Appropriate conversations with students at risk of suicide

Anyinitialconversationwithastudentshouldbeappropriatetothelevelofanyriskofsuicideexpressedbythemorbytheteacherwhoreferredthem.Ifthereisonlyasuggestionofthoughtsaboutsuicidethentheconversationshouldstartwiththisandproceedif,andas,thestudentprovidesevidencethattheyarethinkingofsuicideasone‘solution’totheirdistress.Itisusuallymostappropriatetoinquireaboutcurrentsuicidalideasinthecontextofaseriesofquestions,ratherthanabruptlyanddirectlyaskingaboutsuicide.

Itiscommonforstudentswithadepressivedisordertohavethoughtsaboutsuicide.Manywhoaredistressedwillberelievedtobeaskedabouttheirsuicidalthoughts.Askingstudentsaboutwhattheyarethinking,alongwithcarefulandsensitivequestioning,willnotcauseastudenttobecomemoresuicidal.Careshouldalsobetakentofocusonthepositivereasonswhythestudentshouldnotcarrythroughwithasuicideplan.Inthiswaytheimmediateinterventionbeginswiththisconversationandthiscanleadtothedevelopmentofastrongpositiverelationshipbetweenthestudentandthecounsellor.However,somestudentsmaynotcommunicatetheirthoughtsaboutsuicidedirectlyevenifspecificallyasked.

Liaison with the family and whanau

Whenastudenthasbeenreferredbecausetheyareatriskofsuicidalbehaviour,counsellorsneedtoresolveissuesofconfidentiality(includinganypossibleconflicts)earlyintheassessmentprocess.Theywillneedtoestablishthelimitsofconfidentialityforeachstudent’ssituation.

Whileitisdesirabletoobtainthepermissionofthestudenttocontactothers,ifthereisaseriousandimminentthreattothelifeorhealthofthestudentthisisnotessential(See Rule 11(2d) Health Information Privacy Code 1994, NZAC Code of Ethics)– https://www.privacy.org.nz/the-privacy-act-and-codes/codes-of-practice/health-information-privacy-code-1994/

Wherethepossibilityofsuicideisaconcern,itisimportanttoconsiderspeakingwiththefamilyandwhänauattheearliestopportunity.Theappropriatenessofinvolvingastudent’sfamily,whänau,orsignificantothersisdeterminedbyseveralfactors.

• Insomecasesfamilyorwhänaumembersmaybecontributingtoaperson’ssuicidalrisk(forexample,inabusesituations)inwhichcasethecounsellor’sresponsibilityistodowhattheycantoprotectthestudentatriskofsuicide.

• Ifthestudenthasbeensubjecttoabuse(physical,sexualoremotional)thenitmaybenecessarytomakecontactwithOrangaTamarikion0508Family–0508326459orthelocalpolice.ThereisanagreedprotocolforthereportingandmanagementofchildabuseandneglectbetweenOrangaTamarikiandEducationagencies.Theseshouldbefollowed.

• Referralsto,andresponsesfrom,OrangaTamarikishouldbedocumented.

School counsellors and student confidentiality

Asschoolcounsellorsknow,confidentialityisanimportantissuewhenworkingwithstudents.Manystudentswillaskforotherstopromisesecrecybeforetheymakeadisclosure.Thisshouldbeavoidedandeveryeffortmadetoencouragethemtosharetheirconcernsandplanswithoutanypromiseofconfidentiality.Itisimportantthestudentatriskismadeawareofthefollowinglimitation:

“What you say is confidential to me, unless I believe that you are at risk of harm to yourself, or others. In such a case I will take necessary steps to protect your safety, although wherever possible I will discuss these steps with you before I take them.”

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Ifthecounsellorconsidersthestudenttobeatriskofsuicide,theprimarygoalistomaintainhisorhersafety.Thenextstepistodecidewhethertheprincipalorotherdesignatedstaffmembershouldbeinformed.Fromthere,theprincipal,inliaisonwiththecounsellor,mustdecideif,whenandtowhatextentanyotherstaffshouldbeinformed.

Whenastudentisunwillingforthecounsellortocontacttheirfamilyandwhänau,itmaybeappropriateintheshorttermforanotherstaffmembertobeavailabletothefamilyandwhänautotryandassistwithissuesofconcerntothem,whilepreservingconfidentialityaboutinformationrelatingtothestudent.

Ifthestudentdoesnotwishfamilyandwhänautobecontactedornotifiedandifthisdoesnotcompromisethesafetyofthestudent,thenconfidentialityshouldbemaintained.

Cultural considerations for students at risk of suicide

Whencounsellorsareassessingastudent’ssuicidalintent,itisimportanttodeterminethemeaningandunderlyingmotivesofthebehaviour.Culturalfactorsandbeliefsmayinfluencesuicidalbehaviour.

ThissectionbelowhasbeentakenfromTe Whakauruora Restoration of Health: Mäori suicide Prevention Resource, 2009 andshouldbereferredtowhenworkingwithMäorilearnersandtheirwhänau.

Thetermwhakamomoriisoftenusedasatranslationforsuicide;itdoesnotspecificallymeansuicide,butratherdenotesamuchbroaderbackgroundandmeaning.FormanyinteaoMäori,whakamomorithereforeisnottheactofsuicide,ratheritdescribesfeelings,thoughts,emotionsandactionsthatcanbuildupandleadtoasuicideattempt.

RespondingtoMäoriwhomaybeexperiencingwhakamomorirequiresunderstandingthatsuicidalfeelings,thoughts,emotions,andactionsforsomeMäoriarecapturedwithinaculturalandaspiritualcontext.Someexpressionsheardinclude:

“Grieving without a death”

“My wairua is being squeezed”

“Whakaihi – feeling mokemoke or lost and lonely and set apart from others”

“Ihiihi – feeling mätaku or very afraid”

“Puuihi – feeling whakamä, or full of shame”

“Whakamomori – a yearning to escape haunting thoughts, feelings, emotions and dreams”

Acknowledgingtheculturalandspiritualcontextofsuicidalthoughts,feelingsand/oractionscaninvolveaskingquestionsthatexploreandallowforculturalandspiritualexpressionssuchas:

What has happened?

Why do you think you are you feeling this way?

What are you experiencing?

How long have you been feeling like this?

ItisimportanttoacknowledgethatthepathwaytosuicidecanbeverydifferentforMäorithanfornon-Mäori;andfurthermore,suicideamongMäoricanbevieweddifferentlyfromiwitoiwi.

InthecaseofyoungMäoristudents,culturalexpertssuchaskaumatua,whänausupportworkersandMäorimentalhealthworkerscanprovidevaluableadviceonthesemattersandmaybeabletoresolveanyconflict.Thisisespeciallysoiftheyarealreadypartoftheschoolcommunity.InNewZealandthereareTreatyofWaitangiresponsibilitiesthatsupporttheprovisionofculturallyappropriatetreatmentoptionsforMäori.

FormanyAsiancultures,suicideisseenasstigmatisingandshaming,notonlyfortheyoungpersonbutalsofortheirfamily.Thereareoftensocialtaboosontalkingtopeopleoutsideofthefamilyaboutmattersconsideredtobeprivateorshameful.SuicidalintentforChinesestudentscanbelinkedtosimilarthemesofotheryoungpeople,butalsoinclude:

• perceivedfailuretoliveuptounrealisticfamilyoracademicexpectations

• relationshipissues

• bullyinganddiscrimination

• difficultywithculturalintegration,leadingtoisolation.

Incultureswithastrongemphasisoffamilialidentityorconnectionandprescriptivesocialrolesandstatusinfamily/whänaustructures,suicidalthoughtsorattemptsareofteninfluencedby:

• aperceptionoffailuretofulfilfamily,whänauandsocietalexpectations

• asenseofshameontheyoungpersonandthefamilyandwhänau.

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ThosewhohavecometoNewZealandasrefugeesandhaveexperiencedseveretraumahaveaheightenedriskofself-harmingbehaviourandsuicide.Theymayhaveastrongdistrustofanyservicesandbereluctanttodiscloseinformationorbereferredtomentalhealthservices,owingtopreviousexperiences,ortheymayfeeltheserviceisnotlinkedtotheirbeliefsaboutwellbeingorillness.

Cultural advice and guidance for counsellors

Itisoftenhelpfulforthecounsellortoseekguidanceaboutissuesandbeliefsfromthefamilyandwhänau,religiousorganisationsandcommunityleaderswhendealingwithacultureorreligionthatthecounsellorisunfamiliarwith.Itmayalsobeappropriatetoseektheservicesofalocalhealthservice,culturaladviserorreligiousleaderifthestudentvaluestheirinvolvementandtruststheparticularperson.

Wherethereisasignificantdifferencebetweentheculturalviewsheldbythestudentandthecounsellor,thecounsellorshouldconsultwithaculturallyappropriateserviceorspecialist,inliaisonwithmentalhealthservices.

Thisisclearlythecasewherethestudent’sprimarycultureandlanguageisnotthatofthecounsellorbutcouldalsoincludesituationswherespiritualorothervaluesdiffersignificantly.

Itshouldalsoberecognisedthatsomestudentsmaynotwishtoaccessservicesfromprofessionalsoragenciesfromtheirculturalgroupandmaywishtousemainstreamservices,owingtoconcernsoverconfidentialityorinvolvement.Evenwhenthisoccurs,itisusefulforcounsellorstoseekadvicefromappropriateandqualifiedculturalexperts.

Other groups of students who may be at risk

Counsellorsneedtotakeintoaccountgroupsofstudentswhostatisticallymayhaveahigherriskofsuicidalbehaviour.Studentswhoareorthinktheymaybelesbian,gay,bisexual,transgenderandintersexhavebeenidentifiedinsomestudiesasbeingathigherriskofsuicide.Schoolcounsellorsshouldbeawareofthepossibilitythatstudentswhoarelonelyandisolatedmayhaveissuesabouttheirsexualitythatshouldbeinvestigatedandappropriatesupportgiven.

Counsellors referring students at risk of suicide to other agencies

Itisimportantthattheschoolcounsellorisawareoftheprofessionals,agenciesandgroupsintheircommunitythatproviderelevantservicesandsupportanddevelopsrelationshipswiththembeforetheirservicesarerequired.Schoolsshouldmaintainanup-to-datelistoflocaldoctorsandotherrelevantservicesintheirarea.Thelistshouldincludeafter-hoursdetails,suchaspsychiatricemergencyteams,astheseservicesmaysometimestakeoverfromroutineservicesat4.30pmorearlier.

SchoolcounsellorsareencouragedtofosteraprofessionalrelationshipwiththelocalChild&AdolescentMentalHealthServices(CAMHS).Regular(althoughnotnecessarilyfrequent)face-to-facemeetingshelptobuildrelationshipsandfamiliaritymaymakephoneconsultationsforbriefadvicebothmorelikelytohappenandmoreproductive.

Whenmakingareferraltoahealthcareprofessionaloragency,thesesuggestionsmaybeuseful.

• Aspartoftheirpolicyinthisarea,schoolscanestablishreferralprotocolswithlocalagencies,includingtheeligibilitycriteriafortheagencyandtheintakeandassessmentprotocols.Withestablishedprotocols,theagencycanprovidefeedbacktotheschoolanddevelopsharedcareplansforreferredstudents.

• Anyreferralsshouldbemadetohealthcareprofessionalswhoareexperiencedandtrainedtoworkwithstudentsatriskofsuicideand/orwithdepressivedisorders.Thisincludesclinicalpsychologists,psychiatrists,qualifiedpsychotherapistsandcounsellors.

• Inmakingareferralitisimportanttoconsidertheethnicandculturalbackgroundoftheprofessionalandhowthatmayfitwiththestudent,aswellasanyotherfactorsthatmightinfluencethetreatmentstheyuse.

• Itishelpfulwhenmakingareferraltoindicatetheneedsofthestudentandtheirsuspectedproblemareas,theexpectationsofthereferralandtheongoingrolesandresponsibilitiesforsupport(especiallycrisismanagement).

• Anyintervention(suchascounselling)shouldgenerallybetime-limited,focusedonthestudent’scurrentproblemsandaimed,firstly,atsymptomresolutionandsecondlyatthepreventionoffutureriskofsuicide.

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• Toensurethatadequatefeedbackisreceivedfromthehealthcareworker,theschoolshouldspecifythatitwantsaprogressreportbyaspecifieddate.Thissharingofinformationshouldbedonewiththestudent’sconsentbutalsoinaccordancewithacceptedprinciplesofconfidentiality.

• Thereisaneedtomonitortheoutcomewhenevertreatmentisinitiated.Thisisespeciallyimportantifcounsellingisusedastheonlytreatmentandthepersonfailstoshowanyimprovementinfourtosixweeks.Insuchsituations,theschoolshouldconsulttheprofessional,considerare-assessmentandreviewthemanagementplan.

Itisnotalwayseasytoaccesspromptandappropriatecarefromsupportagencies,particularlyinruralareas.Itisimportantthatschoolsdocumenttheirattemptstogethelpfromsupportagenciesandhealthprofessionals.Effortsshouldcontinue,despitefrustration.Failuretogetanadequateresponseshouldbeaddressedinwritingtotheagencyconcernedand,ifnecessary,totheprofessionalbodiestowhichtheyareresponsible.

Counsellors and follow-up of referred students

Forsomestudents,theriskofsuicidewillperiodicallyreturnandongoingmonitoringwillbeneeded.Thisisespeciallylikelywhenlifeisstressfulforthestudent.Suchcaseswillbepartoftheusualworkloadofcounsellorsandtheprofessionalswhoassistthem.

Ineverycaseitisimportanttoassistthestudenttoreintegrateintotheschoolinconsultationwiththeirfamilyandwhänau,andtheagenciesinvolved.Thiscaninvolvearrangingfor‘catch-up’materialandhelpingteacherstorelateappropriatelytothestudent.Asfaraspossible,allstaffshouldbeencouragedtosupportthestudentinasnormalamanneraspossible–suchassupportingtheirinclusioninactivities,particulargroupactivities,appropriategreetingswithintheschoolenvironmentandoccasionalinquiriesabouthowthingsaregoing.

Support and involvement of teaching staff

Ifastaffmemberhasmadeareferral,theyneedtobetoldwhetherornotthereferralhasbeenactioned.Ameetingshouldtakeplacewiththeteachertodiscusswhatinformationisavailabletodiscusswithothersandwhatinformationshouldnotbediscussed.

Teachingstaffwillneedsomeinformationtohelpthemsupportthestudent.Ifthestudentisawaretheteacherknowstheirsituation,itmaybeappropriateforateachertoprovidesupportbyaskingthestudent:“How’s it going?”Teacherscanalsoprovidesupportby:

• ensuringthestudentremainsinvolvedinclassroomactivities

• facilitatingthestudent’sinvolvementingroupandcooperativelearningactivities

• decreasingdisciplineinfractions

• increasingsupervisionandawarenessofthestudent.

Somecompensationsandsupportmayneedtobemadeforstudentswhohavedepressionoranothermentalillnessorwhoareonmedication.Teacherscanhelpastudentwithdepressionbyinvolvingthem,takingcarenottoexcludethemfromschoolandsocialactivitiesandthroughactivelistening.

Whereastudentexperiencesamentalillness,absencesmaybemorefrequent.Itisbesttoengageandworkwiththefamilyandwhänau,andmentalhealthservicestoensurethestudentremainswithintheschoolenvironmentandthatinterventionshavebeenputinplacetoincreaseattendance.Disruptionstosocialnetworksandresourcesforstudentscanhaveanegativeeffectontheirhealthandwellbeing.

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Supporting a student who is at risk of suicide in their community

Moststudentsatsomeriskofsuicidearesupportedintheirusuallivingarrangementswithinterventionsthatmayinvolvemedication,activesupervisionbyfamilyandwhänau,examinationoftheirphysicalenvironment,culturalsupport,reductionofstressesandthestrengtheningofsocialsupports,includingschoolsupports.

Inanymanagementofastudentatriskofsuicideinthecommunity,theschoolcounsellorneedstohaveclearinformationabout:

• thecurrentmentalstateofthestudent,thetreatmentandthelevelofsuiciderisk

• whetherthestudentisunderthesupervisionofmentalhealthservicesorbeingmanagedbytheirdoctorandacontactnumber,incasethehealthprofessionalneedstobeconsultedaboutanynewconcerns

• whetherthestudentneeds24-hoursupervisionandsupport,includingsupervisionatschool

• whetherthereisongoingaccesstospecialistmentalhealthservices(Specialistmentalhealthfollowupforstudentsindicatingongoingseriousriskofsuicideshouldbeapriority.)

• whetherornottheschoolhastheabilitytorespondtochangesinthestateofthestudent

• thesafetyoftheperson’sphysicalenvironmentandwhatsupportsareavailablethere

• issuesofconfidentiality.

Thefamily,whänau,schoolleadersandothersdirectlyinvolvedshouldbeawarethattheMentalHealthActcanbeusedasaresourcetosetboundariesforthepersonandthatthepolicemaybecalledinemergencies.Whenandhowthismightoccurshouldbediscussedinadvance.

Safety at home for the student

Whenthestudentisintheirusuallivingsituation,thefollowingsafetyfactorswillneedtobediscussedwiththefamilyandwhänau:

• Arefamilyandwhänauabletoaccessappropriatesupport,includingrespondingtoanemergency?

• Howwillthefamilyandwhänaudealwiththepotentiallydistressingandunsettlingeffectonotherfamilyandwhänaumembers?

• Howeasyordifficultwillitbetoremovepotentiallyharmfulobjectsandsubstances(suchaspoisons,ropes,firearms,vehiclesormedicines)fromtheenvironment?Whathelpmightbeneeded?

Healthserviceswillworkwiththestudentandtheirfamilyandwhänautoaddressunderlyingcausesforthedistresstoreducethelikelihoodofrecurrence.Theschoolcounsellormaybeinvolvedinanytreatmentplanningmeetingsforthestudentorthestudentmaybereferredbacktothecounselloratsomestageforongoingcounsellingandmonitoringatschool.

Whereverpossible,anyjointresponsibilityshouldbeaccompaniedbyawrittenunderstandingonrolesandresponsibilities.Ifthereisaspecialisthealthserviceestablishedtomeetthestudent'sculturalneeds,theschoolcounsellorshould,inconsultationwithmentalhealthservices,supportthisinvolvement.

Part 2

Responding to a suicide and managing the consequences

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Schools need to plan how they will respond to suicide

Intheeventofaseriousattemptorsuspecteddeathbysuicide,schoolsneedtobepreparedtolimitthenegativeconsequencesforotherstudents.Ingeneral,thisisthesameforanysimilartraumabutincasesofsuicide,thereisalsoariskthatotherstudentsmayconsidersuicideasapossible‘solution’totheirdistress.Thiscontagioneffect(see page 41)iswelldocumentedinNewZealandandisaseriousthreatinanyschoolwheretherehasbeenawell-publicisedsuicide.

Traumatic Incident Response Plan and suicide

Assuicideisarareeventinschools,itisrecommendedthataSuicideResponsePlanbedevelopedaspartofthe

school’sTraumaticIncidentResponsePlan(TIRP),ratherthanasastand-alonepolicy.TheaimoftheSuicideResponsePlanwithintheTIRPshouldbetomanagetheconsequencesofaseriousattemptat,orcompleted,suicide.

TheaimofaSuicideResponsePlanistomaximiseresilienceandtominimiseriskwithinindividuals,school,family,whänauandcommunityandtopromotethehealthyrecoveryoftheaffectedschoolandcommunity.

ThissectionshouldbereadinconjunctionwithEmergency planning advicehttps://www.education.govt.nz/school/health-safety-and-wellbeing/emergencies-and-traumatic-incidents/preparing-for-emergencies-and-traumatic-incidents/

Developing a Suicide Response Plan

ASuicideResponsePlanneedstobedevelopedbeforeatraumaticincidentoccurs–therewillbenotimetodevelopaplanwhenanincidentoccurs.

ThePlanshouldinvolveallstaffandmakeprovisionforinclusionofstudents,familyandwhänauandsupportagenciesfromoutsidetheschool,asappropriate.ThePlanshouldnotdependuponanysinglepersonbutbeabletobeimplementedbythestaffavailableatthetimeandpromotethecoordinatedresponsibilityofateamofpeoplewhocansupporteachother.

ThePlanshouldincludedetailsabout:

• coordinationofmanagementresponsestotheeffectsoftheevent

• managinganymediainterest

• dedicatedrolestobecarriedout

• communicationwiththefamily,whänauandcommunity

• supportforwellbeingofstudents,theirfamiliesandwhänau,andteachers.

Ministry of Education resources

• Forinformationaboutlocalworkshopstohelppreparepolicies,plansandprocedurescontactSpecialEducationstaffatyourlocalMinistryofEducationOfficeorcall0800TITEAM(0800848326).

• TheMinistryofEducationalsoprovidessupporttoaschoolafteranemergencyorsuddendeathbyworkingalongsideaschool’straumaticincidentteamormanagementteamastheyrespondtoanincidentandimplementtheTraumaticIncidentResponsePlan

See Section 5, Scenario 7: Communicating news of a suicide, page 73.

Managing the aftermath of a death by suicide

Inmanyways,thestepsschoolsneedtotakeafteradeathbysuicidearethesameaswouldberequiredforanystudentdeath.Themainexceptionsrelatetocommunicationsandtotheattentionneededforstudentswhomaythemselvesbevulnerableandcouldbeatriskofsuicidalbehavioursthemselves.

Communicating information about the suicide

Therearecertainstepsthatschoolsneedtotakeafterthesuddendeathofastudent.Evenwhenitisasuspectedsuicide,thecauseofdeathwon’tbedetermineduntilaftertheCoronerhasmadearuling,sotheprocesstobefollowedwillbemostlythesameasforanystudentdeath.Themaindifferenceisinhowtocommunicateandprovidesupporttothestudent’sfamily/whänauandclosefriends,whomaythemselvesbevulnerableandcouldbeatriskofsuicidalbehaviours.

Therearetwocriticalareasthatschoolleadersneedtobemindfulofafterasuspectedsuicide,toprotectstudents:

• AnydiscussionofthemeansofsuicideisexplicitlyrestrictedbytheCoronersAmendmentAct2016.1Thereisariskthatdistressedstudentsmayconsidercopyingthemeansofsuicide.

• Anyresponseactivitiesmustnot,intentionallyorunintentionally,glorifyorsensationalisethedeath.Thereisariskthatvulnerablestudentscanbecomefocusedonsuicideasawaytomeetaneed.

Whilethedeathofastudentinaschoolwillhaveadirectimpactontheschoolcommunity,schoolsalsoneedtobealerttothepossibleimpactofthedeathofarecentpaststudent,astudentinanotherschool,orthewell-knowndeathofastudentinthecommunity.

Schoolsneedtohaveawell-developedsystemthatidentifiesthosewhomaybedistressed(throughfamilies/whänau,teachers),refersandrespondstostudentdistress,andmonitorsconcerns.

Afteradeathbysuicide,schoolsneedtobeawareofthepossibilityofsubsequentsuicidesorsuicideattemptsthataretriggeredbythefirstdeath.Acommoncharacteristicofthesedeathsisthattheaffectedstudentshaveahistoryofpersonalproblems,personaldifficulties,ormentalhealthissuesthathavemadethemvulnerabletosuicidalbehaviour.Havingsystemsandprotocolsinplaceforidentifyingandrespondingtodistressedstudentsandfamily/whänauwillhelpsupportandprotecttheschoolcommunity.

TipsonansweringquestionsaboutsuicidefromstudentscanbefoundintheMentalHealthFoundationresource‘Connecting through Körero’: https://www.mentalhealth.org.nz/get-help/connecting-through-körero

TheMinistryofEducationcanalsoworkwithyourschoolleadershipteamandyourcommunityorganisationstosupportyourcommunityafterasuicide.

See the Template for a statement to students and the Template for a letter to families and whänau in Part 3 of this section.

Forotherusefulresources,gotohttp://education.govt.nz/school/health-safety-and-wellbeing/emergencies-and-traumatic-incidents/preparing-foremergencies-and-traumatic-incidents/

Liaison with the bereaved family and whanau

Somefamiliesandwhänaumaynotwishforthedeathtobedisclosedasasuicide.Whilefamilyandwhänauwishesshouldberespected,schoolsalsohavetotakeintoaccountthebroaderobligationforthecareandsafetyofalloftheschool’sstudents.

Ifthefamilyandwhänaudonotwishtheschooltodiscloseanyinformationaboutthedeathitmaybehelpfulifapersonwhohasagoodrelationshipwiththefamilyandwhänaucontactsthemandexplainsthatstudentsarealreadytalkingaboutthedeath.

Theschoolmayneedtomakeastatementtotheschoolcommunity,suchas“the family and whänau have requested that information about the cause of death not be shared at this time. We ask everyone to respect the privacy of the family and whänau. We know there has been a lot of talk about whether this was a suicide death. Since the subject of suicide has been raised we want to take this opportunity to give you accurate information about suicide in general …”

Funeral ceremonies

TherewasatimeinNewZealandwhenonlytwotraditionsofdeathanddying,MäoriandPakeha,werewidelyobserved.Inrecentyearsthereisgreaterawarenessofculturaldiversityoffunerals.Culture,faith,philosophicaloutlook,allinfluencebereavementanddeterminecustomsandtraditionssurroundingceremoniesfarewellingthedead.Schoolsneedtobemindfuloftherolethesefactorsplayandseekculturalsupportandknowledgeandliaisesensitivelywiththebereavedfamilyandwhänauabout

1https://coronialservices.justice.govt.nz/suicide/making-information-about-a-suicide-public/

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theirwishes.Experiencingdeathisahumansocialandspiritualevent.Studentsseekmeaningandunderstandingabouttheeventthroughtheirexperienceofthebereavementprocesses.Schoolsalsoneedtobemindfuloftherightsofstudentsnottoattendfuneralevents.

Thereisalsonorequirementforanysortoffuneralceremonytobeheldaftersomeonedies.Sometimeswhenadeathissuddenandverytraumaticthebereavedfamilyandwhänaumayfeelthatholdingafuneralwouldbetoopainful.Thisisthedecisionofthefamilyandwhänau.Insomecasesschoolsmaybeaskedtoholdororganisethefuneral.Thisissueneedstobehandledwithsensitivitybutitisnottheroleoftheschool.SupportcanbeaccessedfromtheMinistryofEducationTraumaticIncidentService.Furtherinformationcanbeaccessedfrom:Death without warninghttps://skylight-trust.myshopify.com/products/dww.Alternative ceremonies, Burial or Cremation and Funeralshttps://www.fdanz.co.nz/

Returning the deceased student’s property

Theschoolmustensureitcollectsallofthestudent’sequipmentandbelongingsandreturnthemtothefamilyandwhänauatanappropriatetimesoonafterthefuneral.

Specific cultural activities

Forsomestudentstheremaybeappropriateculturalorspiritualactivitiesthatshouldtakeplace.Forexample,forMäori,akarakiatofarewellthepersonorablessingmaybeimportant.Teacherswillneedtoacknowledgethestudentandwherethestudentsatorwhatthestudentlikedtodo.Wherepossible,studentsshouldbeinvolvedinplanninghowtomarkthis.

Identifying students as risk

Afterasuicide,schoolleadersandtheguidancesysteminconsultationwithteacherswillneedtoidentifyandmonitorstudentsatrisk.Schoolsneedtodevelopareportingsystemsothatteachersorfamiliesandwhänauwhoareconcernedaboutastudentknowwhotheycancontact.Allfamiliesandwhänauandteachersneedtohaveinformationtobeabletorecognisestudentsindistress.Commonsignsofdistressthatshouldbecheckedbyacounsellor,nurseorGPcanbefoundunderRecognising suicidal behaviours in Section 3 on page 26.

Studentswhohaveahistoryofschoolsuspensions,Child,YouthandFamilycareandprotectionconcerns,and/oraretransitioningbetweenfamiliesandwhänauorschoolsareparticularlyatrisk.

Noticing and engaging students who are absent

Studentswhoarealreadyawareofthedeathmaydecidenottoattendschoolormayleaveduringschoolhourswithoutexplanationorpermission.Afterastudentsuicide,itisimportantthattheschoolknowswhereabsentstudentsareandiftheyhaveadultsupervision.Ifstudentsarenotunderadultsupervision,familyandwhänaushouldbenotifiedandthestudentsencouragedtoattendschooltoparticipateinsupportiveactivities.Absencesshouldbecloselymonitoredwithclassrollstakenateachclassandanyabsencesnotifiedtotheappropriatestaff.

Memorial gatherings and other activities

Asapartoftheirgrieving,somestudentsmaygatherattheplacewherethedeathoccurred,atanothersiteofinterest,orcontributetoanonlineforum,andmayevenerecta‘shrine’inmemoryoftheperson.Thesegatheringscanbeintenseandveryemotionalforthoseattending,especiallyforstudentswhoarealreadyvulnerable.Theyneedtobemonitoredbyadultsandfamilyandwhänaumadeawareofthem.Attendanceatsuchgatheringsshouldbetime-limitedandstudentsdiscouragedfromlingering.

Someadultsmayresistthistypeofactivitybutprohibitingthiscanalsobeproblematic.Forexample,thebereavedfamilyandwhänauorfriendsmayfindthisdeeplystigmatisinganditcangenerateintensenegativereactionsandmayexacerbateanalreadydifficultsituation.

Coronialinquests,birthdaysandothereventscancausedistress.Schoolsneedtomonitoraffectedstudentsatthesetimes.Schoolscanplayanimportantroleinchannellingthisenergyinapositivedirectionbyproactivelymeetingwithgroupsorthoseclosesttothestudenttotalkaboutthetypeandtimingofanyactivities.

Thiscanprovideanimportantopportunityforstudentstobeheardandfortheschooltosensitivelyexplainitsrationaleforpermittingcertainkindsofactivitiesandnotothers.Itcanbehelpfultoprovideconstructivesuggestionsaboutpositiveactivities,suchas:

• raisingfundsforthefamilyandwhänau

• sponsoringamentalhealthawarenessday.

Monitoring social media

Socialmediaareimportantcommunicationtoolsforstudents.Theycanbeusedaspartoftheschool’sresponsetothesuicide.Byworkinginpartnershipwithkeystudentsandteachers,theschoolcanidentifyandmonitorrelevant

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socialnetworkingsitesandusethesestrategicallytoshareprevention-orientatedsafemessaging,offersupporttostudentswhomaybestrugglingtocopeandidentifyandrespondtostudentswhoindicatethroughthesitestheycouldbeatrisk.

Supporting peers in class and students who are distressed

Wherepossible,supportforstudentsshouldbemanagedwithintheclassroomsetting.Studentsarebestsupportedbytheadultstheyknowandtrust,theirteachersandfamilyandwhänau.Responsestoanydistressingeventsarealsosupportedthroughthemaintenanceofroutines,‘normalcy’andthespiritualandculturalprocessesassociatedwithdeath.

Moststudentshavemanagedthebasicskillsthatallowthemtohandlestrongemotionsencountereddaytoday,buttheseskillsmaybechallengedafterasuicide.Adolescencemarksatimeofincreaseddifficultieswithemotionalregulation.Schoolsshouldprovidestudentswithappropriateopportunitiestoexpresstheiremotionsandtoidentifystrategiesformanagingthem.

TheschoolTIRPteamcanprovideresourcesonwarningsignsandhowtosupportstudentsthroughthisdifficulttime.Theywillaskteacherstocarefullymonitorclassrolls,identifystudentswhomaybedistressedandnotifydesignatedstaffofanyabsencesfromclassforfollowup.Theywillalsoaskteachersto:

• monitoranydistressedstudentcarefullyandnotifyrelevantstaffofanysuddenorworryingchangesinmoodorbehaviour

• remembertolookoutfortheircolleaguesandotherstaffandbesupportive

• encouragestudentstolookoutforeachotherandtonotifyidentifiedstaffiftheyareconcernedaboutthewelfareofanystudent.Teachersneedtoemphasisethatgettinghelpforafriendisnotabreachofloyalty.

Using a support room

Sometimesaschoolmaysetupaseparateroom,commonlyknownasasupportroom,forstudentswhoarenotabletocopeinclass.Althoughthereisnoevidencetosupportthispractice,itisapragmaticstepsomeschoolshavetotaketoprovidesupportforthosewhocannotremainintheclassroomenvironment.Ifaroomismadeavailable,staffneedtosuperviseit,

providesupporttoupsetstudentsandredirectotherstudentsbacktoclass,asappropriate.Suitabledirectedactivitieswillbeneededtohelpsupportstudents,suchasinformationaboutsuicide,informationaboutsupportagenciesorwebsites,tissues,aplacewherestudentscansitorwritecardstothefamilyandwhänauetc.

Itcanbedifficultinasupportroomenvironmenttomanagetheemotionsandresponsesofstudentstogether,includingwhattheymaybetalkingabout,whotheyarecommunicatingwithandtomonitortheirmovementinandoutofthesupportroomandelsewhereintheschoolenvironment.Asupportroomshouldhaveclearlystatedrulesaboutthelengthoftimestudentscanstayintheroomandsomecriteriaaboutwhousestheroomandwhen.

Particularemphasisshouldbeplacedonensuringallabsencesfromclasses,andthetimethestudentarrivesandleavesthesupportroom,aredocumentedandcheckedagainsttheattendancerolls.Follow-upanystudentswhoareabsentfornoidentifiedreason.

Supporting the close friends

Sometimesitbecomesapparentthatthestudentwhodiedcommunicatedwithfriendsbeforethedeathinawaythatmayaffectthefriends’wellbeing.Thiscanincludeleavingnotes,possessions,textmessagesandotheractivities.

Thesestudentsandtheirfamiliesandwhänaumayneedadditionalsupportandcontact.Familiesandwhänaumayneedguidanceontalkingaboutsuicidewiththeirchildrenandhowbesttosupportthemduringthisdifficulttime.Theymayalsoneedreliableinformationrelatingtomentalhealthandsuicideprevention.Familiesandwhänauandstudentswillneedinformationonactivitiesthatsupportmentalwellbeing.

See Section 5, Scenario 8: Managing student support page 73.

Sport groups and other school activity groups

Thestudentwhohasdiedmayhavebeenamemberofasportingteamorpartofanotherschoolactivity.Afterthedeath,membersofthesegroupsmayneedtobebroughttogethertotalkaboutit.Theschoolshoulddiscusswiththegrouphowanychangesmightbeaddressed,suchaswhattodoatthenextteampracticeorwhowillcollecttheperson’sequipment.Oftenthisdiscussionwillbringchangesthatwillbe

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helpfulandallowindividualstoacknowledgethedeathinappropriateandculturallyacceptableways.Tofacilitatethis,itisparticularlyimportantthatthestudentmanagementsystemisupdatedtoensurerelevantinformationisdisseminatedtothecorrectpeople.

Suicide contagion

Afteradeathbysuicide,schoolsneedtobeawareofthepossibilityofsuicidecontagion.Suicidecontagionreferstothespreadofsuicidalthoughts,behavioursanddeathsafterexposuretosuicidalbehaviour.Contagiousbehaviourisincreasedwhen:

• studentshavedirectcontactwiththeevent,or

• studentsidentifywiththefeelingsorlifesituationofthedeceased,or

• reportingisdetailedorsensationalist,or

• thepersonwashighlyregarded.

Whilethesuicideofastudentinaschoolwillhaveadirectimpactontheschoolcommunity,schoolsshouldalsobealerttothepossibleimpactofthesuicideofarecentpaststudent,astudentinanotherschoolorthewell-publiciseddeathofayoungpersoninthecommunity.Schoolsneedtohaveawell-developedsystemthatidentifiesthosewhomaybedistressed(throughfamiliesandwhänau,andteachers)andmonitorsandrespondstoconcerns.

Insomecasestheremaybestudentswhowillconsider‘copying’themeansofsuicide,whichisthereasonanydiscussiononthemeansofsuicideisnotencouraged.Schoolmanagementneedstoensurethatanyresponseactivitiesdonot,intentionallyorunintentionally,glorifyorsensationalisethedeathasthiscanleadtovulnerablestudentsbecomingfascinatedwiththeideaofsuicide.

Longer term follow-up for the school community

Theaimofanyresponseafteradeathistoassisttheschoolcommunitytoreturntoanormalroutineasquicklyaspossible.Thetimeframesforthiswillvaryaccordingtodifferentneedsandresponsesandmaybeunpredictable.Ingeneral,whileacknowledgingtheimpactasuicidehas,schoolsneedtousetheirwhole-schoolapproachtopromotingwellbeingandtofocusonpositivestrategiestoincreaseresilience.

Theguidingprincipleforadeathbysuicideisthatitshouldbetreatedasotherdeathsintheschoolenvironment,forexample,ifthereistributetodeceasedstudentsintheschoolyearbookoratgraduationoratschoolleavingtime,briefstatementsacknowledgingandnamingthesestudentswhohavediedshouldbemade.Thefocusintheschoolafteradeathshouldbeonareturntolearningroutinesandengagementinactivitiesthatpromotementalhealthandwellbeing(forexamplekeepingactive,involvementinsport,culturalactivities).

Part 3

Responding to a suicide: templates

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Introduction

Thetemplatesinthissectionaredesignedtohelpschoolsmanagetheaftermathofasuicide.

Schoolscanadaptthesetemplatesaccordingtotheirsituationandneeds.

Thetemplatesinclude:

• Astatementtostudents

• Alettertofamiliesandwhänau

• Talkingtostudentsaboutsuicideloss

• Templateforthemedia

• Asampleagendaforfamilyandwhänaumeeting

• Informingfamiliesandwhänauabout‘chokinggames’.

Formoreinformationfollowingadeathbysuicide,schoolscancontacttheMinistryofEducationTraumaticIncidents(TI)teamon0800TITEAM(0800848326).

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Wehavehadadifficulttimedecidingwhattosaytoyoutodayasoneofourstudents,[student'sname]hasdiedandweareaffectedbythisjustasmanyofyouare.

FromwhatIknow:

Briefly review the known facts, actions that are going to be taken, arrangements that have/are being made and any other information that seems relevant and important.

ThecauseofdeathhasnotyetbeendeterminedbytheCoroner’soffice.We’lldoourbesttogiveyouaccurateinformationasitbecomesknowntous.

Apartfromwhatyouhavejustbeentold,isthereotherinformationthatweshouldknowabout?Canyoutellmeaboutthis?

Ask for clarification or correction of the facts to allow students to participate – but only if they want to. Take care to ensure clarification is age and culturally appropriate. If students have heard that the death is a suspected suicide (and teachers are aware of this) then the following statement is helpful.

Weareawarethere’sbeentalkaboutthepossibilitythatthiswasasuspectedsuicide.Weaskyounottospreadthiskindoftalkasitcanbeverydistressingforeveryonewhoknewandloved[student’sname].

Itishardtohearthissortofnews.Weneedtorespectoneanother’semotions,nomatterhowdifferentlywemightfeeloract.Eachofushasourownwayofreactingto,andcopingwiththiskindofnews.It’sokayifyouwanttocryorifyoudon’twanttocry.Someofyoumaynothaveknown[student'sname]verywellandmaynotbeaffected.Othersmayfeelagreatdealofsadness.Somemayfeelangry.Weallhaveourownwayofdealingwithourfeelingsandreactions,thereisnoonerightorwrongway.

Someofyoumayfindyou’rehavingdifficultyconcentratingonyourschoolworkandwecanunderstandthatandothersmayfindthatgettingonwithschoolworkorsportorotheractivitiesishelpful.

Anytimeyouwanttotalkaboutwhathappenedwearegoingtobeheretolisten.

Someofyoumayfeelresponsible,likeyoucouldhavedonesomethingtosavethem.It’simportanttounderstandthatnooneisresponsibleforsomeoneelsetakingtheirownlife.

Wewillneedtopulltogethertosupporteachotherthroughthisdifficulttime.Tohelpuswiththis,[I/we]wouldliketomakesomesuggestions.

Keepingbusycanhelpyoudealwithyourfeelingsandstarttomakethingsbetter.Today,wewill[activities,options].Whatothersuggestionsdoyouhavethatyouwouldliketodo?

Support the natural cohesion and resiliency of the class group through the structure of teaching and classroom activities during the day. Keep emphasising the potential role that class members can play in supporting one another. Care needs to be taken not to disrupt the natural supports that a classroom can provide.

Template for statement to students

Astatementtothestudentsisanimportantfirststepincommunicatingaboutasuspectedsuicide.Thelanguageusedinthisexamplecanbechangedandadaptedtosuitaparticularschoolorsituation.Thewording‘suspectedsuicide’isconsistentwiththeCoronersAmendmentAct2016.Thewordsinitalicsareintendedasguidesandpromptsforteachers.Thistypeofstatementisbestreadafterconsultationwiththefamilyandwhänau(iealladultsinvolvedinthecareofthedeceased)andaccurateinformationaboutadeathavailable.Agoodtimetotalktostudentswouldbewhenstudentsusuallymeetface-to-facewiththeirformteachers.

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Afewofyoumightfeelit’sreallydifficulttobeintheclasstoday,butthisisthebestplaceforyoutobe–withpeopleandfriendswhoyouknow.Thingswillgeteasier.Ifforanyreasonyouneedtoleavetheclassroom,pleaseletmeknowandIwilltalktoyouaboutwhatandwhereyoumightgoifyouneedextrahelp.Evenifitisjusttogotothebathroom,Istillneedtoknowwhereyouare.Thanksfordoingthis.

Bytheendofthedayyourfamiliesandwhänauwillbemadeawareofthedeathof[insertstudent’sname]oryouwillbegivenalettertotakehometoyourfamilyandwhänau.Youandyourfamilyandwhänaushouldaskformoreinformationorhelpifneeded.

In some communities when there has been more than one death, the community comes together to support their students and develop additional interventions. If this happens, mention families/whänau/community meetings and when they are scheduled.

Afteryouhavegiventhisnotetoyourfamiliesandwhänau,trytodoactivitiesthatyouenjoy,suchasplayingsports,videogames,listeningtomusic,beingwithothers,beingwithfriendsandfamilyandwhänau.Youcouldhelpathomewithcleaning,repairsorchorestosupportyourfamilyandwhänauandcommunity.Tidyyourroom,doyourhomeworkactivities.Sharethingswithothers.Makesureyourfamilyandwhänauknowwhereyouareandwhatyouaredoing.

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Template for a letter to families and whanau

Usealetterlikethisonetocommunicateaboutasuspectedsuicide.Itprovidesfamiliesandwhänauwithwarningsignsofsuicideanddetailsabouthowfamiliesandwhänaucanseeksupportiftheyhaveconcerns.Thislettershouldonlybereleasedafterfirstconsultingwiththefamilyandwhänauofthestudentwhohasdied.Thefamilyandwhänaumaynotwanttheletterreleased,ortheirchild’snamementioned.Pleaserespecttheirwishes.Ifthefamilyandwhänaudoesnotwanttheletterreleasedatall,theschoolwillneedtoworkcloselywithothersupportingagenciestomakeadecisiononhowtocommunicatewithstudents'familiesandwhänau,tosafeguardthewellbeingofstudentsintheircommunity.Thinkabouthowyouwillreleasethelettertoensuredistressisminimisedforparentsandstudents

[Nameofschool]

Dearfamiliesandwhänau

ItiswithgreatsadnessthatIhavetotellyouthatoneofourstudents,[insertname,iffamilyhaveapproved],hasdied.Allofuswantyoutoknowthatweareheretohelpyouandyourchildreninanywaywecan.

Identify the student if consent has been given, BUT DO NOT state the method of suicide or provide details about the death.

Wehaveexpressedoursympathytothefamilyandwhänau,andourthoughtsarewiththematthisverydifficulttime.

If appropriate, identify any actions being taken to assist and/or support the family and whänau of the deceased.

Asaschool,wearecommittedtosupportingthewellbeingofourstudentsandourschoolcommunity.Wearehereforyouandyourchildren,ifyouneedoursupport.Wehaveincludedinformationatthebottomofthisletterwhichyoumightfindhelpful.

Weareawaretherehasbeensometalkaboutthepossibilitythatthiswasasuspectedsuicide.ThecauseofdeathhasnotyetbeendeterminedbytheCoroner’soffice.Weaskyounottospreadthiskindoftalk,asitcanbeverydistressingforeveryonewhoknewandloved[student’sname].Pleaserespecttheprivacyofthefamilyandwhänauduringthistime,bothinpersonandonsocialmedia.We’lldoourbesttogiveyouaccurateinformationabouttheirwishesandfuneralarrangements,aswebecomeawareofit.

Ifyouwouldlikesomeguidanceabouthowtotalktoyourchildaboutwhathashappened,youmayfindtheMentalHealthFoundation’sresource‘Connecting through Körero’useful.Itincludeswaystoanswercommonquestions,andhowtohavesafe,openandcompassionateconversationsaboutsuicide:https://www.mentalhealth.org.nz/get-help/connecting-through-körero.

Thisdeathwillcreateavoidinourschool.Duringtimessuchasthis,itiscriticalthatwelooktoourteachers,familyandwhänauandfriendsforguidanceandsupport.Spendingtimeandtalkingwithpeoplewetrustcanhelpusthroughdifficultperiodslikethis.

Youcanhelpyourchildbykeepingregularroutines(sleeping,eating,attendingschool)andencouragingactivitiesthattheywouldnormallyenjoy,suchasplayingsports,videogames,listeningtomusic,beingwithfriends,andfamilyandwhänau.Helpingoutathomeandbeingtogetherdoingthingsyouallenjoyallowstimefortalkingandsupportingeachother.Atatimelikethis,weknowyouwillwanttoknowwhereyourchildisandwhattheyaredoing,andweencourageyoutomonitorthemclosely.Thingsmightbedifficultnow,theywillgeteasierovertimethough.

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Ifthereisanythingthatschoolstaffcandotoassistyouoryourchildtocopewiththisdeath,oryouareconcernedaboutaspectsofyourchild’swellbeing,suchastheireating,sleep,socialisolation,oremotionalstate,pleaseletusknowbycontactingyourchild’steacherortheschoolcounsellor.Contactdetailsforsupportservicesarelistedbelow:

Insert the contact names, addresses and phone numbers of specific supports available.

Therearealsoanumberofservicesinthecommunitythatoffersupport,informationandhelp,youcanfindoutmorehere:https://www.mentalhealth.org.nz/get-help/in-crisis/helplines/.

Consider handing out copies of (and the link to) the Mental Health Foundation’s brochure which has details of helplines and support services: https://www.mentalhealth.org.nz/assets/Helplines-and-local-mental-health-services/MHF-Helplines-A4-WEB-FINAL.pdf

Ifyouhaveimmediateconcerns,atrainedcounsellorisavailableanytimebycallingortexting1737.

Weunderstandfromthefamilyandwhänauthatthefollowingarrangements[arebeing/havebeen]madetofarewell[student’sname]:

Insert all available funeral or tangi information here.

Withpermissionfromfamiliesandwhänau,wewillallowstudentstobeabsentfromschooltoattendthe[funeral/tangi/otheractivity].Wewon’tbestoppingschoolforthisservicebecauseitisimportanttowellbeingthatnormalroutinescontinuetobeavailableforstudents.

Iamsurethatallofyoujoinmeinexpressingoursympathyto[insertstudent'sname]familyandwhänauandfriends.

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Template for talking to students about suicide loss

Talkingtoastudentaboutsuicideisoneofthehardestthingsyoumighteverhavetodo.Itisnormaltofeeluncomfortable.Everyonefeelsunprepared,uneasy,andanxioustellingstudentsthatsomeonetheyhaveknownorlovedhasdied.Thisisespeciallyhardwhenitisasuspectedsuicide.

Asfamilyandwhänau,wewanttoprotectourchildrenfrompain.However,wecan’tavoidtalkingaboutaneventthatwillimpacttheirlifeinsuchatraumaticway,justbecausewe’reworriedabouthowtheymightfeelorreact.Talkingaboutasuspectedsuicideofsomeonetheyknowwillnotbeharmfulforastudent.They’reprobablyalreadytalkingaboutitwithotherstudents,soit’sbetterthatyouhavetheconversationwiththem,sotheycanlearnthefacts.Italsogivesthemtheopportunitytoaskquestionsthatmaybebotheringthem.

Asadults,wecanbesupportiveinhelpingstudentstoexperiencelifenaturally,andwecanleadtheminpositivedirections.Researchhasshowndiscussionofsuicidewithstudentsdoesnotleadtoanyincreasedthinkingaboutsuicideortosuicidalbehaviours.Responsiblediscussioncanallowstudentstoidentifyotherswhomayexhibitsuicidalthinkingorbehavioursandgivethemsupport.

Thefollowingpointsmaybehelpful:

Be open and honest, and communicate at the student’s level of understanding.

Suicideisacomplicatedformofdeathandrequireshonestywithstudents,butalsorestraint,dependingonthelevelofunderstanding.Answerstudents’questionshonestly.Youdon’tneedtoprovideinformationbeyondtheirquestions.

Onethingtokeepinmindisthatwhenadultshidethetruthinanefforttoprotectstudents,thestudentoftenseesorhearsinformationanywayfromothersources,suchasthroughsocialmediasites,texting,aconversationtheyhaveoverheard,orfromaneighbour,arelative,oranotherstudent.Youhavebettercontroloverinformationwhenyoutellstudentsthetruthyourself.Youalsoneedtostatethat,althoughthestudenthasheardthesethings,thecauseofdeathhasyettobedetermined-thisisthejoboftheCoroner’sOffice.Rumoursoftencirculateafteradeath.Askstudentsnottospreadrumours,astheycanbeinaccurate,andinanycase,arelikelytobedeeplyupsettingthefamilyandwhänauofthestudentwhodied.

It’sokaynottousetheword‘suicide’ifyoudon’twantto.Youcanusedifferentterms,suchas‘wantingtoendtheirlife’ortalkingaboutsomeonefeeling‘deepsadness’.Itcanbehelpfultomirrorthewordsthatstudentschoosetouse.

Sensitively encourage conversation about the person who has died.

Considerwhatthestudentmayalreadyknoworhaveexperienced.Forexample,iftheywitnessedthepoliceinthehome.Understandingtheirpersonalexperiencecanguideyouinhelpingthestudentopenupaboutwhathappenedandwhatheorsheknows.

Givestudentsopportunitiestoaskquestions.Askthemwhattheywouldliketodoaftertalkingtogether.Theymaywanttotalkmore,stayclosetoarelative,doanactivity,playagame,orgetsomeemotionaldistancefromtheevents.Followthestudent’slead.Observetheirbodylanguage.Rememberthateveryonegrievesdifferentlyandthereisnorightorwrongwaytogrieve.Therearenorightorwrongfeelingstohave.Allfeelingsorreactionsarenormalforthem.Somestudentsneedtobeinvolvedandwantalotofinformation,otherstudentsmaynotwanttobeinvolvedandwantverylittleinformation.

Itisokaytoaskthemiftheywouldliketotalkaboutitmore.Listentotheirthoughtsandfeelingscarefully.Letthemknowit’sokaytofeelthatway(evenifyoucan’trelatetotheirexperiencesandfeelings).Takecarenottomakethemfeeljudgedorshamedforhowtheythinkorfeel.Doyourbesttobeavailabletotalkaboutwhathappened,andletthemchoosetheirownwayofcopingandgrieving.

It’salsookaytonotknowwhattosayordo.Behonestwithstudentsandsay,“I don’t know.”Letthemknowthatalthoughyoumaynothaveanswerstoalloftheirquestionsrightnow,it’sbecauseyouarealsolearning.Letthemknowyouunderstandthisisatrickytopic,andthatitcanbehardforyoutounderstandtoo.

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It’sveryimportanttodrawattentiontothestudent’slifebeforetheydied.Suicideisthecause of death,butitis not whothestudentwastotheirfriendsandfamilyandwhänauwhiletheywerealive.Talkaboutmemoriesandwhatthatpersonmeantwhiletheywerealive,becausethisiswhatwillbeleftforthestudenttorememberintheyearstocome.

“What do I say when a student asks ‘why’ someone ended his or her own life?”

Respondinawaythatfeelsthemostcomfortingforyouboth.Thefollowingaresomesuggestedphrasestouse:

“There isn’t an easy answer to that question. There can be all sorts of reasons, but people who take their own life have lost hope that their lives will ever get better. It is always important to reach out for help when your problems seem too big to deal with.”

“It is no one’s fault. Suicide is never caused by just one thing. It’s multi-layered – the result of many factors coming together. There are things we can all do to take care of each other, and make sure anyone else we know who is feeling sad knows that there is help available.”

"People who want to die by suicide feel a lot of emotional pain. They feel that dying is the only way to end their pain. The pain can also stop them connecting with support and other things that can help them stop hurting.”’

“Problems are usually temporary, not permanent, and with support, those problems can usually be made better.”

Somestudentsmayfeelresponsible,liketheycouldhavedonesomethingtosavethestudentwhodied.It’simportanttoreassurethemthatnooneisresponsibleforsomeoneelsetakingtheirownlife.Itmaybehelpfultopreparethestudentincaseothersmakejudgmentalorhurtfulcommentsabouttheirfriendwhohasdied.Askthemforsuggestionsonhowtheycouldrespondifthishappens,andtrytocomeupwithsomeresponsestogether.Thismayeasetheburdenofthemfeelingunpreparedandbeingputonthespot.Beingpreparedwillhelpthemfeelconfidentthattheyarenot‘lying’orattractingmoreattentiontowhathappened,ordisrespectingthepersonthathasdied.Theyareinsteadmakingtheirownchoicesaboutwhattosaytoothersaboutothers,orwhattoshareabouttheirownlife.

Discuss appropriate ways to handle problems that may occur.

Emphasisetheimportanceofworkingthroughfeelingsandseekinghelpfromothers.Beawareofyourstudent'sstressorsandtalkaboutthemtogether.Encouragestudentstotalkaboutandexpresstheirfeelings.Providealisteningearandbeasupportsotheycantalkwithyouabouthowtheyfeel.Studentsdealmuchbetterwithtoughcircumstanceswhentheyhaveatleastonepersonwholistensandbelievesinthem.

Assiststudentssotheydon'tbecomeoverwhelmedwithnegativethoughts.Helpthemlearntomanagenegativethinkingandchallengethoughtsofhopelessness.Helpthemtostayinvolvedwithothersinactivitieswhichtheyenjoy,andaresupervised.

Studentsneedtoknowthatevenifsomeoneelsecommitssuicide,helpisavailabletothemandanyonewhoneedsittocopewiththerangeoffeelingsandemotionstheymightbeexperiencing.Emphasisethatalcoholanddrugsarenothelpful.Ifneeded,treatmentortherapycanhelpastudentdealwithnegative,unhelpfulthoughts.

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Sample media statement

Schoolpersonnelwereinformedby[insert]thata[insertage]-year-oldstudentat[insertschool]schoolhasdied.

Ourthoughtsandsupportgooutto[his/her]familyandfriendsatthisdifficulttime.

Membersoftheschool’scrisisresponseteamaresupportingtheschoolcommunity.

Wehavegiveninformationtostudentsandtheirfamiliesandwhänautohelpsupportthemthroughthistime,includinginformationabouthowadultscanhelpstudentscopewithanunexpecteddeath.

Familiesandwhänauhavebeenaskedtocontacttheschoolformoreinformationorsupportiftheyneeditforstudentsindistress.

Pleasestrengthenandsupporttheschool’sresponsebyplacinginformationaboutcrisisandsupportservicesandpersonalself-careinanymediaarticles.

Iaskthatyourespecttheprivacyofstudentsandtheirfamilyandwhänau,anddonotapproachstudentsastheyleaveschool,ortheirfamilyandwhänauduringthisdistressingtime.

Template for the media

Itisalwaysbesttobepreparedtodealwithmediainterest.Usethesekeymessagesforrespondingtomediaenquiries.Awrittenresponsemaybethebestwaytorespondtoanyquestions.Ensuretheschoolhasanominatedmediaspokesperson–usuallytheprincipal.Allstaffneedtobeawareofthisroleandreferallmediaenquiriestothedesignatedperson.

First Part: general information

SchoolPrincipal

• Welcomesallandexpressessympathy.

• Outlinesthepurposeandstructureofthemeetings

• Introducesthemselvesandmembersofthemeetingconvenorteam.

• Expressesconfidenceintheschools’abilitytoassistthestudentsandensurethattheyhaveaccesstoadditionalsupportiftheyneedit.

• Encouragesfamily,whänauandschoolcollaborationduringthisdifficulttime.

• Reassuresattendeesthattherewillbeanopportunityforquestionsanddiscussionlater.

• Pointsoutthatstudentsusuallyhavethecapacitytomanagetheiremotionsontheirownduringnormalcircumstances,butaftereventslikethistheymayneedmoresupportandsupervision.Thiscanbedonebytalkingsensitivelyandappropriatelyabouttheaboutthedeath,supportingattendanceatculturalandreligiouseventstoacknowledgethedeathofthestudent,andencouragingconstructiveactivitiesonthebehalfofothers.

• Statesthemeeting’sgoal–torespondtotheunexpecteddeaths,regardlessofcause,andremainawarethatthisisadifficulttimeforeveryone.

• Discouragesthespreadofunhelpfultalkaboutthecauseandcircumstancesofthedeath.

• Informsfamiliesandwhänauabouttheschool’sandDHB’sresponseactivities,includingresponsestomediarequests.

• Informsfamiliesandwhänauaboutstudentreleasepolicytoattendfunerals.

Crisis Response Team Leader (or other appropriate Crisis Team member)

• Discusseshowschoolwillhelpstudentscopewiththeiremotionsduringthistime.

• Sharestipshandoutonwarningsignsandnotingthatoverninetypercentofsuicidesarelinkedtounderlyingmentalhealthissuessuchasdepressionoranxietythatcancausesubstantialpsychologicalpainbutmaynothavebeenapparenttoothers(orthatmayhaveshownupasbehaviourproblemsorsubstanceabuse).

Sample agenda for family and whanau meeting

Meetingswithfamiliesandwhänaucanprovideahelpfulforumfordisseminatinginformationandansweringquestionsafterasuspectedsuicide.ItisrecommendedthatthesemeetingsarerunbymentalhealthservicesorDHBsuicidepreventionservices.Considerconveningameetingifthereiscontinuingandongoingcommunitydistress,suchaswhentwoormorestudentshavediedbysuicide.Theschoolprincipal,Boardoftrusteeschairperson,pastoralcareteamandMinistryofEducationTraumaticIncidentteammembersshouldattend.Representativesfromcommunityresourcessuchasmentalhealthproviders,crisisservices,culturalrepresentatives,andclergymayalsobeinvitedtobepresentandprovidesupportmaterials.

Awordofcaution:Large,open-microphonemeetingsarenotadvised,sincetheycanresultinanunwieldy,unproductivesessionthatmaybecomefocusedonscape-goatingandblaming.

Ideallyameetingshouldbeplannedintwoparts,andbeconvenedbythosesupportingthecommunityasmentionedabove:

• Thefirstpart,shouldprovidegeneralinformationtofamiliesandwhänau,withoutopeningthemeetingtodiscussion.

• Thesecondpartisagoodopportunitytoinvitefamilyandwhänautomeetinsmallgroups,forquestionsanddiscussionwithcommunitymentalhealthservicerepresentatives.

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• Remindsfamiliesandwhänauthathelpisavailableforanystudentwhomaybestrugglingwithmentalhealthissuesorsuicidalfeelings.

• Providescontactinformation(names,telephonenumbers,andemailaddresses)formentalhealthresourcesatschoolandinthecommunity,suchas:

– schoolcounsellors

– communitymentalhealthagencies

– crisisservices

– othersupportservices.

Second Part: small group meetings

• Ideally,thereshouldbenomorethaneighttotenfamilyandwhänaumemberspergroup.

• Eachgroupshouldbefacilitatedbyatleasttwotrainedstaff.

• Supportstaffshouldbeavailabletodirectfamilyandwhänautomeetingrooms,distributehandouts,andmakewaterandtissuesavailable.

• Ifpossible,staffshouldbeavailabletomeetwithfamilyandwhänaumembersindividuallyasneeded.

Someadditionalconsiderations

• Sincesomefamilyandwhänaumayarrivewithyoungchildren,provideonsitechildcare.

• Provideseparatediscussiongroupsforstudentswhomayaccompanyfamilyandwhänau.

• Mediashouldnotbepermittedaccesstothesmallgroups.Arrangefortheschool’smediaspokespersontomeetwithanymedia.

• Insomecases(forexample,whenthedeathhasreceivedagreatdealofattention)itmaybenecessarytoarrangeforsecuritytoassistwiththeflowoftrafficandwithmediaandcrowdcontrol.

Giveaccurateinformationaboutsuicide

• Giveinformationwhichexplainsthatsuicideisacomplicatedbehaviourthat’snotcausedbyasingleeventsuchasabadgrade,anargumentwithfamilyandwhänau,orthebreak-upofarelationship.Inmostcases,suicideiscausedbyanunderlyingmentalhealthissuelikedepressionorsubstanceabuse.Mentalhealthissuesaffectthewaypeoplefeelandpreventthemfromthinkingclearlyandrationally.Havingamentalhealthissueisnothingtobeashamedof,andhelpisavailable.

• Talkingaboutsuicideinacalm,straightforwardmannerdoesnotputideasintostudents’minds.Givesomesupportorresourcesaboutthisforfamilyandwhänau.

• Addressblamingandscapegoating.Itiscommontotrytoanswerthequestion“why?”afterasuicidedeath.Sometimesthisturnsintoblamingothersforthedeath.

• Donotfocusonthemethodorgraphicdetails.Tellfamilyandwhänauthattalkingindetailaboutthemethodcancreateimagesthatareupsettingandcanincreasetheriskofimitativebehavioursbyvulnerableyouth.

• Ifasked,itisokaytogivebasicfactsaboutthemethod,butdon’tgivedetailsortalkatlengthaboutit.Thefocusshouldbenotonhowsomeonekilledthemselvesbutratheronhowtocopewithfeelingsofsadness,loss,anger,etc.

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Addressanger

Acceptexpressionsofangeratthedeceasedandexplainthatthesefeelingsarenormal.

Addressfeelingsofresponsibility

Reassurethosewhofeelresponsibleorthinktheycouldhavedonesomethingtosavethedeceased.

If you are talking with students

Encouragehelp-seeking

Encouragestudentstoseekhelpfromatrustedadultiftheyorafriendarefeelingdepressedorsuicidal.

“It is okay to feel angry. These feelings are normal and it doesn’t mean that you didn’t care about [student's name]. You can be angry at someone’s behaviour and still care deeply about that person.”

“This death is not your fault.”

“We can’t always predict someone else’s behaviour.”

“We can’t control someone else’s behaviour.”

“We are always here to help you through any problem, no matter what. Who are the people you would go to if you or a friend were feeling worried or depressed or had thoughts of suicide?”

“There are effective treatments and supports to help people who have mental health issues or substance abuse problems. Suicide is never an answer.”

“This is an important time for all in our community to support and look out for one another. If you are concerned about a friend, you need to be sure to tell an adult you trust.”

Givepracticalcopingstrategies

Encouragestudentstothinkaboutspecificthingstheycandowhenintenseemotionssuchasworryorsadnessbegintowellup,including:

• simplerelaxationanddistractionskills,suchastakingthreedeepslowbreaths,countingtoten,orpicturingthemselvesinafavouritecalmandrelaxingplace

• engaginginfavouriteactivitiesorhobbiessuchasmusic,talkingwithafriend,reading,orgoingtoamovie

• exercising

• thinkingabouthowthey’vecopedwithdifficultiesinthepastandremindingthemselvesthattheycanusethosesamecopingskillsnow

• writingalistofpeopletheycanturntoforsupport

• writingalistofthingsthey’relookingforwardto

• focusingonindividualgoals,suchasreturningtoasharedclassorspendingtimewithmutualfriends.

Often,youthwillexpressguiltabouthavingfunorthinkingaboutotherthings.Theymayfeelthattheysomehowneedpermissiontoengageinactivitiesthatwillhelpthemfeelbetterandtaketheirmindoffthestressfulsituation.

Studentsshouldalsobeencouragedtothinkabouthowtheywanttoremembertheirfriend.Ideasrangefromwritingapersonalnotetothefamilyandwhänau,toattendingthefuneralserviceortangi,todoingsomethingkindforanotherpersoninhonouroftheirfriend.Acknowledgingtheirneedtoexpresstheirfeelingswhilehelpingthemidentifyappropriatewaystodosocanbegintheprocessofreturningtheirfocustotheirdailylivesandresponsibilities.

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Template for informing families and whanau about ‘choking games’

Astatementtofamiliesandwhänauisanimportantstepincommunicatingaboutanygameinvolvingexperimentationwithasphyxia.Thisexperimentationissometimestermedthe‘chokinggame’,‘blackoutgame’,‘passoutgame’,‘scarfgame’,or‘spacemonkeygame’.Experimentinginthishighlyriskybehaviourcancausedeathorseriousbraindamage,strokesandconvulsionsfromthedeprivationofoxygentothebrain.Onlysendoutthiscommunicationiftheschoolbecomesawareofthistypeofactivityoccurringwithstudentsinthecommunityoratschool.Thiscommunicationwillneedtobeamendedtoreflectthesituationyourschoolcurrentlyfaces.BeforesendingoutthiscommunicationtalkwithlocalpoliceandmentalhealthservicesandtheMinistryofEducationTraumaticIncidentservice(0800848326).

Therehavebeencasesofaccidentaldeathscausedbystudentstryingthe‘chokinggame’.

Inthe‘game’apersonchokesthemselvesorothersinordertogeta‘floaty’feeling.Studentshaveendedupinaccidentandemergencyclinicshavingaccidentallyharmedthemselves.Theyhadnoideaoftherisksinvolvedandtheharmtheycausetotheirbrains.

Atthemomentitdoesnotappearthatthisbehaviouriswidespread,butgiventhelevelofcommunicationbetweenstudents,itcouldspreadrapidly.Informationaboutthegameandpartiesisoftencirculatedbytextmessageoronsocialnetworkingsites.Pleasebeawareofthistypeofcommunication.

This‘game’isdangerousandcanendindeath.Thedangerisincreasedifthestudentisalonewhentheytryit.Signsthatstudentsareengaginginthistypeofbehaviourcaninclude:

• mentionofthechokinggame(orgamebyothernames)

• marksorbruisesontheneck

• bloodshoteyesorothersignsofeyestress

• wearingclothingthatcoverstheneck,eveninwarmweather

• confusionordisorientationafterbeingaloneforaperiodoftime

• thepresenceofunusualitemssuchasdogleashes,ropes,scarves,bungeecords,andbelts

• severeheadaches,oftenfrequent

• secretivebehaviour,irritability,hostility,disorientationafterspendingtimealone

• bleedingundertheskinofthefaceandeyelids

• questionsabouttheeffectsofstrangulation.

This‘game’canstartasaninnocentrisk-takingexperience,butifthebrainisstarvedofoxygenseriousconsequences,includingdeath,canoccur.

Youmaywanttotalktoyourchildaboutanythingtheyhaveheardaboutchokingasa‘game’andabouttherisks.Youcanstartbyaskingthemiftheyhavehadanyworryingtexts,emailsorsocialmediaposts.Iftheyhave,askyourchildaboutthem.Askthemiftheyhaveheardaboutthe‘chokinggame’.Talktothemaboutwhatyouknowandtellthemthatthisisverydangerousandtheycoulddie.Tellthemthatthe‘floatyfeeling’or‘passout’sensationisthebeginningofbraindamage–braincellsaredyingandthatcancausedeathorpermanentbraindamage.Askthemtotellyouiftheygetanyofthesetexts,emailsorsocialmediapostingsandthenaskthemtodeletetheminsteadofpassingthemon.

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Ifyourchildhasnotheardanythingaboutthe‘game’youmightwishtoexplainthattherearesomemessagesgoingaroundaboutadangerousgameandiftheyreceiveonetheyshouldtalktoyouaboutit,deletethemessage,andnotpassiton.

Students’behaviourcanchangefromday-to-daysoyoushouldtalkwiththemoften.Ifyouareconcernedaboutyourchild,discussyourconcernswiththemandremainvigilant-checkcellphonetexts,keepbedroomdoorsopen,checkifgroupsofstudentsareinashedtogetheretc–safetyismoreimportantthanprivacy.

Ifyouareconcernedaboutyourchild,orifyouknoworbecomeawareofanyactivities,‘games’,ormessagesinvolvingchokingpleaseinformyourschool.

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Section 4 – Prompts for developing policies and procedures to prevent suicidal behaviours and promote wellbeing

» Introduction

» Promptsforschoolleaders

» Promptsforschoolcounsellors

Introduction

Thepurposeofthesepromptsistoprovideareferenceforschoolleadersandcounsellorsintheirworktopromotethewellbeingofstudents–specifically,topreventsuicidesandsuicideattempts,andtorespondappropriatelytosuchevents.

Eachdevelopmentandimplementationtableissupportedbyoneormoreactionpoints.Theseactionpointsarefollowedbyquestionpromptsthatmaybeusedaschecklists,discussionstartersorreminders.

Ensurerelevantpoliciesorproceduresdevelopedfromthissectionareincorporatedintotheschool’sTraumaticIncidentResponsePlan(TIRP)planandcanbeusedtoensureitcoversalltherelevantareas.TheywillbealsousefulforschoolsthatdonotyethaveaTIRPinplace.

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Prompts for school leaders

Successfuldevelopmentandimplementationofplanstopreventsuicideandrespondtosuicidalbehavioursrequirevisionandleadershipfromtheboardoftrustees(Board)andSeniorLeadershipTeam(SLT)toensuresharedunderstandingsandbeliefsabouttheapproachestobetaken.

Table 1: School leaders develop and lead a whole-school approach to promoting student wellbeing, including the prevention of suicidal behaviours

Actions Prompts

1.1 TheBoardensuresthattheethosandphilosophyoftheschoolisconducivetoasafeandprotectivelearningenvironment

• DoBoardpoliciessupportpositive,pro-socialbehaviour,familyandwhänaupartnerships,connectednessforstudents,andculturalandcivicdevelopment?

• IstheBoardawareoftheindicatorstheycanusetoidentifythingstheywanttochangetoimprovestudentwellbeing?(See for example, Wellbeing@school website and tools – www.wellbeingatschool.org.nz)

• AreBoardmembersawareoftheschool’sapproachtopromotingstudentwellbeing,includingthepreventionofandresponsestosuicidalbehaviours?

• HastheBoardensuredthatschoolpersonnelhaveaccesstothenecessaryresources,supportandskillstoimplementacomprehensivesuicidepreventionapproach?

1.2 Theprincipalandseniorleadershipteam(SLT)ensureawhole-schoolapproachtopromotingstudentwellbeingisdevelopedthroughschool-widepolicies,proceduresandleadership.

• Doschool-widepoliciesandpracticesworktopromoteresilience,socialbehaviour,equalityandfairness,andtodecreasebullying,anti-socialbehaviourandviolence?

• Arepoliciesandproceduresunderstoodandusedbyallstaff?

• Aretheapproachesandproceduresledandsupportedbystrongleadership?

• HaveyoureceivedinformationaboutorparticipatedinanyrelevanttrainingoranapproachsuchasPositiveBehaviourforLearning(PB4L)?Seehttp://pb4l.tki.org.nz/or the My FRIENDS Youth programme for building resilience See https://www.friendsresilience.org/(ContactyourlocalMinistryofEducationofficeformoreinformation.)

1.3 TheNewZealandCurriculumisactivelyusedasacontextforincreasinganawarenessofmentalhealthissuesamongstudents.

• ArethegeneralandspecificprovisionswithintheNewZealandCurriculumunderstoodandusedascontextstohelpdevelopresilienceandtodecreasesuicidalbehaviours?

• Doreviewsofcurriculumimplementationincludetheuseofthecurriculumtosupportandpromotestudentwellbeing?

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Table 2: A major focus of a school’s approach to preventing suicide should be to identify those at risk and then to seek appropriate support, care and management for them.

Actions Prompts

2.1 Schoolleadersensurethatcounsellors,deans,andteachersareawareofriskfactors,andknowtheproceduresforidentifying,assessing,andreferring(whereapplicable)studentswhoareatriskofsuicidalbehaviours.

• Areproceduresforidentifyingandassessingstudentsatriskofsuicidalbehaviourreviewedannually?

• Arethenotificationprocessesclearandwellunderstoodbyallstaff?

• Areallstafftrainedaboutandremindedofthewarningsignsthatastudentmaybeatriskofsuicide?

2.2 Schoolleadersensurethatschoolcounsellors,deansandteachersknowwhenandhowtoseeksupportforstudentsatrisk.

• Arethereestablishedproceduresorprotocolsforstafftofollowwhenseekingsupportforstudentsatrisk?

• Dothecounsellingstaffanddeansresponsibleforpastoralcarehavethenecessarytrainingandskilltoprovideorseekexternalsupport(throughreferrals)forstudentsatrisk?

• Aretrainedstaffavailabletorespondtoareferralandattendsupportandplanningmeetings,forexample,withmentalhealthservices?

• Aretheschool’ssystemsalignedwiththoseoflocalmentalhealthandotherservicestoensuresmoothaccessandtransitions?

• Arepoliciesaboutstudentconfidentialityreviewedinrelationtostudentsatriskofsuicide?

• Whatproceduresareinplacetoensurethattheschoolactsinpartnershipwithfamilies,whänauandanyotherkeyagencies,groups,orindividualswhenastudentisreferredforsupport?

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Actions Prompts

2.3 Schoolleadersensurethatplansforthecareandmanagementofstudentsatriskofsuicidearedevelopedandenacted.

• Whatprotocolsandproceduresareinplaceforthemanagementofstudentsatriskofsuicide?

• Hastheschoolestablishedstronglinkswithmentalhealthagenciesandotherservices?

• Whatprotocolsareinplacebetweentheschoolandexternalagenciesforsharinginformationanddevelopingsharedcareplansforreferredstudents?

• Areschoolcounsellorsabletoprovideappropriatemonitoringofstudentswhoareparticipatinginspecificsupportprogrammes(deliveredinoroutofschool)?

• Istheschoolcounsellorabletosupportastudentatriskwithintheirfamilyandwhänaucontextincollaborationwithotherinvolvedagencies?

• Haveteachersreceivednecessarysupport,training,and/oradvicetoenablethemtodealappropriatelywithastudentatrisk,inaccordancewithanagreedcareplanforthestudent?

• Haveallstaffbeenmadeawarethattheyshouldreportsuicide-relateddiscussionsorworryingbehaviourstoschoolmanagementandcounsellingstaff?

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Table 3: Effective support for students at risk of suicide requires partnerships with family and whanau, and with other professional support agencies

Actions Prompts

3.1 Schoolleaderspromotestrong,respectfulpartnershipsbetweentheschoolanditsfamilies,whänau,iwiandcommunitiestohelpbuildresilience,preventsuicide,andprovidesupportforstudentsatriskofsuicide.

• Doprincipalsandboardstakealeadroleindevelopingandmaintainingschool-communityrelationships?

• DothevaluesandpracticesoftheschoolleadersandallstaffsupportMäorisucceedingasMäori?

• Howwell-informedareschoolleadersabouttheknowledge,capabilities,skills,andbeliefsheldwithintheiwiandthecommunityinrelationtostudentwellbeing?

• Hastheschoolengagedculturalexpertssuchaskaumatua,whänausupportworkersandMäorimentalhealthworkerstoadvisetheschoolonculturallyappropriatesupportandresponsetoyoungMäoriwhoareatriskofsuicide?

• HowdoestheschoolworktogetherwithwhänauandiwitobettersupporttheemotionalwellbeingofMäoristudentswhomaybeatriskofsuicide?

• Wheretheschoolcommunityhasotherculturalgroupsorpopulations(suchaslesbian,gay,bisexual,transgender,intersex),hastheschoolsoughtguidanceaboutrelevantissuesorbeliefsinordertobetterprovidesupporttostudentswhomaybeatriskofsuicide?

3.2 Schoolsneedtoknowaboutandestablishrelationshipsandreferralprotocolswithlocalhealthcareprofessionalsandmentalhealthagencies.

• Areschoolcounsellorssupportedtoformrelationshipswiththeprofessionals,agenciesandgroupsinthecommunitybeforetheirservicesarerequired?

• See table 2, 2.3 for actions and prompts about protocols and working relationships with agencies

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Table 4: Schools develop a post-suicide response plan (before a traumatic incident occurs) as a framework for school leaders and staff to respond in the aftermath of a suicide.

Actions Prompts

4.1 EachschoolshoulddeveloporreviewaTraumaticIncidentResponsePlan(TIRP)thatincludesrespondingtoasuicide.

• DoestheschoolhaveandusetheMinistryofEducationguides,Managing emergencies and traumatic incidents – The resources, and Managing emergencies and traumatic incidents – the guide?

• IftheschoolalreadyhasaTIRP,hasitbeenreviewedtoincluderespondingtoasuicideorserioussuicideattempt?

• IftheschooldoesnothaveaTIRP,whowillinstigatetheprocessandoverseecompletionandongoingreview?Whenwillthisbegin?

• HaveallstaffreceivedtraininginuseoftheTIRPandinparticular,whattheyneedtodoincaseofastudentsuicide?

• DoestheschoolhavearelationshipwiththelocalDHBSuicidePreventionandPostventionCoordinator?

4.2 Schoolleaders,includingtheschoolcounsellor,mustbepreparedtorespondurgentlyintheeventofasuicide,attemptedsuicide,orthreatofimminentsuicide.

• Isthereaplaninplaceforurgentactionifastudenthascarriedoutoristhreateningimminentsuicide?

• Hastheplanbeencommunicatedtoallstaff?

• Areschoolleadersandrelevantstaffreadyandpreparedtoacturgentlywhenrequired?

4.3 Schoolsrespondtothebereavedfamilyandwhänau,classmatesandfriends,andfacilitateactionstosupportthem.

• Haveschoolstaffascertainedwhat(ifanything)siblings,classmates,andfriendshavebeentoldaboutthecircumstancesofthedeath,andtakenthewishesofthefamilyandwhänauintoaccount?

• Hastheschoolliaisedwiththefamilyandwhänauoverdetailssuchasrepresentationatthefuneral,appropriateculturalorspiritualactivities,memorialplaces,orotheractivities?

• Hastheschoolarrangedforthesensitivereturnofthestudent’sproperty(books,equipment,artworketc)?

• Havestaffreceivedadvicefromthecounsellororschoolleadersonmanagingsupportforclassmates,teammates,andfriendsofthestudent?

• Arestaffabletoworkinpartnershipwithkeystudentstoidentifyandmonitorsocialmediasites(egInstagram)?Aretheyabletousethesepartnershipstoprovidesupportandsafemessages,andtoidentifyandrespondtostudentswhomaybeatrisk?

• Areallstaffawareoftheriskof‘suicide contagion’andwaystominimiseordealwiththis?(For further information see page 41).

• Doestheschoolhaveaplanforprovidinglonger-termsupportandfollowup,includingawarenessofdatesoroccasions(inquest,birthdays,anniversaries)thatmayrequiremonitoringofsomestudents?

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Prompts for school counsellors

School counsellors have a key role in promoting student wellbeing as well as identifying, assessing, referring and supporting students who may be at risk of suicidal behaviour.

Table 1: School counsellors actively implement and support a whole-school approach to promoting student wellbeing, including the prevention of suicidal behaviours.

Actions Prompts

1.1 Schoolcounsellors,alongwiththeprincipalandseniorleadershipteam(SLT)ensureawhole-schoolapproachtopromotingstudentwellbeingisdevelopedthroughschool-widepolicies,proceduresandleadership.

• Doschool-widepoliciesandpracticesworktopromoteresilience,socialbehaviour,equalityandfairnessandtodecreasebullying,anti-socialbehaviourandviolence?

• Arepoliciesandproceduresunderstoodandusedbyallstaff?

• Doyouprovidestrongleadershipforusingtheagreedapproachesandproceduresforpromotingwellbeing?(See for example, Wellbeing@school website and tools at www.wellbeingatschool.org.nz)

• Doteachersrecognisethatstudentwellbeing,includingsuicideprevention,istheresponsibilityofallstaff,notjusttheguidancestaff?

• HaveyouenactedanapproachsuchasPositiveBehaviourforLearning(PB4L)?Seehttp://pb4l.tki.org.nz/.

• HaveyouconsideredusingtheMy FRIENDS Youth programme for building resilience?Seehttps://www.friendsresilience.org/

• Iftheschoolusesotherexternalprogrammes,haveyoureviewedthemforsuitabilityandsafety?

1.2 Schoolcounsellorsprovideteachersandotherswithadviceandsupportaboutin-classstudies,discussionsandreading/viewingthatmayinvolvethetopicofsuicideorself-harm.

• Areteachersawareoftherisksinvolvedinsuicidediscussionsandhowtoavoidorhandlethese?

• Areyouabletoadviseteachersonwaystohandletopics,suchasself-harmingbehaviours,suicidalbehaviourorgamesinvolvingpotentialdeathwhenteachersreportornoticethemintheclassroomorelsewhere?

• Doyouhaveresourcesand/orinformationyoucanprovidetoteachersthatfocusontopicsthatpromotewellbeingandpositivementalhealthratherthanpotentiallydangeroustopics,suchas‘suicideawareness’units?

• Areyouabletoadviseteachersonalternativematerials(novels,plays,films)tothosethatmaydirectlyorindirectlyinfluencestudents’behaviour?

• AreyouabletosupportteacherstodrawontheHealthandPhysicalEducationcurriculumandtheNewZealandCurriculumkeycompetenciesaswaysofpromotingresilienceandwellbeing?

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Actions Prompts

1.3 Schoolcounsellorsprovideadvicetofamiliesandwhänauaboutappropriatematerialsandapproachesonrequest.

• Areyouabletoadvisefamiliesandwhänauonwaystohandletopics,suchasself-harmingbehaviours,suicidalbehaviourorgamesinvolvingpotentialdeathwhenteachersreportornoticethemintheclassroomorelsewhere?

• Doyouhaveresourcesand/orinformationyoucanprovidetofamiliesandwhänauthatfocusonpromotingwellbeingandpositivementalhealthratherthansuicideitself?

• Areyouabletoadvisefamiliesandwhänauhowtotalkaboutsuicidewithstudents?See support services page 75.

Table 2: A major focus of a school’s approach to preventing suicide should be to identify those at risk and then to seek appropriate support, care and management for them.

Actions Prompts

2.1 Schoolcounsellorsareawareofriskfactorsandknowandcommunicatetheproceduresforidentifyingandassessingstudentswhoareatriskofsuicidalbehaviours.

• Doyouorotherqualifiedexpertsprovideregulartraining(professionaldevelopment)remindersandinformationtoallstafftoraisetheirawarenessofthewarningsignsthatastudentmaybeatriskofsuicide?

• Arethereestablishedproceduresforidentifyingandassessingstudentsatriskofsuicidalbehaviour?See page 11, Assessment of students at risk of suicide: for school counsellors.

• Arethenotificationprocessesclearandwellunderstoodbyallstaff?

• Areproceduresandprotocolsreviewedannually?

• Whatproceduresareinplacetoensurethattheschoolactsinpartnershipwithfamiliesandwhänau(andanyotherkeyagencies,groupsorindividuals)whenastudentisassessedatmoderateorhighriskofsuicide?

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Actions Prompts

2.2 Schoolcounsellors,deansandteachersknowwhenandhowtoseeksupportforstudentsatrisk.

• Doyouhaveestablishedproceduresorprotocolsforstafftofollowwhenseekingyoursupportforstudentsatrisk,forexample,informationaboutwhentorefer,whotoreferto,howtorefer,whatwillhappenandwhatinformationtheycanexpecttoreceive?

• Doyouandothersresponsibleforpastoralcarehavethenecessarytrainingandskillstoprovideorseekexternalsupport(throughreferrals)forstudentsatrisk?

• Aretrainedstaffavailabletorespondtoareferralandattendsupportandplanningmeetings,forexample,withmentalhealthservices?

• Areyouawareof(andholdinformationabout)therangeofsupportsystemsandservicesavailablethroughtheschoolandinthecommunity?

• Areyouandotherreferringstaffawareofeligibilitycriteriaforsupportservices?

• Doyouhaveestablishedproceduresorprotocolswithlocalmentalhealthandotherservicestoensuresmoothaccessandtransitionstotheseservices?

• Arepoliciesaboutstudentconfidentialityreviewedinrelationtostudentsatriskofsuicide?

• Whatprovisionshavebeenmadetodealwithpossibleconflictsofconfidentiality,forexample,whereastudenthasbeensubjecttoabuseathome?

• Howdoyouensurethatyouactinpartnershipwithfamiliesandwhänau(andanyotherkeyagencies,groupsorindividuals)whenastudentisreferredforsupport?

2.3 Schoolcounsellorsensurethatplansforthecareandmanagementofstudentsatriskofsuicidearedevelopedandenacted.

• Whatprotocolsandproceduresareinplaceforthemanagementofstudentsatriskofsuicide?See page 14, Management of students at risk of suicide: for school counsellors.

• Hastheschoolestablishedstronglinkswithmentalhealthagenciesandotherservices?

• Whatprotocolsareinplacebetweentheschoolandexternalagenciesforsharinginformationanddevelopingsharedcareplansforreferredstudents?

• Areyouorsuitabletrainedstaffabletoprovideappropriatemonitoringofstudentswhoareparticipatinginspecificsupportprogrammes(deliveredinoroutofschool)?

• Areyouabletosupportastudentatriskwithintheirfamilyandwhänaucontextincollaborationwithotheragenciesinvolved?

• Haveteachersreceivedthenecessarysupport,training,and/oradvicetoenablethemtodealappropriatelywithastudentatrisk,inaccordancewithanagreedcareplanforthestudent?

• Haveallstaffbeenmadeawarethattheyshouldreportsuicide-relateddiscussionsorworryingbehaviourstoschoolmanagementandcounsellingstaff?

• Areyouawareofthepotentialrisksofprogrammesthatpromoteawarenessraisingofsuicideorpeersupportprogrammesthatexpectstudentstosupportdistressedpeers.

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Table 3: Effective support for students at risk of suicide requires partnerships with family and whanau and with other professional support agencies.

Actions Prompts

3.1 Schoolcounsellorsparticipateinthedevelopmentofstrong,respectfulpartnershipsbetweentheschoolanditsfamilies,whänau,iwiandcommunitiestohelpbuildresilience,preventsuicideandprovidesupportforstudentsatriskofsuicide.

• Whatdoyouseeasthecounsellor’sroleindevelopingandmaintainingschool-communityrelationshipstopromotestudentwellbeing?

• DoyourvaluesandpracticessupportMäorisucceedingasMäori?

• Howwellinformedareyouabouttheknowledge,capabilities,skillsandbeliefsheldwithintheiwiandcommunityinrelationtostudentwellbeing?

• Haveyouengagedculturalexpertssuchaskaumatua,whänausupportworkersandMäorimentalhealthworkerstoadviseonculturallyappropriatesupportandresponsetoyoungMäoriwhoareatriskofsuicide?

• HowdoyouworkwithwhänauandiwitobettersupporttheemotionalwellbeingofMäoristudentswhomaybeatriskofsuicide?

• Wheretheschoolcommunityhasotherculturalgroups(suchasPacificandAsian)orpopulations(suchasrefugee,lesbian,gay,bisexual,transgender,intersex)haveyousoughtguidanceaboutrelevantissuesorbeliefstobetterprovidesupporttostudentswhomaybeatriskofsuicide?

3.2 Schoolcounsellorsneedtoknowaboutandestablishrelationshipsandreferralprotocolswithlocalhealthcareprofessionalsandmentalhealthagencies.See also table 2.

• Haveyoubuiltstrongrelationshipswithprofessionals,agenciesandgroupsinthecommunitybeforetheirservicesarerequired?

• See table 2, 2.3 for actions and prompts about protocols and working relationships with agencies.

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Table 4: School counsellors are directly involved in developing a post-suicide response plan (before a traumatic incident occurs) as a framework for school leaders and staff to respond in the aftermath of a suicide.

Actions Prompts

4.1 EnsuretheschoolhasaTraumaticIncidentResponsePlan(TIRP)thatincludesrespondingtoasuicide.

• IftheschoolalreadyhasaTIRP,hasitbeenreviewedtoincluderespondingtoasuicideorserioussuicideattempt?

• HaveyoutakenpartinannualworkshopsheldbytheMinistryofEducationthatsupportschoolstodevelopTIRPs?

• DoyouknowaboutandusetheresourcesprovidedbytheMinistryofEducation,Managing emergencies and traumatic incidents – The resources document?

• DoyouhaveanestablishedrelationshipwiththelocalDHBSuicidePreventionandPostventionCoordinator?

4.2 Schoolcounsellors,alongwithotherschoolleaders,mustbepreparedtorespondurgentlyintheeventofasuicide,attemptedsuicide,orthreatofimminentsuicide.

• Isthereaplanforurgentactionifastudenthascarriedoutoristhreateningimminentsuicide?

• Hastheplanbeencommunicatedtoallstaff?(See Emergency Checklists on pages 9 and 10)

• Areschoolleadersandrelevantstaffreadyandpreparedtoacturgentlywhenrequired?

4.3 Schoolcounsellorsrespondtothebereavedfamilyandwhänau,classmatesandfriendsandfacilitateactionstosupportthem.

• Haveschoolstaffascertainedwhat(ifanything)siblings,classmatesandfriendshavebeentoldaboutthecircumstancesofthedeathandtakenthewishesofthefamilyandwhänauintoaccount?

• Hastheschoolliaisedwiththefamilyandwhänauoverdetails,suchasrepresentationatthefuneral,appropriateculturalorspiritualactivities,memorialplacesorotheractivities?

• Hastheschoolarrangedforthesensitivereturnofthestudent’sproperty(books,equipment,artworketc)?

• Haveyouprovidedstaffwithadviceonmanagingsupportforsiblingsandotherrelativesatschool,classmates,teammatesandfriendsofthestudent?

• Arestaffabletoworkinpartnershipwithkeystudentstoidentifyandmonitorsocialmediasites?Aretheyabletousethesepartnershipstoprovidesupportandsafemessages,andtoidentifyandrespondtostudentswhomaybeatrisk?

• Areallstaffawareoftheriskof‘suicidecontagion’andwaystominimiseordealwiththis?(For further information see page 41)

• Isthereaplanforprovidinglonger-termsupportandfollowup,includingawarenessofdatesoroccasions(inquest,birthdays,anniversaries)thatmayrequiremonitoringofsomestudents?

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» Scenariosfordiscussion

» Scenario1:Suicidepreventionprogrammes

» Scenario2:Suicidethemes

» Scenario3:Dangerousgames

» Scenario4:Topicsfordiscussionorstudy

» Scenario5:Suicidalthoughtsdisclosed

» Scenario6:Breakingconfidences

» Scenario7:Communicatingnewsofasuicide

» Scenario8:Managingstudentsupport

Section 5 – Scenarios

Scenarios for discussion

Thissectioncontainseightdifferentscenariostoillustratesituationsthatschoolsmayexperience.Thescenariosarefictionalanddonotreflectanyoneactualeventinaschool.Schoolscanusethemasabasisfordiscussionastheydevelopandreviewpoliciesandprocedures.Eachscenarioisaccompaniedbyasetofpointstoconsiderindiscussion.

Scenario 1: Suicide prevention programmes

Theschoolreceivesaletterbyavoluntaryorganisationthatiscurrentlytouringschoolspresentingaone-hourpresentationonsuicideawareness.Thepresentationincludesadramaticpieceabouttheimpactastudent’ssuicidehasonhisfriends.Thestatedintentionsoftheprogrammearetohelpstudentsrealisethetragedyofsuicide,teachthemaboutthewarningsignsofsomeoneindistressandencouragefriendstotellatrustedadultiftheyareconcernedaboutafriend.

Consider:

• Thiskindofactivityispotentiallydangerousforanystudentwhoisatriskofsuicide.

• Communicatethisclearlytotheorganisationandviacommunitynetworks.

Scenario 2: Suicide themes

AfamilyorwhänaumembercontactstheEnglishHeadofDepartmentexpressingconcernthatherYear11daughterisstudyingayoungadultnovelcontainingsuicidethemesinherEnglishclass.Shehasattendedatalkonsuicideandhasheardthattalkingaboutsuicideinschoolscanincreasesuicides.Shewantstoknowwhatthejustificationisfortheschoolincludingthenovelintheprescribedtexts.

Consider:

• Cantheeducationalreasonsforincludingthistextbeachievedthroughatextthatdoesnotdiscusssuicide?

• Issuicideromanticisedorglorifiedinthenovel?

• Isthemethodofsuicidedescribed?

• Howcentralissuicidetothethemeofthestory?

• Doesthestorydiscusshelp-seekingbehaviourorotherinterventionsinapositiveway?

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Scenario 4: Topics for discussion or study

Scenario 3: Dangerous games

Astudentselectedsuicideasthefocusofaresearchstudy.Ahealthorganisationcallstheprincipalconcernedthattwostudentshaveaskedtheorganisationfordetailsonthenumberofyoungpeoplereferredforhelpwithmentalhealthconcernsandhaveaskedforinformationonyoungpeopleintheircommunitywhohavediedasaresultofsuicideoverthelastfiveyears.Whenthestudentswerequestionedaboutthistheysaiditwasforanassignmentforschoolandtheyhadpermissionoftheirteacherandfamilyandwhänautoinvestigatethisissue.

Consider:

• Haveyoudiscussedtheproposedresearchwiththestudent?

• Haveyousetparametersandframedtheresearchaspartofwiderinvestigationofwellbeing,mentalhealthissues,resilienceorproblem-solving?

• Canyoumonitortheprogressoftheresearchandanyeffectsonthestudentsortheirpeers?

• Haveyoudiscussedtheprojectwithacolleague?

Aletterhasbeensenthomefromanothersecondaryschoolintheareadescribingadangerouschokinggamestudentshavebeenplaying.Somestudentshavebeensenttextsaboutthegameandsomestudentshavereceivedtextssayingfivestudentshavediedplayingthegame.Duringahealthclass,somestudentsstartjokingaboutplayingthisgame,whiletheywaitforaclassactivity.Otherstudentsstartlaughingaboutkidstheyhaveheardaboutwhohavebeendrinkingandplayingthegameovertheweekend.Thisstartsadiscussionamongthestudentsandtheteacheraboutthechokinggameandsuicide.

Consider:

• Teacherswillneedtotalkinafactualmannerwithstudentsaboutthedangersofthistypeofgameandtellschoolmanagement.

• Schoolmanagementwillneedtoputoutastrongmessagetostudentsandfamiliesandwhänauaboutthecirculatingtextandwarnthemabouttheharminvolvedinplayingthechokinggame.

• SchoolmanagementcanseeksupportfromtheMinistryofEducationTraumaticIncidentserviceforguidance.TheMinistryofEducationcanprovideadviceforcommunicatingtostudentsandthewidercommunityandcansupportliaisonbetweenschools,communitygroupsandothergovernmentagencies.

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Scenario 5: Suicidal thoughts disclosed

Scenario 6: Breaking confidences

Arecently-graduatedteacherapproachesaseniorteacherconcernedaboutthesuicidalthoughtsdisclosedinanEnglishassignmentwrittenbyoneofthestudents.Theteacherisnotsurewhethertotakethewritingsseriously.

Consider:

• Haveyoudiscussedtheassignmentwiththestudent?

• Ifnot,doyoufeelconfidenttodoso?

• Whocanassistyou?

• Whoshouldyoutell?

• Howyoucaninterveneinapositiveway.Forexample,canyouensurethestudentisincludedandconnectedinclassandschool?

Astudentphonesapopularteacherinthemiddleofthenight.Thestudentsoundsdrunkandisthreateningsuicide.Thestudentdoesnotwantanyoneelsetoknow,particularlyhisfamilyandwhänau,andwantstheteachertopromisenottotellanyone.

Youmust:

• Followthestepsintheemergencyprocedures,contactemergencyservicesanddowhateveryoucantoensurethestudentisnotleftaloneuntiltheyarrive.

Consider:

• Whataretheethicalandprivacyconsiderations?

• Howwillyoumanagethestudent’ssafetyintheschoolenvironment?

• Whatwilltheprincipalneedtocommunicatetoteachers?

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Scenario 7: Communicating news of a suicide

Scenario 8: Managing student support

AstudentyoutaughtdiedbysuicideonaSundaynightandnewsofthedeathhasquicklyspreadamongthestudentpopulationthroughtextingandsocialnetworkingwebsites.Youhearaboutthisviaatextfromastudent.

Youmust:

• Ensuretheschoolprincipalreceivesinformationaboutthedeath.Theschoolprincipalwillsetuparesponseteamandcheckandconfirmthattheinformationyouhavereceivedisaccurate.ItisimportantfromthistimeonwardsthatallcommunicationaboutthedeathisledbytheschoolresponseteamorTIRPteam.

Consider:

• Youneedtomaketimeforyourselfandbeawareofyourgriefresponsetothedeath.Attendallstaffmeetingsandstayup-to-dateonevents.Ifneeded,makeuseofsupportservicesprovidedbytheschool.Shareyourthoughtsandfeelingswithsomeoneyoutrust.

• UsetheinformationandresourcessuppliedbytheschoolTIRPteam.

• Payattentiontoclassroomdiscussionsaboutthedeath,especially‘rumours’abouthowthestudentdiedormethodsused.

• Directthediscussiontorememberingthestudentandthatthestudent’slifeismoreaboutthewaytheylivedthanhowtheydied.

• Remainalerttotalkamongthestudentsofany‘blaming’forthedeathoraccusationsofstudentsnotcaring,iftheyarenotdemonstrablyupset.

• Challengeblamingbehaviourasnotbeinghelpfulandemphasisethatnopersonistoblameforthedeath.

• Remindstudentsthatpeoplegrievedifferentlyandthat‘notcrying’doesnotequatetonotcaring.

• Becarefulthatdiscussionsdonotglorifyorromanticisethedeathormakethedeadpersonahero.

John(astudent)diedbysuicideandhisbodywasfoundbythedragonboatcoachinaboatshedonSundayafternoon.StudentshadpracticescheduledforTuesdaynightandnewsandlocationofthebodyspreadquickly.Whenstudentsarrivedatschooltheyfounditemsandnotesfromthedeceased.Manymembersofthedragonboatteambecameupsetwhentheyheardthenewsviatexting.

Consider:

• DidtheschoolTIRPteammeetSundaynightandstarttorespondtothenewsandeffectsofthedeathfortheschoolcommunity?

• Didschoolstafftakeparticularcaretomeetindividuallywithclosefriendstodeterminethenatureofnotesandothermessagestostudentsandtoassurestudentsthatthedeathwasnottheirfault?

• DidtheschoolhavecopiesofAfter the Suicide of Someone You Know: Information and Support for young people?(Phone0800299100or049396767oremailresources@skylight.org.nztoordercopies).

• Haveappropriateschoolstaffspokenwithstudentsidentifiedasclosefriends,aswellasmembersofthedragonboatteams?

• Didyoudiscussblameandthatitiscommontotrytoanswerthequestion‘why’afterasuicidedeath?

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Section 6 – Support services and information about self-harm

» Supportservices

» Informationaboutself-harm

» Acknowledgements

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Support services

Therearearangeofservicesandprogrammesthataimtosupportpeople’swellbeingorarefocusedonpreventingsuicide.ThesecanbefoundintheEvery Life Matters He Tapu te Oranga o ia tangata Suicide Prevention Strategy 2019–2029 and Suicide Prevention Action Plan 2019–2024 for Aotearoa New Zealand.Gotohttps://www.health.govt.nz/system/files/documents/publications/suicide-prevention-strategy-2019-2029-and-plan-2019-2024.pdf.

Theseservicesandprogrammesareavailableforanyonetoaccess,support,joinorletothersknowabout.Thisisbynomeansanexhaustivelist,andit’sworthkeepinganeyeoutinyourcommunitytoseeifotheropportunitiesareavailable.

YoucanalsocontacttheSuicidePreventionOfficeformoreinformationabouttheopportunitiesthatareavailableforindividuals,whänauandfamilies,andcommunitiestoplaytheirroleinsuicideprevention.Phone0800855066.Emailsuicideprevention@health.govt.nz

Information about self-harm

Thereisnowconsiderableevidencetosupportdistinguishingbetweenself-harmsandsuicidalbehaviours.Peoplecanself-harmtodecreasedistress,whichenablesthemtocontinuefunctioning.Incontrast,peopleattempt

orcompletesuicidetoendtheirlives.Self-harmisalsoidentifiedasariskfactorforsuicideandshouldalwaysbetakenseriously.Studentsself-harmingshouldbetreatedasat-riskuntilfurtherin-depthassessmentindicatesotherwise.

Self-harm resources

• TheMentalHealthFoundationhasafactsheetonself-harmwithlinkstosupportgroupsandotherresources:https://www.mentalhealth.org.nz/get-help/a-z/resource/49/self-harm

• Self-InjuryOutpostandSupport(SIOUS)providesinformationandresources,includingaself-injuryguideforschoolprofessionals,informationforfamiliesandwhänau,resourcesoncopingforthosethatself-harmandpersonalstoriesofrecovery:http://sioutreach.org/

• Supportfordevelopingandimplementingaschoolprotocolfornonsuicidalselfinjury(NSSI)canbefoundhere:http://www.selfinjury.bctr.cornell.edu/perch/resources/schoolprotocol.pdf.Thiscoverswhatallschoolstaffneedtoknowaboutself-harmandtalksabouttheformationofateamofschoolstafftoworktogethertosupportastudentwhoisself-harming.Theprotocolincludesstepstofollow(applicabletothecontextofNewZealandschools)whenitisknownastudentisself-harming.

• CornwellUniversityalsohasself-harmandrecoveryresourcesforschoolstaffandtherapists,familiesandwhänauandothercaringadults,andforthepeoplewhoself-harm:http://www.selfinjury.bctr.cornell.edu/resources.html.

• CornwellUniversityalsoprovidesweb-basedtraining.Thecoursetakesbetween8and11hours,dependingontheformatchosen.Thetrainingcostsareoutlinedonthesite.Accessthetraininghere:http://www.selfinjury.bctr.cornell.edu/training.html.

• Self-Injury: Simple Answers to Complex Questions Center for Self-Injury Recovery(June2014),isabookthatseveralNewZealandguidancestaffhavefounduseful.Itiswrittenforbothmentalhealthprofessionalsandconsumers.Thebookisaguideforunderstandingself-harmandprovidestreatmentapproachestoaddressthesebehaviours.

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Acknowledgements

TheMinistryofEducationthanksTePouoTeWhakaaroNui(TePou),theUniversityofOtago,andtheMinistryofEducation–ProfessionalPracticeUnitwhotookpartindevelopingthisresource.

TheevidencebaseunderpinningthisresourcewascommissionedbyTePouonbehalfoftheMinistryofHealth,andundertakenbyProfessorSunnyCollings,SocialPsychiatry&PopulationMentalHealthResearchUnit,UniversityofOtagoWellington.

FirstpublishedbyMinistryofEducation1998,revisededition2013Furtherrevisionscompleted2019©Crowncopyright2019.

AcommitmenthasbeenmadethroughtheEvery Life Matters He Tapu te Oranga o ia Tangata Suicide Prevention Strategy 2019–2029toworktogetherwiththeMinistryofHealthandtheOfficeoftheChildren’sCommissionertoupdatethisresource.

Allrightsreserved.Enquiresshouldbemadetothepublisher.

ISBN9780478406962(Web)

Preventing and responding to suicide – Resource kit for schools