Teen Suicide Prevention: Empowering Teachers & Students Through Policy

Simone Imani Boyd, M.A., Melissa J., Dreier, A.B., Saskia L. Jorgensen, B.A., Kai Kellerman, M.S., Samuel Gerry, Serena Moghaddas, & Jessica L. Hamilton, Ph.D.

Suicide is the second leading cause of death for young people in the United States (U.S). The rates of suicide attempts and deaths have increased in the past decade. There has been an especially pronounced increase in suicide rates for youth of color and LGBTQIA+ (e.g., gay, transgender) youth. Teens who have multiple minoritized or stigmatized identities (e.g., Black and queer youth) experience increased risk for suicidal behaviors. Based on this alarming information, the U.S. surgeon general declared youth mental health a national emergency.

Youth suicide could be preventable through community efforts. Although many people experiencing suicidal thoughts do not seek professional mental health care, the majority of people who have thoughts of suicide disclose these thoughts before attempting suicide. For example, most teens who attempt suicide tell an adult or peer before the attempt. Among adults who die by suicide, almost half have contact with their primary care physician within a month of dying. These findings inspired the development of adult suicide prevention programs within primary care settings, which have demonstrated success. Applying similar low-cost, low-effort programs in school settings that provide teachers, school administrators, and students with the tools to manage suicidal crises has the potential to be highly effective at preventing youth suicide.

In March 2021, Representative Tony Cardenas introduced Bill H.R. 1803 to the House of Representatives. H.R. 1803 is a grant program that can be used to evaluate existing school-based suicide prevention programs, hold educational seminars for teachers and students, and start educational campaigns to prevent suicide among students. We suggest the inclusion of the following initiatives in this bill to ensure that it can have the broadest impact within schools and can be equitably implemented in high schools across the United States:

Empowering Teachers & Administrators

1. Expand access to existing suicide prevention training programs for teachers and administrators. Although teachers are uniquely positioned to identify and support students who are at elevated risk for suicide, the majority are not equipped to recognize the signs of suicide risk. Teachers also may have incorrect beliefs about suicide, including the myth that asking about suicide can cause suicidal thoughts in young people. Gatekeeper trainings for suicide prevention represent a brief (i.e., 1–2 hours), public health intervention to inform and empower teachers to play an active role in preventing suicide within their schools. Gatekeeper trainings are effective interventions to increase teachers’ suicide literacy and knowledge, comfort asking about suicide, and self-efficacy to intervene when suicide risk is identified. However, these trainings are not common within public schools. Expanding access to training programs for school administrators and teachers is an important step in empowering school staff to recognize and effectively prevent adolescent suicide risk.
2. Strengthen existing suicide prevention training programs for teachers and administrators. Increasing teachers’ and administrators’ knowledge and reducing stigma about suicide will not prevent teen suicide alone. Although many prominent suicide education programs increase knowledge about suicide risk in teachers and students, they do not provide skills in identifying and referring students who are at elevated suicide risk. Tools and techniques exist that increase gatekeepers’ ability to identify and refer students at high risk of suicide. These techniques should be implemented in conjunction with educational programs, or programs that integrate education and skill building in risk identification and management.
3. Provide evidence-based suicide risk assessment tools and recommendations for risk management. Knowledge of suicide risk and intervention must be paired with standardized tools to assess suicide risk and recommendations for actions at different suicide risk levels. Suicide risk screening tools are available that can briefly triage teens exhibiting higher suicide risk or provide a comprehensive picture of suicide risk and protective factors. Additionally, there are many resources available for teens at different levels of suicide risk, however, knowing which resources to offer based on the level of risk assessed may not be widely available to teachers and administrators. Suicide risk screeners and treatment recommendations should be distributed to school staff.

Empowering Teens

1. Improve mental health and suicide prevention curriculum in schools. Health curriculum can vary from district to district, let alone state to state. However, previous national public health priorities for youth have led to the creation of health curriculum materials that were made available to schools nationwide. Educational programs that instruct students how to understand and label their emotions, recognize signals that they are in crisis, and access appropriate resources and personnel have been shown to reduce suicidal thoughts and suicide attempts and increase knowledge about suicide in teens. Making these programs accessible on a national scale will allow a greater number of educators and students to have access to suicide prevention information.
2. Provide crisis management and coping skills to students. Unfortunately, increasing awareness about suicide will not stop teens from experiencing suicidal thoughts. Although teens spend much of their time in school, suicidal thoughts do not exclusively occur in school. This means that teens need skills that will help them survive intense emotions or suicidal crises until they are able to access resources they need. Dialectical Behavior Therapy (DBT) is a form of psychotherapy that specifically addresses suicidal thoughts and behaviors through teaching teens how to regulate and cope with strong emotions. Skills from DBT have been adapted to be delivered in school settings, and implementing this program on a national level through health or physical education courses can increase the accessibility of these life-saving skills.
3. Increase knowledge of and access to suicide prevention resources online. Technology and social media play a huge role in the lives of modern teens. There are a variety of high quality resources online for those experiencing thoughts of suicide, including hotlines, online chats, information and tips to cope, and even remote therapists for teens to connect with. By leveraging these technologies and bolstering knowledge of these online supports and how to access them, schools can tap into a larger network of existing suicide prevention resources. Schools can do this by posting resources publicly within their physical space (e.g., posters), printing information on student ID cards, or posting well maintained lists of resources on the school website and social media platforms. By partnering with students themselves, schools will be able to share these resources in places that students will actually see and use them. Nationally, all schools should be made aware of what kind of resources exist and should have the tools on hand to spread these resources, educate their communities on the options that exist, and use what we already have to improve existing efforts to support their students’ mental health.

Levels of intervention for teen suicide prevention.