Well, what I want to say is it is not white and black ever when it comes to determining the level of care to ensure youth’s safety and the intent to end his or her life. We know that it is much much better to prevent by recognizing the risks way ahead. I use the word teen more than child here as suicide is higher in teens than in children where it is rare. However, the need to escape from psychological pain is tough at any age. So here are some pointers for the teachers.
First, the basic question is to recognize what is at stake if someone attempted suicide. We ask a plethora of questions like a filter to capture the seriousness: When was it attempted, what is inciting reason, how many times before, was it done in secrecy or anyone was made aware, access to the means to carry out the act like guns, note written/left behind, family crisis and support, isolated, substance use, mental illness and so on. There are ton of suicide prevention questionnaires to help figure the risk for suicide, but sadly none of them are fail proof to assess the risk. You may not have knowledge of all these or have the chance to ask, but know that these are important things.
Second, know that not all children or adolescents with suicidal thoughts are the same. Here, the potential risks blend with the actual inciting incidents. A potential risk in someone is crisis in another. Some of the patterns give you an idea of how it varies from person to person: early onset depression or related brain/mental illnesses, teen on drugs being self destructive and miserable, a tween threatening to kill self if staff in the school is strict or peers are bullying, academic struggles, a socially anxious teen cutting arms and feeling helpless, relationship breakup in vulnerable youth, family problems including abuse and so on. Many of the problems are exponentially worse if the family support is poor, problems are many or if the teen is impulsive. Approach to helping them regain health and strength varies based on the type of the problem. Ending life with psychological pain is not by choice for anyone, if they know they have a way out. Showing the way is the key.
Third, the safety net. Was I anxious to keep the kids at work safe, time to time? Hell, yea! Our secret for holding the kids we treat? We believe that we have high level of tolerance and endure the anxiety with faith, and do everything we can to buffer the risk, 24/7 when in crisis. We take the risk to serve without being frightened of ‘what if’ and be cautious to do all that we can. We say to them literally that “we are on the ride with them through the journey and will not drop them.” We tell them that they are not alone. So what can you do to help? Here is a checklist: (a) As lead teacher, principal or counselor, you need to work with the clinical team to collaborate in ensuring that such a safety net is in place. A simple teleconference with all parties would help. (b) I do not need to tell you that school counselors or social workers can be helpful. But given the scarcity of resources, in reality, it tends to be not adequate, but still an important piece. Do not rely on this alone, if a kid is suicidal. (c) Problem solving: This is super important if the environment is acrimonious with hidden struggles between students or there are learning difficulties. (d) I think kindness and connectivity from you, your colleagues and peers will matter greatly. I bet you will be their advocate, right?! You can be the role model to generate the positive vibes to ‘include them.’ Give them hope to live.
Fourth, as a teacher, develop a sense of understanding of the youths’ needs. More like what should you know as a teacher to feel comfortable in having a child in the classroom again? Three things that are critical to have a child/teen in classroom are not “actively suffering” with mentally illness, not using substances, and having a caring and connected support system to evade stress or psychological pain and isolation. Teachers and parents do not always know how to assess the first two and may partially understand the depth of the third issue. Connecting to the clinician to help figure these three things is quintessential.
Fifth, avoid rigid rules in decision making when to accept the kid back into the classroom. Better if this is left to the clinician and the family to jointly decide, with your input, indeed. Some kids need to return to normal routine without too much drama and some need extended time to recover. This is where risk-benefit analysis comes into play.
Take risk to normalize as soon as possible? Exercise caution to admit them to secure inpatient unit and keep them out of school for an extended period? It depends, and you do not have to decide as a teacher. Heart of the matter is connection, preventing isolation and tailored support, to help youth prevail.