The School Counselor and Suicide Prevention, Intervention and Postvention

ASCA Position

School counselors work to protect the health and well-being of all students by proactively enhancing awareness of mental health and ensuring policies and procedures are in place to intervene and respond to youth suicidal behavior. School counselors exercise reasonable care when a student poses serious and foreseeable harm to self or others and informs parents/guardians, school administration and/or emergency services if necessary.

The Rationale

Suicide is the third-leading cause of death for young people between the ages of 15 and 35 and the second-leading cause of death for youth ages 10 to 14. Between 2000–2021, suicide rates for this age group increased 52.2% (CDC, 2023). Deaths are only a portion of the burden of suicidal behavior; suicide attempts and suicidal thoughts among youths exceed deaths among this group. In 2020, approximately 105,000 youths aged 14–18 years visited emergency rooms for self-harm injuries (Gaylor et. al, 2023). 
 
The prevalence of suicidal behavior has varying impacts on subgroups. LGBTQ+ youth are at increased risk for suicidal thoughts and are statistically more likely to attempt suicide than their peers due to environmental and societal risk factors. Data from 2019–2021 reveals that female students’ rate of suicidal behavior has increased as well (Gaylor et. al, 2023). 
 
Research indicates that universal school-based suicide prevention efforts can prevent the development of suicidal thoughts and behaviors in adolescents and that youth suicide risk identification and prevention in schools is likely to help high-risk youth obtain needed treatment that they otherwise would not have received (Ayer & Colpe, 2023). School counselors’ implementation of suicide prevention, intervention and postvention efforts are critical in reducing the threat of youth suicide and supporting student well-being. 

The School Counselor's Role

School counselors have a legal and ethical responsibility to provide a holistic approach to student’s social/emotional well-being and comprehensive suicide prevention policies including prevention, intervention and postvention components.
 
Prevention Components
School counselors: 

• Advocate for comprehensive district policies around suicide prevention 
• Educate staff to recognize risk factors, warning signs, protective factors, response procedures, referrals, postvention and resources regarding youth suicide prevention 
• Provide developmentally appropriate student instruction on the importance of safe and healthy choices and coping strategies focused on resiliency building and how to recognize risk factors and warning signs of mental health conditions and suicide in oneself and others (American Foundation for Suicide Prevention et al., 2019)
• Use data from universal screeners to proactively identify and address students’ academic, career and social/emotional needs while ensuring appropriate supports are in place to respond to students’ immediate needs (ASCA, 2023)
• Participate in district and school crisis team planning and practices 

Intervention Components
School counselors inform parents/guardians and school administration when a student poses a serious and foreseeable risk of harm to self or others. This notification is to be done after careful deliberation and consultation with appropriate professionals and/or an interdisciplinary crisis team. If school counselors are required to use assessments, screenings or any type of instrument to determine the suicide risk, they advocate for the use of an evidence-based tool and do not negate the risk of students’ potential harm to self even if the assessment reveals a low risk. In addition, school counselors understand that risk assessments are just one component of the assessment process and, therefore, should be used with caution and for the purpose of information-gathering (ASCA, 2022). Parents/guardians are always contacted and notified of anything learned through an investigation of potential suicide, or with any instrument, that will guide parents/guardians in efforts to protect their child (Stone, 2022). School counselors provide culturally responsive mental health resources to parents/guardians and recommendations for next steps based on perceived student need. School counselors follow state legislation and district policy when responding to suicide risk. 
 
School counselors collaborate with the student to develop a safety plan and explore coping strategies (Stone, 2022). School counselors avoid no-harm contracts because they can provide a false sense of safety, and there is insufficient evidence about their effectiveness. Instead, school counselors discuss with parents/guardians safety proofing of home and all environments that student frequents to secure and remove all access to firearms and other lethal means of suicide.
 
School counselors engage appropriate emergency response personnel. When a student is actively suicidal and the immediate safety of the student or others is at-risk, school staff should immediately contact appropriate emergency response personnel per federal, state and local laws as well as school district policy (e.g., administrators, 911 dispatcher, child protective services, law enforcement). If parent/guardian abuse or neglect is the expressed reason for the student’s suicidal ideation, it is best practice for the school counselor to contact child protective services rather than the parents/guardians in an effort to protect the student and ensure the student’s safety and well-being (ASCA, 2020).
 
Postvention Components
Following a suicidal crisis and/or a psychiatric hospitalization, school counselors meet with the student’s parents/guardians, other relevant staff and, if appropriate, include the student to discuss re-entry and address next steps needed to ensure the student’s readiness for return to school and plan for the first day back. Recommended actions include: 

• Coordinate with any outside health care providers
• Discuss and document any necessary accommodations (i.e. exempted work, adjusted deadlines, building safety plan) 
• Identify school support person to periodically check-in with the student for ongoing support
• Notify teachers and other relevant staff that the student is returning after a medically related absence and may need adjusted educational supports 

Following a suicide loss, school counselors take the following steps to assist with the grief process, reduce the risk of contagion and provide needed support: 

• Mobilize a crisis response team
• Contact the family of the deceased student
• Notify staff, students, parents/guardians 
• Monitor student and community reactions (e.g., social media) 
• Provide additional support resources if needed 

Summary

Through the implementation of comprehensive suicide prevention policies including prevention, intervention and postvention components, school counselors prioritize the health and well-being of all students.