Protecting Students From Themselves: A School’s Role in Preventing Adolescent Suicide
By Margaret Field
The strings of teens killing themselves in the Bay Area have recently received a new name: “The Silicon Valley Suicides”, alluding to a deep-rooted sadness in an area of the country typically known for its technological prowess. Despite the lack of recent academic conversation concerning adolescent suicide (most research dates to the early 2000s), Silicon Valley is not the only place where this is a serious problem; suicide has become the second leading cause of death among youths 15 to 19 years of age (King et. al 255), and approximately 16% of students in grades 9-12 have reported considering suicide (“Suicide Prevention”). As teens, parents, journalists, and educators alike turn to social media and the Internet in general to voice their grief, blame commonly falls on schools and parents for the high pressure that they put on students. On the other hand, however, some educators believe that mental illness, as the cause of these suicides, is a personal problem that should be solved outside of school. The reality is a combination of both problems. High schools are sources of high pressure on teens and should be central in improving the alarming rates of adolescent suicide; however, their main focus should be screening for and beginning to treat mental illness, rather than solely eliminating academic pressure. By adopting a clinical approach to preventing suicide and treating at-risk students, schools will be able to significantly decrease adolescent suicide rates.
As incidences of suicide are significantly more common in areas notorious for academic achievement, one cannot ignore the correlation between academic stress and adolescent suicide. Given that suicide rates at Palo Alto and Gunn High School are four to five times the national average (Rosin), the first step in reducing teen suicide is looking to schools and parents to reduce the pressure they put on students. However, reducing hours of homework or numbers of exams allowed will not drastically change social and parental influences on students. In her article, “The Silicon Valley Suicides,” Hanna Rosin describes a debate between students and Palo Alto High School officials over removing zero period, an extra class period offered at 7:20 in the morning. Almost every student currently enrolled in a zero period class did not want it to end (Rosin). Rosin remarks that “the written testimonies… are at times alarming for their Stockholm-syndrome quality. ‘I would just like to say that a lot of the stress’ is ‘from all the limits you guys are trying to enforce,’ reads one typical statement.” Students have learned to cope with stress by taking earlier classes in order to have more time for homework and extracurriculars, sacrificing their health as giving up sleep seems to be the only way to get everything done. It is such a common problem that adolescents come to believe it is normal, and reducing requirements will not change their mindsets. Carolyn Walworth, a current senior at Palo Alto High School, observes in her op ed, “The Sorrows of Young Palo Altans,” that students have learned “that it is okay and necessary to have great apprehension regarding [their] grades.” In these elite high schools, there are complex, deep-rooted issues combining high pressure environments with mental illness, and Walworth continues to assert that “telling us to go see a school counselor for stress… is analogous to putting a band aid over a fresh gunshot wound.” Ultimately, topical solutions like adjusting school policies on homework are simply not enough; we must work towards a healthier culture altogether with the knowledge that mental illness is the main source of suicide. Lessening academic stress is a useful first step, but an excessive workload is an aggravator to mental illness that exists more insidiously even without so much pressure. William G. Kirk, professor of psychology at Eastern Illinois University, writes about the problems behind mental illness in children. According to Kirk, there are some adolescents who thrive in high-pressure environments with little emotional support, while others end up withdrawn, depressed, and even suicidal (28). This lends itself to the idea that suicide is not purely situational, but the result of an internal struggle that goes unnoticed until it is too late. In fact, depression and other mental illnesses are ranked as a top risk factor for suicide by the Center for Disease Control and Prevention (“Suicide Prevention”), so education in schools towards growing up with an understanding of mental health is a necessary yet missing link in many places. During an adolescent’s formative years, an image of a healthy mind is often hard to pinpoint, and for students already affected by mental illness, the difference between normal and unhealthy levels of emotional stress can be indistinguishable. However, this distinction forms the basis for a school’s approach to reducing suicide.
It is important to recognize the general misunderstanding of mental illness in the high school context because schools can actively work to reverse misconception and target the cause of the problem directly; recognizing that suicidal tendencies are a result of mental illness increases the likelihood that individuals will seek help for themselves or peers, and affects the kinds of help that a high school makes available to its students. Although the Surgeon General states that stigmas of mental health disorders can increase reluctance to reach out for help, this is not the case in all experimental studies. Jerry
Ciffone is a social worker who has studied the effects of curriculum-based suicide prevention in high school. According to Ciffone’s account, students who learned to associate suicide with mental illness also improved in their “help-seeking” attitudes and behavior (46). Ciffone explains that “when students understand that what they are dealing with in themselves or in their peers is not normal, there may be a greater sense of urgency to get help” (47). This “help-seeking” behavior is vital to preventing suicide when so much stigma and misunderstanding of mental illness permeates the high school environment and“giving up” is the worst kind of failure. Rosin’s article reports the story of Taylor Chiu, a student who attempted suicide as a freshman at Palo Alto High School. She describes wishing “she had some reason to explain to her parents why she felt so sad. She didn’t want to ask for a break, she said, because people would think she was lazy. ‘But having a mental disorder? People would listen to that’” (Rosin). Chiu’s depression kept her from realizing she had a problem, but with a better understanding and appreciation for mental health, she might have asked for help sooner. Educating about and discussing mental health as a cause of suicide will help dispel the idea that looking for support is equivalent to giving up and encourage students to ask for help.
Once students learn to seek treatment for mental illness, they must have a place to find assistance; when parents or money prevent students from accessing treatment, schools should take up the responsibility. Many high schools have counseling for students, and creating a community that opens up dialogue about mental illness is important by not only helping students who ask for it, but identifying at-risk students who have yet to reach out. Dr. Douglas Fisher emphasizes the role of classroom teachers in facilitating open discussion about mental illness, as many students do not build relationships with their counselors or school nurses. Instead, “classroom teachers and building administrators serve as an early warning system” for noticing suicidal students and preventing student suicides (785). On the other hand, David Shaffer, a psychiatrist and Professor at Columbia University, argues against attempts at prevention, since teaching about suicide in schools could come across as suggesting suicide “as an understandable response to common adolescent problems” (qtd. in Ciffone 41). Shaffer also sees curriculum-based approaches as denial of the mental illness responsible for suicide. However, preventative tactics built upon an understanding of mental illness prove to be effective when approached in a clinical manner. A health system in Detroit known as the Henry Ford Health System has begun a preventative program with the goal of zero suicides. While it seems like a lofty goal, their approach is systematic and specific, and has reduced suicides by eighty percent since the program started (Silberner). The effort began in 2001 with the intent to treat depression when Henry Ford launched its “perfect depression care” in hopes of not only reacting to suicide attempts, but also identifying patients who might be at-risk and treating them ahead of time. It is this “ahead of time”– the preventative aspect of the program– that differentiates it from other systems and makes it successful in reducing suicides. Use of crisis management teams to intervene or treatment of individuals only after they attempt suicide is short-sighted and less impactful than prevention.
Joanne Silberner, who reports on the health system in her article, “What Happens When You Try to Prevent Every Suicide?,” describes the Henry Ford Health System’s plan as a “cookbook approach.” There are three main components: the first, which is not entirely novel, yet vital to the plan, is screening. Doctors use a series of two questions (which may lead to more) in order to assess each patient: “How often have you felt down in the past two weeks? And how often have you felt little pleasure in doing things?” The doctors ask these questions at each visit, and if they recognize a mental health problem, they assign a care plan for treatment, the second part of the plan. Then specific preventative measures are taken. The therapist will contact the family of the patient and instruct them to eliminate anything in the home that could be a means for suicide, and patients write “safety plans” which include hopeful messages and alternatives or diversions from suicide. None of these components is revolutionary, yet the combination proves to be hugely successful.
This process, which diagnoses, prevents, and begins treatment of suicidal individuals should become commonplace in schools, with screening for suicidal students similar to the yearly or twice-yearly screenings schools already use to check for hearing problems or scoliosis. Just like hearing problems and crooked spines that go undetected during a child’s adolescence, unrecognized mental illness can quickly become a serious problem that plagues an individual throughout his life, and mental illness should be detected and treated with the same importance as physical disorders. Implementing serious medical care inside high schools may be unrealistic, but the diagnostic tasks, preliminary treatment, and training for counselors outlined in the program are small yet impactful changes that schools can and should make. Psychiatrist Doree Ann Espiritu, head of the suicide prevention program at Henry Ford, stresses the importance of properly training the individuals who carry out screening and preliminary response to at-risk individuals. “Providers are trained to be comfortable asking their patients about suicidal thoughts,” and convey a message of hope: one patient says “there is no question that the message I got from Day 1 is that they knew they could help me, and they would help me” (qtd. in Silberner). School counselors and even classroom teachers should adopt these attitudes and responses, as any contact with students is an opportunity to promote discussion of mental illness and healthy approaches. Although school teachers and even counselors may not be equipped to take over treatment of students with mental illness, they should be trained in identifying risk factors and beginning the process of treatment. A successful implementation of screening and preliminary treatment in high schools will make prevention of adolescent suicide accessible to students and effective in saving their lives.
Schools should advance with the understanding that while academic pressures become the tipping point for suicidal adolescents, mental illness is still at the root of the problem. High schools like those in Silicon Valley have developed cultures that place mental health as second to academic success, with devastating consequences, and more schools are likely to follow if they do not change their approaches. High School staff, parents, and their children need to work together to understand and prioritize mental health in order to prevent suicide and allow a greater number of students to access treatment for mental illness even before they become suicidal. Although they are not solely to blame for creating this culture, schools can certainly work to improve it. No amount of suicide is acceptable, and we owe it to our youth to make mental health a priority.
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Fisher, Douglas. “Keeping Adolescents ‘Alive and Kickin’ It’: Addressing Suicide in Schools.” Phi Delta Kappan 87.10 (2006): 784-86. JSTOR. Web. 3 Dec. 2015.
King, Keith A., et al. “Preventing Adolescent Suicide: Do High School Counselors Know the Risk Factors?” American School Counselor Association 3.4 (2000): 255-63. Abstract. JSTOR. Web. 3 Dec. 2015.
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