September is National Suicide Prevention Awareness Month. When it comes to mental health, particularly for students and youth, suicide is one of the most challenging topics to address. The subject matter is difficult, the stigma around it is very real, and it comes packaged with misconceptions that range from well-intentioned to ignorant that can make a conversation about it even trickier to navigate.

Misconceptions like the one that says that talking about suicide will introduce the idea and encourage an individual to commit suicide if they hadn't considered it before, actually do harm where the intent is anything but harmful. 

(The truth is that talking about suicide with students reduces the stigma around it, and direct intervention often involves asking directly whether a person is thinking of hurting themselves.)

Luckily, we're getting better at talking about it. That's good because Suicide Prevention has taken on a new urgency in 2021. Last year, the CDC released a report that showed the suicide rate rose 56% for Americans aged 10-24 between 2007 and 2017, which would be alarming even those numbers didn't reflect the realities of mental health challenges that have been compounded by the coronavirus pandemic. 

What We Know About Youth Suicide Rates and Prevention 

There are some basic facts about suicide in children and adolescents that we've come to understand, and they are sobering:

• Suicide is the second leading cause of death for middle and high school-aged children and young adults
• Suicide rates begin to rise sharply in adolescence, as illustrated in the CDC 2001-2019 WISQARS data (included below)
• We're aware of the so-called "gender paradox"; wherein boys and men are more likely to complete suicide, but girls and women have more suicide attempts overall
• The vast majority of youth suicides — indeed all suicides — are associated with mental illness, substance use disorder, or both
• Approximately 40% of youth suicide attempts are associated with a precipitating event, trauma, or situational crisis — we'll come back to this in just a moment
• Access to means, a previous history of attempts, and instances of self-harm or injury are all risk factors for youth suicide attempts and completions

Image: Center for Disease Control

With all of this said, another thing we know about suicide in youth and student populations ... It's changing. 

Special Considerations for Suicide Prevention Awareness in 2021

Among those changes are the risk factors thought to be well understood, including the rates of youth suicide by race. When researchers at the Center for Suicide Prevention and Research at Nationwide Children's Hospital (Columbus, OH) disaggregated data, they found that while white children were more likely to attempt or complete suicide than Black children, that was only part of the story. 

What they found should raise colossal red flags: suicide is the second leading cause of death for Black children, consistent with the cohort. But then they found that while suicide rates have been steadily decreasing for white youth, they've risen exponentially for Black children and adolescents. In fact, a 2018 study found that among the youngest school-age children (5-12 years of age), suicide rates were twice as high for Black youth than white

Then, there's that "gender paradox" we just mentioned. The gap in suicides in girls and boys has been narrowing year-over-year, starting in 2017, according to the Journal of the American Medical Association. 

Disaggregation matters. A broad grasp of the issue of youth suicide is important, but it isn't until we dig into the data available that we see a familiar thru-line: in almost every instance, low-income and LGBTQIA+, and other minority student groups are all at disproportionate risk of suicide. 

Finally, there's no getting around the fact that suicide prevention awareness is both more urgent and more challenging in times of crisis and trauma, which is exactly what mental health professionals that work with student populations are grappling with this year. The psychological, social, emotional, and mental ramifications of the pandemic and its accompanying secondary traumas require a trauma-informed response to suicide prevention, and that may be true for some time to come. 

Suicide Prevention, School Counselors, and Self Care

Often, school counselors represent the only accessible mental health resource for students. That responsibility, combined with counselor burnout (especially in buildings and districts with high counselor-student ratios) requires regular self-checks in a normal year. This is not a normal year. Last year was not a normal year. If the hits feel like they just keep coming, that's because they do. 

Adding heavy and important topics like suicide prevention awareness is a recipe for a plate so full it cracks. So, we want to take a moment here to talk to the hardworking and dedicated counselors that are reading this right now:

Hey, there. Thank you so much for showing up for students today, and every day. How are you doing, really? What do you need right now?

We're asking because we know you may not be asking yourself. That's why we'll be including some resources for counselor self-care in this particular roundup.

Yes, the focus needs to remain on the students who need access to adults they can trust and the mental health resources school counselors can provide. But that focus can't be sustained if counselors don't have stress management and self-care strategies to address their own mental health challenges, including compassion fatigue and potentially triggering conversations around suicide and self-harm. 

If you're having trouble diverting a little of the concern and perception you extend to students toward yourself, maybe it will help to remember ASCA considers self-care to be an ethical mandate and not an optional luxury. 

Suicide Prevention Awareness Resources for School Communities

Guides 

• A Model School District Policy on Suicide Prevention - American School Counselor Association (ASCA)

The result of a collaboration between the American School Counselor Association, the National Association of School Psychologists, and The Trevor Project, this model for suicide prevention in school communities is research-based and practical.

• Mental Health Intervention in the Event of a Disaster - University of New Mexico (UNM)

This guide from UNM is usually used to guide trauma-informed care in the wake of a natural disaster, but the information and strategies within are especially prescient for school counselors during the coronavirus pandemic.

Reports & Data On Suicide Prevention in Youth Populations 

• Sounding the Alarm on Black Youth Suicide - American Psychological Association 

This article provides an explainer on the rising rates of youth suicide in Black communities, and provides an important perspective in regard to collecting and analyzing data, specifically when it comes to looking at aggregated vs. disaggregated student data.

• Expert Panel Summary: Upstreaming Youth Suicide Prevention - American Association of Suicidology 

The argument for "upstreaming", or focusing preventative efforts  by addressing early and systemic known suicide risk factors — like a family history of depressive disorders, substance use disorders, and adverse life experience — is discussed at length in this expert panel. Collaborators included representatives from tribal communities, the SPRC, and Harvard Medical School, among others.

• National 2021 Survey on Youth Mental Health  - The Trevor Project

The Trevor Project began as a suicide prevention hotline  and has grown into a critical resource for youth suicide prevention in LGBTQIA+ populations. Their annual report is detailed, disaggregated, and focused on current events. It's a powerful tool in any school counselor's toolkit.

Articles

• Dear Adult Leaders: Enough With the Suicide Prevention Videos. Have Real People Talk to Students About Mental Health -The 74 Million

This "arcticle" is actually an open letter to adults, and worth a read. It stresses the importance of speaking frankly and thoughtfully about suicide and including the lived experience of survivors in youth suicide prevention measures and initiatives.

• What We Know About Student Mental Health in the Pandemic  - Education Week

Education Week's youth suicide prevention metadata summary  explores the effect the Coronavirus pandemic has had on the mental health of our country's students and the resultant increased risk of suicide. 

• Identifying and Overcoming Burnout: Essential Practices for Counselors - ASCA

This ASCA blog features critical but realistic school counselor self-care strategies in the context of burnout, but its worth bookmarking in this unprecedented year as a reminder for counselors to turn inward at intervals.

• The Ethics of Self-Care - ASCA

We touched upon the obligation of counselors to practice self-care, but we're hardly mental health experts here at SchooLinks. The folks at ASCA are, however, and this article outlines the argument for approaching personal custody as an ethical mandate for mental health professionals.

Videos & Webinars

• SPARK Talks (Video Series) - SPRC

SPARK serves a mnemonic for the goal of each of SPRC's bite-sized videos on a suicide prevention or suicide awareness topic. Each one is Short, Provocative, Action-oriented, Realistic, and Knowledgeable. They cover all demographics, but cover plenty of ground when it comes to youth suicide prevention.

• Creating a Safety Net with On- and Off-Campus Partners - Suicide Prevention Resource Center  (SPRC)

Suicide prevention, intervention, and post-vention all require multiple points of contact and care for students that extend beyond their building and district. Creating sustainable networks of care is critical, and this webinar draws on subject matter experts' real-world expertise to create a practical framework for building them.

Additional Resources for Youth Suicide Prevention & Awareness

• 15 Resources for Minority Mental Health Month -  SchooLinks

Back in July, we released a list of mental health resources that aim to address the mental health needs of minority student populations. With the understanding that at every turn, these groups are disproportionately impacted by crises, we're including it here for reference.

• Mental Health First Aid for Schools - Mental Health First Aid

This "micro-training" clocks in at eight hours long, but packs a preventative punch by educating adults on the unique mental health challenges and youth-specific suicide risk factors. It is recommended for counselors, coaches, educators, and other school community adults.

• Suicide Awareness Training for Faculty and Staff: A Training Model for School Counselors  - SPRC

This resource provides ways and means for school mental health professionals to develop suicide prevention in-service for the school community as a whole.

We can all prevent suicide. If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24/7 across the United States. Call 1-800-273-8255