Suicide Prevention Board Policies and Administrative Regulations for School Districts

Joe Balabis, MPH

San Mateo County Behavioral Health and Recovery Services

Today’s Discussion

• Suicide and hospitalization data – CA and SMC

• Roles of schools in suicide prevention

• Current Suicide Prevention Policies

• SP Policy Template and Components

• Strategies for implementation

• Discussion on potential barriers and solutions

Youth Suicides in California & SMC

Youth and transition-age youth (age 5-24) deaths by suicide (2004 – 2012)

California:• Total suicide deaths: 3,797• Average suicide deaths per year: 422

San Mateo County:• Total suicide deaths: 63• Average suicide deaths per year: 7• 43% of total suicides were in 5-19 age group.

Data Source: As cited on kidsdata.org, California Dept. of Public Health, Office of Statewide Health Planning and Development, Patient Discharge Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 1990-1999, 2000-2010, 2010-2060; CDC, WISQARS (Jun. 2014).

2004 to 2012 2004-2012

County Suicide Deaths (ages 5-24)

Self-Inflicted Injury Hospitalizations (ages 5-20)

Alameda County 127 960

Contra Costa County 110 576

San Francisco County 56 248

San Mateo County 63 547

Santa Clara County 153 1,106

Comparisons to Bay Area Counties

Data Source: As cited on kidsdata.org, California Dept. of Public Health, Office of Statewide Health Planning and Development, Patient Discharge Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 1990-1999, 2000-2010, 2010-2060; CDC, WISQARS (Jun. 2014).

Commonly reported methods for self-injury include: poisoning, cutting and piercing.

Self-Inflicted Injury Hospitalization Rate: 2004 to 2012

Definition: Number of hospitalizations for non-fatal self-inflicted injuries per 100,000 children/youth ages 5-20.

Data Source: As cited on kidsdata.org, California Dept. of Public Health, Office of Statewide Health Planning and Development, Patient Discharge Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 1990-1999, 2000-2010, 2010-2060; CDC, WISQARS (Jun. 2014).

Depression-Related Feelings, by Grade Level: 2008-2010

Definition: Percentage of students in grades 7, 9, and 11, and non-traditional students, reporting whether in the past 12 months, they had felt so sad or hopeless almost every day for two weeks or more that they stopped doing some usual activities.

Data Source: As cited on kidsdata.org, California Department of Education, California Healthy Kids Survey (WestEd).

Percent San Mateo County

Female Male

Grade Level Yes No Yes No

7th Grade 28.8% 71.2% 22.9% 77.1%

9th Grade 34.8% 65.2% 22.5% 77.5%

11th Grade 36.9% 63.1% 22.4% 77.6%

Non-Traditional 45.9% 54.1% 32.4% 67.6%

San Mateo County Percent

Grade Level Yes No

7th Grade 26.1% 73.9%

9th Grade 28.9% 71.1%

11th Grade 30.1% 69.9%

Non-Traditional 39.1% 60.9%

2014-2015 Adolescent Report

The San Mateo County Youth Commission conducted a wellness study with over 5,000 San Mateo County students.

The report found:

• More than 70% of San Mateo County students felt depressive symptoms.

• Approximately 38% of high school girls and 28% of boys have had suicidal thoughts.

Why is this important for school staff and administrators?

• School staff are in contact with youth for most of their days.

• School staff may be in a position to see warning signs of suicide or non-suicidal self-injury.

• Suicide ideation, threats or attempts may happen on campus.

• School staff may be in a position to intervene and help a student in crisis.

• Other students will be affected by a suicide attempt or completion.

• School staff should know how to prevent, respond to, and recover from a suicide attempt or completion.

Why Board Policies and Administrative Regulations?

• They provide official steps for addressing suicide prevention, intervention and postvention at a district level.

• Recognizes and prioritizes the issue of suicide and suicide prevention.

• Standardizes approaches at all schools within a district.

• Reassures school personnel in the event of suicide ideation, attempt or completion.

Current Board Policies (BP) and Administrative Regulations (AR)

• In San Mateo County, 8 school districts have adopted policies (BP 5141.52) that address suicide:

• Belmont-Redwood Shores Woodside Elementary• Burlingame San Mateo Union High• Hillsborough City Cabrillo Unified• Redwood City South San Francisco Unified

• 6 school districts have adopted regulations (AR 5141.52):

• Belmont-Redwood Shores Woodside Elementary• Burlingame San Mateo Union High• Redwood City South San Francisco Unified

• 17 school districts, and County Office of Education, have yet to adopt a BP or AR for suicide

Opportunity for all districts to have BP and AR in place

• Letter from State Superintendent Tom Torlakson encouraging all school districts to adopt BP/AR focusing on suicide.

• School districts within SMC and in neighboring counties have already adopted similar policies and procedures.

• Support from county agencies and community allies (e.g. suicide prevention, crisis collaboration, education)

• Resources in state and nationally to assist with the creation of the BP & AR• California School Board Association• The Trevor Project

• Recent suicides among young people in the County.

Santa Clara County Results

Alum Rock Union School District Fremont Union High School District Milpitas Unified School District San Jose Unified School District

Berryessa Union School District Gilroy Unified School District Moreland School District Saratoga Union School District

Campbell Union High School District Lakeside Joint School District Mount Pleasant School District Sunnyvale School District

Campbell Union School District Loma Prieta Joint Union School District Mountain View Los Altos High School District

Union Elementary School District

East Side Union High School District Los Gatos Union School District Oak Grove School District

Evergreen School District Los Gatos-Saratoga Joint Union H.S. District Orchard School District

Franklin-McKinley School District Luther Burbank School District Palo Alto Unified School District Santa Clara County Office of Education

Some Other California Counties Have A Suicide Prevention Policy

ALPINE COUNTY UNIFIED SCHOOL DISTRICT Fairfield-Suisun Unified School District Salinas Union High School District

Beaumont Unified School District FORTUNA UNION HIGH SCHOOL DISTRICT SANTA MONICA-MALIBU UNIFIED SCHOOL DISTRICT

Claremont USD Gonzales Unified School District SANTA YNEZ VALLEY UNION HIGH SCHOOL DISTRICT

Chula Vista Elementary School District Lompoc Unified School District SCOTT VALLEY UNIFIED SCHOOL DISTRICT

Davis Joint USD Murrieta Valley Unified School District Woodland Joint Unified School District

EL RANCHO UNIFIED SCHOOL DISTRICT Pleasanton Unified School District

Components of a suicide BP and AR

1. Preventiona) Staff education and training - should specify type and frequency

(Youth Mental Health First Aid)b) Prevention programs for students (peer support, integrated into

health education, community collaborations)c) Parent training

2. Interventiona) Assessment and referralb) Crisis response and notification (crisis line, law enforcement,

parents)c) Staff response support

Components of a suicide BP and AR

3. Postventiona) Re-entry proceduresb) Notification of school communityc) Support for students and staff affected

Board Policies and Administrative Regulations should be made known and accessible to school staff.

Source: Model School District Policy on Suicide Prevention, The Trevor Project, American Federation for Suicide Prevention

Support for Implementation

• BHRS & COE to work on BP and AR templates to include SMC-specific resources.

• SMC Suicide Prevention Committee to suggest crisis response protocols based on situations.

• BHRS currently provides FREE Youth Mental Health First Aid training to all school-based staff (Measure A).

• State and local programs exist to increase student mental health awareness.

• County crisis collaboration team to improving prevention, response and postvention resources and protocols.

Group Discussion

• What barriers or challenges may prevent or delay adoption of these BP and AR by school boards?

• How can we overcome these barriers and challenges?

• What key people or allies should we involve when approaching a school board about this?

• What concerns do you have regarding these policies and regulations?

Questions

Joe Balabis

jbalabis@smcgov.org

(650) 573-3474

Suicide Prevention Committee meets every 4th Wednesday of the month from 1:30pm-3:00pm