They have been locked at home for almost two years due to the pandemic, the constant change in routine with schools opening and closing, social distancing and fear of contagion increase the likelihood that the population of children and young people with mental health problems. According to the State of the World’s Children 2021 report published by UNICEF, 13% of young people between the ages of 10 and 19 have a mental disorder. In 50% of cases, they began before the age of 14.
In Spain, suicide is the leading cause of unnatural death among young people aged 15 to 29. On average, ten young people decide to end their lives every day. In the case of Mexico, the National Institute of Public Health of Mexico estimates that for every successful suicide, 20 non-random attempts were made. What can educational institutions do to prevent this point from being reached?
As students begin to return to the classroom, schools are becoming the places where children and young people spend the most time, so schools play an important role in suicide prevention. Suicidal behavior is not just the intention to commit suicide; it includes reflections and attempts, so schools need to know how to intervene and have the resources to help them stop suffering in silence.
Educational institutions are an ideal resource for students to learn social-emotional skills; it’s where they socialize with people their own age. It is the first place where they spend a significant number of hours without the supervision of their loved ones. This is why it is essential that schools seize the opportunity to improve the ability to manage emotions, self-control and relationships with others. Institutions must invest in prevention, providing timely and effective care for child and youth mental health issues. According to a study published in the Journal of Affective Disorders, it was found that by applying to emotional resilience programs, schools reduced symptoms of anxiety and depression in children aged 6-12. Additionally, there are instances where schools are the only places where students have access to these support resources.
The educational community must also be informed of the detection of any warning signs indicating that a student has mental or emotional problems in order to refer them to help. The training of academic staff after a suicide attempt is essential, but it is also essential to prepare their colleagues to become good prevention agents. A girl or adolescent has someone she can talk to and feel heard generates a vital support line that can save her life. That schools have spaces and professionals to whom students can talk about the issues that concern them is an essential step in preventing suicide. In addition, in this way, cases of bullying are also detected and resolved.
Having protocols is also a necessary measure as it helps in knowing how to deal with students having suicidal thoughts or attempts. Knowing what to do in these cases may be the only thing preventing a fatal outcome. In addition to this, work in class on aspects of mental health such as emotional management skills, problem solving, cognitive flexibility strategies, stress regulation and how to act in a crisis.
The meta-analysis of school-based suicide prevention programs published in The International Handbook of Suicide Prevention, Second Edition, which contains different suicide prevention programs, found that the prevention measures that work best are:
Awareness and education program
School programs should be created with an awareness and education program to teach students about suicide, its risk factors, and what to deal with in a suicidal student situation. The study concluded that facilities with such programs showed significant behavioral change and a reduction in the incidence of suicidal ideation and attempts, demonstrating that the awareness and education model of suicide prevention programs is a promising avenue that deserves to be explored further.
2. Detection is key
Less than 25% of families are aware of their children’s self-harming and suicidal behaviors, especially since young people do not seek help. One solution, according to the study, is to administer a preliminary screening questionnaire and then refer students with red flags to a school counselor or make it easier for them to get emergency psychiatric help.
Are the program strategies focused on sensitization and detection? An example is a program used by the United States Air Force to address suicidal and self-harming behavior known as “question, persuasion, and referral” (QPR). Its purpose is to increase suicide awareness among school staff, identify students at risk, improve staff skills to intervene, and generally increase communication between school staff and students. This involves teaching staff how to identify youth at risk and then respond appropriately by referring to mental health resources.
The study showed that these at-risk students do not usually seek help from adults themselves, so training educators to act as gatekeepers seems like a more logical solution. However, training adults and peers is essential, as they are more aware of perceptions and behaviors within their social circles. A peer monitoring program is even more effective than “Ask, persuade and refer”.
These peer- and tutor-run support programs were used to empower them to spread positive messages that change social norms in school settings. Encourage students to develop positive life skills and attitudes and foster a belief and strategy that promotes help-seeking from adults. Additionally, the program seeks to expect peers to seek help when faced with suicidal tendencies.
4. Vocational training
The study suggests applying the CARE/CAST program on Care, Assessment, Response, Empowerment and Training (CARE) to students to cope and support (CAST) as it develops skills to prevent suicide. First, the CARE part concerns screening with direct intervention followed by motivational interviewing. Then there is the CAST part which aims to increase coping and mood regulation, reduce substance use, and increase academic performance. It is about training skills to small groups of low average students, with a high percentage of absenteeism or direct referrals from staff. These are 12 sessions that aim to teach skills and behavioral changes that reduce suicide risk factors.
Mental health and suicidal behaviors must be part of the educational context. Beyond simply following the curriculum, schools, educational staff and students need to be aware of the importance of social co-responsibility and its role in suicide prevention. As mentioned above, there are always attempts before attempting suicide; Knowing how to identify these and other warning signs can prevent a fatal outcome and help the student move forward.
Translation by Daniel Wetta