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Suicide and Child Abuse Reporting
7/1/2018
Carolyn Stone, Ed.D.
Sunday July 01, 2018
by: Carolyn Stone, Ed.D.

Section: Inside Insight


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A colleague asks you to talk to one of her students whose English journal describes disturbing suicidal ideation. William writes about needing to “end it all, to float like a balloon into the sky never to return.” Earlier in the year William’s friend told you he was concerned, as often talks about suicide. You talked to William following both his friend’s report and the English teacher’s report. Both times William convinces you he is fine, and you make no attempt to call his parents. You used discretion and judgment in your assessment in determining William was not at risk. He ended his life. Can school counselors afford to treat suicide as a discretionary duty in which we can exercise judgment?
 
Although the majority of school counselors recognize and adhere to their ministerial duty to report child abuse, we still hear too often about suicidal ideation not being reported to parents.  Reporting suicidal ideation to parents is as much a legal/ethical imperative as that of reporting suspected child abuse to authorities.

Ministerial duty to report child abuse: School counselors are among those mandated by the Child Abuse Prevention and Treatment Act (CAPTA) of 1974, Public Law 93-247 to report suspected abuse and neglect to proper authorities. Discretion is not acceptable.

Child abuse state statutes vary slightly in language, but there are common themes in most state’s statutes. School counselors and other educators are mandatory child abuse reporters, which means they have an absolute duty to report. Certainty is not required; suspicion is enough to establish a duty, and the duty is not discretionary but inextricably clear.

School counselors do not use discretion and weigh in on whether or not the abuse is an acceptable form of punishment in the family’s culture, whether or not calling child protective services (CPS) will make matters worse for the family or whether the school counselor believes it is better not to report because CPS might mishandle the case. All of these considerations would be exercising discretion, and the state statutes on child abuse reporting do not allow for discretion. Rather, child abuse reporting is a ministerial obligation, and the school counseling profession applauds this fact and adheres to it.
Knowing the child abuse requirements, why do we treat suicidal ideation differently and use judgment as to whether or not to call parents? Discretion shouldn’t enter into the decision to call any more than it should enter into the discussion to report child abuse.

Ministerial duty to report suicidal ideation. Suicide reporting, akin to child abuse reporting, is also a ministerial duty. Yet, the profession continues to treat suicide as something we can assess and determine if a parent needs to know. Suicide reporting, as in the case of child abuse, does not hinge on certainly of harm or one’s discretion. Waiting to act until you’re certain suicide is a risk is dangerous. Calling parents upholds school counselors’ most significant obligation to students: above all –  do no harm.

The courts and legislators define ministerial duty and often agree school counselors can exercise discretion in reporting to parents their child’s suicidal ideation. However, let’s remind ourselves that the law is the absolute minimum. Although the courts and statutes might not hold school counselors to a ministerial duty to report a student’s suicidal ideation to parents, ethically, the profession believes it is a ministerial duty. Ethics are aspirational. As former Supreme Court justice Potter Stewart said, “Ethics is knowing the difference between what you have a right to do and what is right to do.”

As a profession, regardless of whether or not we have a state statute to guide our behavior, we must make certain everyone in our profession understands calling parents whenever we are placed on notice that a suicide is even a remote possibility is not an option or judgment call but an absolute duty. If you are a school counselor educator, a school counseling department head, the lone school counselor in your school or a colleague among many, advocate to all to avoid the fatal mistake of not informing parents about their child’s reported or rumored suicidal ideation.

School counselors’ role is clear and appropriate given the hundreds of students for whom they are responsible. Any time it comes to a school counselor’s attention that a child 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.

Discretion is dangerous. Professionals all agree we have an absolute duty to report child abuse, yet, preparation programs, district school counseling supervisors and practicing school counselors continue to exercise judgment as to whether or not to involve parents. Confidentiality pales in comparison to a child’s death. Calling parents is not a choice; it is an obligation. Parents are invested and in the best position to see to their child’s long-term needs. The consequence is too great to exercise discretion and decide not to give the chance to intervene on behalf of their child.

Suicide assessments: Suicide assessment are inaccurate at best and dangerous at worst. Assessing the possibility of suicide is using discretion and creating problems on a number of levels, not the least of which is the consequences of being wrong. School counselors who rely on suicide assessments for definitive answers are risking danger for themselves and their students. Using a suicide assessment to negate the possibility of a suicide is a faulty practice. If used at all, a suicide assessment should be a tool to underscore to parents/guardians the urgency of the need to monitor their child and get the child professional help.

Assessments requiring school counselors to quantify the risk (high risk, medium risk or low risk) based largely on student response is frightening. This is a dangerous practice, and school counselors should consider the information gleaned from a student’s self–report as unreliable. To tell a parent the risk is low is to create for a parent a false sense of security when the student may have hidden the real truth.
The standard of care for school counselors required by their district to assess students for suicide is to employ these assessments with extreme caution with a recommendation that a follow-up assessment be completed by a mental health professional who can spend the amount of time needed to 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.

If required to assess, use assessments as a segue to provide parents everything learned from the assessment, to urge further evaluation, to stress monitoring of their child’s safety and to provide resources for mental health. Point out the fallacies of quantifying a suicide. 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 lethality of suicide. Advocate for the development of a suicide prevention campaign. Work to get the district leadership to create a suicide protocol and a suicide prevention coordinator. Ask your state school counseling association to advocate for legislation addressing the usual validity of peer reports and not just waiting for a self-report to act.

If students deny suicidal ideation, school counselors general can escape legal liability as the courts often considered our role discretionary or under governmental immunity. However, this gives school counselors no solace as we want to hold ourselves to a higher standard of care than the minimum.
It is a well-known fact that students will say and do whatever they need to if they want to get out from under the school counselor’s gaze. Student self-report is not reliable. Peer report is often much more reliable as students will be honest with peers if they are determined to hide their pain from adults. Following are a few examples of some of the court cases in which parents sued districts naming school counselors as defendants because the school counselor either didn’t alert parents or they told the parent their child was low risk on an assessment.

Eisel v. Montgomery County Board of Education (1991): Nicole Eisel made suicidal statements to her classmates, denied suicidal ideation to her school counselor and, shortly thereafter, consummated her murder/suicide pact.

Armijo ex rel. Chavez v. Wagon Mound Pub. Sch., 159 F.3d 1253 (10th Cir. 1998): The school counselor, at the principal’s directive, took a suspended student home during the school day unbeknown to the parents. The visibly distraught student was left alone in a home known to have guns, increasing the student's risk of suicide.

Rogers v. Christina Sch. Dist., 73 A.3d 1 (Del. 2013): The school counselor knew the student had attempted suicide the day before, but the student convinced the school counselor he was now fine, only to take his life hours later.

Mikell v. School Administrative Unit 33: A school counselor’s assessment revealed low risk, and his mother was notified that she did not have to pick her child up from school as he was safe to remain at school. The child committed suicide, and the parent sued arguing that the school took over custody and control of her child to keep him safe when they told her he was low risk and did not have to be picked up.

Killen v. Independent School District No. 706 (1996): A ninth-grade student killed herself at home with a firearm. Although the school counselor had warned the parents their daughter had expressed suicidal feelings and recommended counseling, the parents alleged the school counselor didn’t inform them when their daughter subsequently made a more specific statement about committing suicide.

Grant v. Board of Trustees of Valley View School District (1997): A student’s friends reported his suicidal ideations and drug overdose to the school counselor. The school counselor called the student’s mother and urged her to take him to a hospital for drug treatment. Later that day, the student jumped to his death from a highway overpass. His mother alleged the school counselor failed to tell her about his suicidal expressions.
 
School Counselor’s Role
School counselors can exercise discretion in the resources they choose to give parents; otherwise, there should is no discretion regarding suicide. Parents/guardians need resources to intervene on their child’s behalf. A mental health professional can help parents determine if a child is suicidal and work to help the family address the complexities of the child’s mental health. A network of referral resources and working with the family to secure a placement are a school counselor’s tools in trying to intervene on behalf of suicidal students.

School counselors are clear with parents/guardians about a 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 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 for the profession 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 CPS.

So many students have denied self-harm, and to use their denial as evidence the student is fine is outside the standard of care for the profession. The profession believes in a ministerial duty to call parents if placed on notice by self-report, peer report, hearsay, rumors or anonymous report that a student might be suicidal. There are far too many examples of disastrous results when school counselors exercise discretion and choose not to alert parents as to the possibility of a student’s suicide. Simply 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. Err on the side of caution, and call parents/guardians.