Child Suicide







      Preventing Student Suicide with Just a Few Simple Questions      Suicide among children and teens   is shockingly on the rise. In the wake of each tragedy, parents, peers, and educators are filled with devastation and regret. Spending so much time with children, teachers often feel guilty that they didn’t realize their student was suicidal. Other times, they sensed something was wrong but weren’t sure how to effectively intervene. So how can teachers determine if their students are at risk for suicide, and what can they do about it?    Learning these simple steps could help you save a student’s life:    1. Separate suicide and NSSI   One of the obstacles in providing proper interventions is educators not grasping the difference between suicidal behavior and non-suicidal self-injury (NSSI). Both are serious and require intervention, but the response for suicidality is different than for NSSI. Properly identifying a student’s behaviors is an important first step in getting them the right help. A few key characteristics of the two include:   Suicidal behavior/ideation:     The person has some   intention of dying       They know that their   behavior could result in death      May   seek the most painless way   to do it     NSSI:     Has   no intention   of dying      Does not believe   their actions could result in dead      Seeks physical pain   to escape emotional pain    NSSI has   3 possible functions:      To   obtain relief     from a negative feeling or cognitive state e.g. stress, worry thoughts, loneliness, emptiness    To   resolve     interpersonal conflict e.g. family arguments, divorce, sibling rivalry, peer conflict    To   induce  a positive feeling state e.g. euphoria, decrease numbness       For an in-depth look at NSSI and what to do about it,    click here     2. Explore the C-SSRS   The Columbia-Suicide Severity Rating Scale (C-SSRS) was developed to provide a simple, accurate, and effective tool that anyone can use to evaluate risk for suicide. You do not need to be a mental health professional to administer it; all it requires is asking a series of simple questions and referring them to mental health services if their answers raise any red flags.    The full C-SSRS screening tool is available in several versions.   Below are a few quick links to commonly used versions.      Click here to access all versions of the C-SSRS.           C-SSRS for Teachers           C-SSRS for Family and Friends           C-SSRS for Teens to Talk to Friends           C-SSRS for Parents      3. Identify ideation   The first step in applying the C-SSRS is identifying ideation. If you are concerned your student may be at risk for suicide, start by asking these 2 questions:    “Have you wished you were dead or wished you could go to sleep and not wake up?”    “Have you actually had any thoughts of making yourself not alive anymore?”     4. Ask more as needed   When administering the C-SSRS, you only need to ask as many questions as it takes to determine whether your student has had suicidal ideation or behaviors. If your student answered no to both ideation questions, you can rule out ideation and jump right into the behavior questions listed in our next point. If they answered yes to either or both ideation questions, ask a few more ideation questions to gain understanding:    “Have you been thinking about how you might do this?”    “Have you had these thoughts and had some intention of acting on them?”    “Have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan?”     5. Assess for behaviors    Whether or not your student has indicated ideation, you must also ask behavioral questions. Determine whether they’ve engaged in suicidal behaviors by asking the following questions:    “Have you made a suicide attempt?”    “Have you done anything to harm yourself?”    “Have you done anything dangerous to where you could have died?”     6. Inquire about interruptions   Next, ask your student if there were ever times where they had attempts that were either stopped by someone interrupting them, or by them having second thoughts:    “Has there been a time when you started to do something to end your life but someone or something stopped you before you actually did anything?”    “Has there been a time when you started to do something to end your life but you stopped yourself before you actually did anything?”     7. Ask about preparatory behaviors   Even if your student has not indicated making any attempts, it’s important to find out if they’ve done anything to prepare to end their life. Examples could include collecting pills, purchasing a gun, writing a suicide note, or giving valuables away.      “Have you taken any steps toward making a suicide attempt or preparing to kill yourself?”     8. Know when it’s an emergency   If your student answers yes to any questions regarding ideation, behaviors, or non-suicidal self-injury, it’s important to refer them to mental health resources. For a student to require a 911 call and/or immediate escort to emergency services, they should meet either of the following criteria:    Active suicidal ideation with some intent to act, without specific plan    Active suicidal ideation with specific plan and intent     Check out these video clips to learn how to ask C-SSRS questions:    Joanna’s example         </iframe>" data-provider-name="YouTube"          Gabriel’s example         </iframe>" data-provider-name="YouTube"          Andrea’s example         </iframe>" data-provider-name="YouTube"            Click here to watch Columbia University’s C-SSRS webinar      9. Reach out and speak up   If your student’s answers have indicated suicidal ideation, suicidal behaviors, or non-suicidal self-injury, quickly share your findings with the school leadership, crisis response team, school psychologist, school counselor or other mental health professional on campus. If you’re not sure who to alert, call 911. As a preventative measure, advocate for mental health programming to be offered on campus so that all students learn healthy coping skills and become aware of available resources.    10. Host a C-SSRS training   The best way to prevent tragedy on campus is to get your faculty on the same page with effective tools that address mental health emergencies. While you don’t have to be a mental health professional to administer the C-SSRS, it’s best to complete a brief online training and receive additional in-person education from a mental health professional to fully grasp how to evaluate student answers in real-life scenarios.      Here is a listing of C-SSRS training options      including pre-recorded and live webinars.    If you represent a private school or district that would like to do an in-service teacher training, our Specialists can:    Visit your campus for in-person training    Answer questions and review key concepts of applying the C-SSRS    Provide realistic examples of evaluating students’ risk for self-harm    Help teachers prepare students for educational units or aspects of popular culture that may romanticize suicide (example:  Romeo and Juliet,  TV shoes depicting suicide, etc.)       

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      Dr. Marta M. Shinn, Ph.D.,  is an expert in Child and Educational psychology and is experienced in training educators on use of the C-SRSS screening tool.       
	 Click here to schedule your appointment with Dr. Shinn 
       Dr. Christopher J. Sample, Psy.D.  specializes in supporting men and teen boys through life’s transitions. If your teenage son is struggling with depression or is concerned for a friend, Dr. Sample can help.          
	 Click here to schedule your appointment with Dr. Sample 
       Dr. Elsa Torres, Psy.D.,  is a specialist in Diagnostic Testing and Counseling. If you or someone you love has had thoughts of suicide, don’t put off seeking help. Dr. Torres can provide a safe place to listen and provide support.       
	 Click here to schedule your appointment with Dr. Torres 
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              The purpose of this article is to provide an overview of the highlighted topic. For a full consultation, assessment, and personalized treatment plan, schedule an appointment  with one of our specialists.   More about Variations Psychology   Variations Psychology is a group practice specializing in Child and Family Psychology.  Our specialists provide therapy to infants, children, adolescents, and adults to help them overcome the many challenges they may face throughout the lifespan of a family. We also conduct diagnostic testing of child and adult conditions that may impact the family’s mental health and development (e.g. ADHD, Autism Depression, Anxiety, Learning Disorders, college entrance exams, graduate and professional licensing exams such as MCAT, LSAT, GRE, CBEST, NCLEX, GMAT, CA Cosmetology Exam, CA Contractors State Licensing Exam, and CA Bar Exam).  See our   Specialists   page to select the specialist that best suits your need, or simply give us a call and we will guide you..  Variations Psychology is located in Newport Beach, CA and provides counseling to residents throughout Orange County and its surrounding areas including Newport Beach, Newport Coast, Irvine, Shady Canyon, Laguna Beach, Laguna Hills, Coto de Caza, Corona del Mar, Costa Mesa, Yorba Linda, Dana Point, Laguna Niguel, Aliso Viejo, Mission Viejo, Pelican Hill, Crystal Cove, Rancho Santa Margarita, San Clemente, Lake Forest, Huntington Beach, Sunset Beach, Seal Beach, and more.      
       References:   The Columbia Lighthouse Project (2018). The Columbia Protocol for Your Setting.  The Columbia Protocol for Communities and Healthcare.  Retrieved from  The Columbia Lighthouse Project (2018). Community Card for Teachers.  The Columbia Protocol for Communities and Healthcare.  Retrieved from  The Columbia Lighthouse Project (2018). Community Card for Friends and Family.  The Columbia Protocol for Communities and Healthcare.  Retrieved from  The Columbia Lighthouse Project (2018). Community Card for Teens.  The Columbia Protocol for Communities and Healthcare.  Retrieved from  The Columbia Lighthouse Project (2018). Community Card for Parents.  The Columbia Protocol for Communities and Healthcare.  Retrieved from  The Columbia Lighthouse Project (2017).  C-SSRS Training . [Video webinar]. Retrieved from  Shinn, M.M. (2018). Cutting & Other Self-Harm: What Every Parent Needs to Know.  Psychologically Speaking . [Variations Psychology blog post].  Retrieved from    Shinn, M.M. (2018). 8 Tips to Create a Mentally Healthy Classroom.   Psychologically Speaking . [Variations Psychology blog post].  Retrieved from   Shinn. M.M. (2019). Parent’s Guide: What to do When Your Child’s Friend Dies by Suicide.  Psychologically Speaking.  [Variations Psychology blog post]. Retrieved from    Shinn. M.M. (2019). Suicide Prevention in the School Setting.  Variations Psychology, Futures Academy.  [Webinar].   Posner, K.; Brent, D.; Lucas, C.; Gould, M.; Stanley, B.; Brown, G.; Fisher, P.; Zelazny, J.; Burke, A.; Oquendo, M.; Mann, J.(2008) Columbia-Suicide Severity Rating Scale (C-SSRS). The Research Foundation for Mental Hygiene, Inc. Retrieved from    How to Cite This Blog Article:    Shinn. M.M. (2019). Preventing Suicide in Students: How 3-6 Questions Can Save Lives.  Psychologically Speaking.  [Variations Psychology blog post]. Retrieved from:

Preventing Student Suicide with Just a Few Simple Questions

We’ve all been pained by recent news stories of teens and even young children dying by suicide. This week’s blog delves into how teachers can save lives with 3-6 simple questions.