Putting It All Together: Implications for School Psychology

Abstract

The seminal New Zealand Christchurch Health and Development Study followed a cohort of babies born in 1977 for 25 years. Based on data from over 1,000 members of the original sample, researchers identified individual, family, and other correlates of suicidal ideation and attempts during adolescence (e.g., Fergusson, Horwood, Ridder, & Beautrais, 2005) and concluded that suicidal behavior is best understood within a dynamic ecological framework that encompasses multiple influences, which combine over time to elevate or reduce (Ayyash-Abdo, 2002), what Fergusson, Beautrais, and Horwood (2003) called an accumulative risk model (p. 61). The articles in this important School Psychology Review special series synthesize U.S. findings that further confirm results from this classic earlier study, and provide new insights as to how school psychologists might assume roles in the reduction of youth suicidal behaviors through school-based prevention. In the following paragraphs I discuss some of the ways in which this special series significantly contributes to our understanding of school-based suicide prevention and also comment on the ethical-legal issues associated with such efforts. Universal School-Based Suicide Prevention At the universal level, all students in a school, grade, or classroom receive interventions designed to reduce suicidal behaviors (Miller, Eckert, & Mazza, 2009). The Youth Suicide Prevention and Intervention Program (YSPIP) implemented in the Miami-Dade County Public Schools (Zenere & Lazarus, 2009) is an extremely promising, multifaceted, school-based approach to reducing student suicidal behaviors. School staff are trained in how to recognize and respond to signs associated with suicide risk, and students are provided suicide prevention education. Interventions at this level include a curricular program to teach healthy problem-solving and coping behaviors. In addition, as part of the life management skills lOth-grade curriculum and the Good Samaritan Communities of Caring program, students learn to recognize warning signs of suicidal behaviors in themselves and others, and the importance of seeking adult assistance. Miller et al. (2009) examined empirical evidence for the effectiveness of school-based programs to prevent suicide and found meth- odological shortcomings in most studies evaluating their effect. I strongly concur with Miller et al. (2009) that additional quality research is needed regarding intervention integrity, effectiveness, and generalizability of universal suicide prevention efforts. However, I caution us to remember that it is very difficult to assess some of the possible long-range positive effects of curricular and other universal suicide prevention programs. As a result of suicide prevention instruction, youths gain knowledge of warning signs and how to respond when they recognize those signs in themselves or others. This is knowledge that they carry with them into their post-high school lives at college, in the workplace, the military, and as members of a family. Furthermore, universal interventions that train school staff and students how to recognize and respond to signs associated with suicide promote an ethic of responsible caring that may help foster a safe and supportive school climate. Miller et al. (2009) also call for evaluation of the possible effects of school-wide efforts to promote student wellness on the prevention of student suicidal behaviors. Consistent with this emphasis on fostering positive mental health and the broad ethical principles of beneficence and social justice, school psychologists have an obligation to use their expertise to cultivate school environments that are healthy, safe, and welcoming for all persons (Jacob & Hartshorne, 2007). Nickerson and Slater (2009) provide new empirical support for an association between school safety (being threatened, injured, or having property damaged at school) and suicidal behaviors. …