(The NAPPP Webinar in April had discussion
around 13 Reasons as well as
NAPPP Proclamation on Suicide
Prevention/Intervention. Webinar available on
NAPPP website along with discussion guide
for 13 Reasons. Please see below
guidelines for working with “13 Reasons Why”)
Schools
have an important role in preventing youth suicide, and being aware of potential
risk factors in students’ lives is vital to this responsibility. The trending Netflix
series 13 Reasons Why, based on a young adult novel of the same name,
is raising
such concerns. The series revolves around 17-year-old Hannah Baker, who takes
her own life and leaves behind audio recordings for 13 people who she says in some
way were part of why she killed herself. Each tape recounts painful events in which
one or more of the 13 individuals played a role.
Producers
for the show say they hope the series can help those who may be struggling
with thoughts of suicide. However, the series, which many teenagers are binge
watching without adult guidance and support, is raising concerns from suicide prevention
experts about the potential risks posed by the sensationalized treatment
of
youth suicide. The series graphically depicts a suicide death and addresses in wrenching
detail a number of difficult topics, such a bullying, rape, drunk driving, and
slut shaming. The series also highlights the consequences of teenagers
witnessing
assaults and bullying (i.e., bystanders) and not taking action to address the
situation (e.g., not speaking out against the incident, not telling an adult
about the
incident).
Cautions
We
do not recommend that vulnerable youth, especially those who have any degree of
suicidal ideation, watch this series. Its powerful storytelling may lead impressionable
viewers to romanticize the choices made by the characters and/or develop
revenge fantasies. They may easily identify with the experiences portrayed and
recognize both the intentional and unintentional effects on the central
character. Unfortunately, adult characters in the show, including the second
school counselor who
inadequately addresses Hannah’s pleas for help, do not inspire a sense of trust
or
ability to help. Hannah’s parents are also unaware of the events that lead to
her suicide
death. While
many youth are resilient and capable of differentiating between a TV drama and
real life, engaging in thoughtful conversations with them about the show is
vital. Doing
so presents an opportunity to help them process the issues addressed, consider the
consequences of certain choices, and reinforce the message that suicide
is not a solution to problems
and that help is available. This is particularly important for adolescents who are isolated, struggling, or vulnerable to
suggestive images and storylines. Research
shows that exposure to another person’s suicide, or to graphic
or sensationalized accounts of death, can be one of the many risk factors that
youth struggling with mental health conditions cite as a reason they
contemplate or
attempt suicide. What
the series does accurately convey is that there is no single cause of suicide. Indeed,
there are likely as many different pathways to suicide as there are suicide deaths.
However, the series does not emphasize that common among most suicide deaths
is the presence of treatable mental illnesses. Suicide is not
the simple consequence
of stressors or coping challenges, but rather, it is most typically a combined
result of treatable mental illnesses and overwhelming or intolerable stressors. School
psychologists and other school-employed mental health professionals can assist
stakeholders (e.g., school administrators, parents, and teachers) to engage in supportive
conversations with students as well as provide resources and offer expertise
in preventing harmful behaviors.
Guidance
for Educators
1 While we do not
recommend that all students view this series, it can be appreciated
as an opportunity to better understand young people’s experiences,
thoughts, and feelings. Children and youth who view this series will
need supportive adults to process it. Take this opportunity to both prevent the
risk of harm and identify ongoing social and behavior problems in the school
community that may need to be addressed. Help students
articulate their perceptions when viewing controversial content, such
as 13 Reasons Why. The difficult issues portrayed do occur in schools and
communities, and it is important for adults to listen, take adolescents’ concerns
seriously, and be willing to offer to help.
1. Reinforce that
school-employed mental health professionals are available to help. Emphasize that the behavior of the second counselor in the series is understood
by virtually all school-employed mental health professionals as inappropriate.
It is important that all school-employed mental health professionals
receive training in suicide risk assessment. Make sure parents,
teachers, and students are aware of suicide risk warning signs.
Always take warning signs seriously, and never promise to keep them
secret. Establish a confidential reporting mechanism for students.
Common
signs include:
o
Suicide threats,
both direct (“I am going to kill myself.” “I need life to stop.”) and indirect (“I need it to stop.” “I wish
I could fall asleep and never wake up.”). Threats can be verbal or
written, and they are
often found in online postings.
o
Giving away
prized possessions.
o
Preoccupation
with death in conversation, writing, drawing, and social media.
o
Changes in
behavior, appearance/hygiene, thoughts, and/or feelings. This can include someone who is typically sad who
suddenly becomes extremely happy.
o
Emotional
distress. Students who feel
suicidal are not likely to seek help directly; however, parents,
school personnel, and peers can recognize the warning signs and take immediate
action to keep the youth safe. When a student gives signs that they
may
be considering suicide, take the following actions:
o
Remain calm, be nonjudgmental,
and listen. Strive to understand the intolerable emotional pain that has resulted in
suicidal thoughts. Avoid statements
that might be perceived as minimizing the student’s emotional
pain (e.g., “You need to move on." or "You should get over it.”).
o
Ask the student directly
if they are thinking about suicide (i.e., "Are you thinking of suicide?").
o
Focus on your
concern for their well-being and avoid being accusatory. Reassure the student that there is help
and they will not feel like this forever.
o
Provide constant
supervision. Do not leave the student alone.
o
Without putting
yourself in danger, remove means for self-harm, including any
weapons the person might find.
o
Get help. Never agree to keep a student's suicidal thoughts a
secret. Instead, school staff should take the student to a
school-employed mental health professional. Parents should seek help
from school or
community mental health resources. Students should
tell an appropriate care-giving adult, such as a school
psychologist, administrator, parent, or teacher.
- School or district officials should determine how to handle memorials after student has died. Promote memorials that benefit others (e.g., donations for a suicide prevention program) and activities that foster a sense of hope and encourage positive action. The memorial should not glorify, highlight, or accentuate the individual’s death. It may lead to imitative behaviors or a suicide contagion (Brock et al., 2016).
- Reinforcing resiliency factors can lessen the potential of risk factors that lead to suicidal ideation and behaviors. Once a child or adolescent is considered at risk, schools, families, and friends should work to build these factors in and around the youth.
o
Family support
and cohesion, including good communication.
o
Peer support and
close social networks.
o
School and
community connectedness.
o
Cultural or
religious beliefs that discourage suicide and promote healthy living.
o
Adaptive coping
and problem-solving skills, including conflict resolution.
o
General life
satisfaction, good self-esteem, and a sense of purpose.
o
Easy access to
effective medical and mental health resources.
- Strive to ensure that all student spaces on campus are monitored and that the school environment is truly safe, supportive, and free of bullying.
- If additional guidance is needed, ask for support from your building- or district-level crisis team. The team may be able to assist with addressing unique situations affecting your building.
NAPPP Position Statement adopted 2011
“Suicide Prevention Resolution for general population”
WHEREAS, more than 34,000
suicides occurred in the U.S in 2009, with suicide being the 11th leading
cause of death for all Americans, the second leading cause of death among 25-34 year olds, and
the third leading cause of death among 15- to 24-year olds, and
WHEREAS, in 2009, 13.8% of
students in grades 9-12 seriously considered suicide in the previous 12 months
(17.4% of females and 10.5% of males), and
WHEREAS, peers are often the
first to know of someone considering suicide and referral skills are vital to
such life-threatening issues,
WHEREAS, studies have shown that peer programs have been found to be one of the most proven and effective prevention and intervention strategies for persons exhibiting suicidal ideations, and
WHEREAS, the Mission of the National Association of Peer Program Professionals (NAPPP) is to help adults establish, train, supervise, and evaluate peer programs,
THEREFORE BE IT RESOLVED that
NAPPP encourages peer program professionals to establish
awareness, preventive, and responsive strategies to suicidal ideations through
their peer programs that follow NAPPP Programmatic Standards and Ethics.
See Preventing Suicide:
Guidelines for Administrators and Crisis Teams for additional
guidance.
Suicide Awareness Voices of Education (SAVE) and the JED Foundation
have created talking points for conversations with youth specific to
the 13 Reasons Why
series, available
online.
More Resources:
Additional
Resources
Websites
More Resources:
Additional
Resources
- National Suicide Prevention Hotline, 1-800-273-TALK (8255), or text "START" to 741741
- Center
for Disease Control Suicide Datasheet
- SAMHSA
Prevention Suicide: A Toolkit for High Schools
- Suicide
Prevention Resource Center, After a Suicide: Toolkit for Schools
- Memorials:
Special Considerations for Memorializing an Incident
Websites
- National Association of School Psychologists, www.nasponline.org
- American Association of Suicidology, www.suicidology.org
- Suicide Awareness Voices of Education, www.save.org
- American Foundation for Suicide Prevention, https://afsp.org/
- www.stopbullying.gov
- Rape, Abuse & Incest National Network, www.rainn.org
From the National Association of School
Psychologist
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