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Assessments and Third-Party Software Alerts for Suicide Ideation
Carolyn Stone, Ed.D.
Monday January 01, 2018
by: Carolyn Stone, Ed.D.

Section: Inside Insight

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Your district purchased a software program that monitors all student activity on district-issued computers and district e-mail addresses. School officials are alerted if a student’s online activity generates a keyword that, according to the software’s algorithm, indicates possible suicidal ideation. You learned about this new software the day after it was installed when you were handed a list of 12 students and asked to assess their suicide risk as their online activity put them in the alert category. Most of the student online activity was more than 14 hours old. Are there legal and ethical issues to consider?

This is an all-too-real scenario being repeated in schools across the country whose districts have purchased this type of software. A number of companies are providing software they say can detect possible suicidal ideation by picking up keywords students use in searches and communications and alerting school officials that students have used the keywords. One school counselor who reached out with concerns said. “I came into my office the morning after the devices were handed out to find about a dozen of these types of notices that were all sent after my official day had ended. Some of the notices were 14 hours old. The alert included the students’ names with the message, ‘Urgent: Potential Self-Harm Activity Detected. This is to inform you that [name of software] has detected a potential self-harm activity.’”

The practice of school districts monitoring students online activity has generated a national debate about privacy. “Most schools, I think, would prefer not to monitor student activity on social media outside of their official school activities,” said Sonja Trainor, director of the Council of School Attorneys at the National School Boards Association. “There are thousands of student communications per day via social media outside of school-based activities, and there’s no way a school district could keep on top of all of that, nor do they want to be policing students’ private lives outside of school.” 

The privacy issue is complex and will not be the focus of this column. The legal and ethical complications for school counselors as the designee required to attend to the alerts and then assess lethality of suicide are the issues to be tackled here. 

Third-Party Software Alerts
The strong argument for the software is that this product can save lives. This line of reasoning makes it difficult to argue against installing the software, but developers must go right to the parents/guardians, instead of the school counselor, if a student’s online activity yields red flags. This direct line of communication should convey to parents the reason the software generated concern and provide possible referral resources. Involving school counselors in the loop and requiring them to assess suicide risk is problematic. I spoke with a software developer who said the company doesn’t dictate whether the school or school personnel receive these alerts. The decision is typically left to the school or district. Some school districts use parts of the software but are not activating and/or accepting the alerts. However, if alerts are used, inevitably school  counselors will be the ones to do the follow up. 

Having educators in this communication loop could create unneeded and unwarranted liability for the school district and the staff charged with monitor.ing the software. Should the district opt to purchase the software but opt-out of the self-harm alerts, the possibility exists that the district could be liable if a student’s online activity could be considered a predictor for a suicide attempt. 

This argument is weak, however. Legal precedent has shown that a school district’s actions or lack of action would have to be the actual cause of the student’s death. But is this an argument you want to test?

On the other hand, problems can arise if the district activates the alert. In addition to potential liability, the amount of monitoring that would be required is burdensome and unrealistic. If school districts elect to use the software, it needs to be set up so the alert goes directly to parents with details about the activity  and a warning for parents to be vigilant. 

Additionally, third-party software alerts put school counselors in a disciplinarian trap. Their effectiveness is damaged if they’re viewed as the ones monitoring students’ online activity. It is unlikely students will stop to sort out just why the school counselor is involved; rather, when the school counselor is the first line of communication with them about online activity that might have stemmed from an innocuous research paper, students will look at the trusting relationship with a jaundiced eye. Even if school counselors are able to explain to and reassure the students their intent is to help, this might do little to assuage the shock that their school counselor knows their posts.

School counselors know and accept their role in suicide prevention. The role is clear and appropriate given the hundreds of students for whom they are responsible. Any time it comes to the school counselor’s attention that a student is in danger of suicide the absolute obligation is to call parents/guardians. School counselors do not wait for certainty; rather, even a remote possibility of suicide is enough to establish duty. Suicide reporting, as in the case of child abuse, does not hinge on certainty of harm or one’s discretion, and waiting to act until there’s certainty of suicidal ideation is dangerous. School counselors’ high standard of care is to provide parents/guardians with referral resources for their child. Calling parents upholds school counselors’ most significant obligation to students: above all, do no harm. School counselors are clear with parents/guardians about their child’s expressed, implied or veiled suicidal ideation. This is not the time to soften the message. School counselors stress to parents that expressions of suicide or other warning signs require their vigilance. School counselors confer with the appropriate school officials to make certain the student stays in protective custody and is not dismissed to take whatever means the student normally uses to get home. If the parents/guardians intentionally do not seek help for their child with the first notice, the standard of care is that the school counselor makes an outreach to the family reiterating the suicide risk, the urgency to seek help for their child, and the acknowledgement that a neglect case has to be lodged with Child Protective Services. 

The courts understand we cannot prevent suicide, but when school counselors hear of suicidal ideation it is a drop everything reaction. However, if given lists with 12 students’ names (and that is just a list for one day out of 196 school days in this real scenario) then attending to a comprehensive school counseling program so all students can realize their potential relegates us to a disciplinary role, spending days on end with 1 percent of the population and missing the work we can do to advocate for all our students. The number of keywords that must be considered to even get at the possibility of suicide will lead to many false positives and a full-time job to monitor. The role for school counselors’ in suicide prevention is clear; families/guardians are always notified regardless of the student’s age. The school counselor’s role cannot possibly extend to the overreaching and burdensome monitoring of third-party software alerts. Parents/guardians should be notified directly from third-party software providers. 

Suicide Assessments
Requiring a school counselor to assess students for suicide risk is problematic on many levels, not the least of which is the fallibility of assessing suicidal risk. The standard of care for school counselors when being required by others to assess students for suicide is to employ these assessments with extreme caution, with a follow-up assessment completed by a mental health professional who can spend the amount of time needed to more accurately assess the risk. School counselors have hundreds of students, while mental health practitioners have far fewer and can spend more time with each client. 

Relying on an in-school suicide assessment for definitive answers is faulty practice at best and dangerous at worst. To rely on an assessment and not alert parents/guardians is negligent and may meet the governmental immunity exception of wanton and reckless behavior. Further, an assessment requiring the school counselor to quantify the risk (high risk, medium risk or low risk) based largely on student response is concerning. This is a dangerous practice as the information gleaned should be considered unreliable, and to tell a parent that the risk is low is to con.vey what the school counselor cannot possibly know with certainty. 

If districts require school counselors to complete assessments they should only be used as segue to provide parents every.thing learned from the assessment, to urge further evaluation, to stress monitoring of their child’s safety and to provide resources for mental health. Never negate a risk. So many students have denied being suicidal, and to use their denial as evidence the student is fine is outside the standard of care for the profession. Suicidal students will tell the assessor whatever they need to say to escape their gaze. There are far too many examples of students doing this with disastrous results. The mere exercise of questioning a student regarding suicide is reason enough to call parents to report the suicidal risk as this question is obviously triggered by some precipitating event. 

School counselors should advocate against a district purchasing third-party software unless the software is designed to alert parents directly. If the district requires suicide assessments demanding school counselors quantify suicide, point out the fallacies of this practice. Advocate for a protocol/system of action that protects students, involves community and mental health agencies and avoids placing school counselors at the center of receiving and assessing the risk of alerts. 

Advocate for the district leadership to create a suicide protocol, hire a suicide prevention coordinator and develop a suicide prevention campaign, such as the model protocol ASCA, the National Association of School Psychologists, American Foundation for Suicide Prevention and The Trevor Project created. 

Carolyn Stone, Ed.D., is a professor at the University of North Florida and the chair of ASCA’s Ethics Committee. She can be reached at cstone@unf.edu.

To submit your questions for a future column, e-mail them to ethics@schoolcounselor.org.