Phillips then submitted those questions to counselors within the county’s 18 schools who are on the forefront of the system’s suicide prevention efforts.
The following are the questions submitted, and the counselors’ responses which were compiled by Phillips and returned to the Times-News with no specific attribution to any one person.
What changed with regards to suicide prevention protocol after the new training was completed last year?
Hawkins County Schools previously used the US Department of Education’s Office of Safe and Drug Free Schools’ Suicide Prevention Protocol. This protocol was very thorough and our counselors felt comfortable using it. In 2017, however, at the request of school systems statewide, the Tennessee Suicide Prevention Network developed a Suicide Prevention procedure document that was piloted first in Maury County Schools. The TSPN procedure document was then presented at a state school counselor conference in 2018. Several of our school counselors attended TSPN’s session and returned to Hawkins County requesting to look into adopting the TSPN procedure. We hosted the TSPN for a training with all school counselors, and it was determined that we would adopt the TSPN procedure. For the most part, the information between the two documents is very similar. The most significant change is that the TSPN procedure includes the use of the Columbia Suicide Severity Rating Scale (CSSRS). The CSSRS allows trained professionals, including school counselors, to better determine the severity of risk when a student in crisis is identified. The student is asked a series of questions, and based on their responses, next steps are determined. This could include a referral to a local outpatient mental health provider or a referral to an inpatient facility.
Are there any statistics available about the number of suicide prevention interventions that have taken place in Hawkins County Schools over a certain period of time?
Suicide prevention interventions are handled confidentially by counselors at the school level. Anecdotally, there has been a significant increase in the need for access to mental health providers for all grade levels.
What have been the leading causes of student stress that results in the need for an intervention, or thoughts of suicide?
Many times, we don’t know the exact cause of issues that are presented. Issues vary by the students’ age and social development. We do know that the opioid epidemic began around 2011 in this part of the United States, and that there was an unprecedented increase in the number of children who were born addicted. As most of those children have begun school, teachers and administrators are seeing an increase in the number of students who need more support both academically and socially. In these younger students, we see disruptive behavioral issues that are often symptomatic of childhood trauma and toxic stress.
Likewise, the pressures of adolescence contribute to stress, anxiety, and depression in our older students, who are balancing school, work, extracurricular activities, deciding what direction to go after high school, etc. Our school counselors are working with students in all grade levels to develop healthy coping skills. Teaching students to build resilience is critical, as learning to cope with stress, sadness, and disappointment is part of life. Also, as the use of cell phones, social media, and access to the internet has increased over the last decade, students have reported feeling more isolated. Therefore, we try to work with students to improve their one on one interpersonal communication skills, so they can better discuss any issues they may be having before it reaches the point of crisis.
What are some of the ways that counselors become aware that a student is in crisis?
In our younger students, mental health issues are often identified based on behavior issues, which are a symptom of stress. Behavior can be looked at as a form of communication, especially for younger children; young children do not have the words to communicate what they need, so often, acting out is the best way they know to let us know that they need help.
Another important source of information is the student’s peers. We find that students in all age groups look out for each other; they let school staff know when they are worried about their friends too.
Every staff member participates in annual Youth Suicide Prevention training as well, which includes learning to identify and respond to the warning signs of depression, anxiety, and other social and emotional issues. If our staff notices changes in a student’s typical demeanor, they make an effort to talk with the student one on one.
Students have the ability to schedule time to meet with their school counselor if they have an issue. We also encourage parents to communicate with school counselors in the event life situations change, and the student needs extra support.
Talk about how you deal with a student in crisis who might be thinking about suicide.
When a student is determined to be in crisis, they meet with the school counselor, who then contacts the parent/ guardian. The CSSRS is administered, and based on the level of severity, the student may be referred for outpatient services, or put in contact with Frontier Health’s Mobile Crisis Unit, who works to find an inpatient facility for the student.
In your opinion, what, if anything, can be done to improve the situation and reduce student stress and/or the need for suicide prevention protocols?
With the increase in academic rigor in all grade levels, time for incorporating social/emotional learning in the classroom is limited. We try to provide a strong sense of community at our schools so no student feels isolated. As mentioned, we are also working to increase opportunities for students to use communication skills, as well as providing time to interact and work with peers. It is important that students are taught skills to build resilience and develop healthy coping methods for dealing with feelings of sadness, loneliness, and disappointment when they arise. Our counselors and administrators agree that limiting the use of social media would also help students feel a greater sense of self confidence, while experiencing less depression, and sense of isolation.
Reducing student stress requires collaboration between school, home, and community. Our students live in a rural area where mental health access is limited. Often, the school counselor may be the only mental health professional that a student has the opportunity to see. When approaching serious mental health needs, school counselors are in the unique position to act as the first line of defense for students in crisis, but we also need enough community mental health services to be able to refer these students, without an extended wait for services, whether inpatient or outpatient.
What are the greatest challenges in terms of accessing mental health support for students?
As a school system, we work hard to address every student’s needs. We do our best to utilize the resources we have in our community to address issues identified in our students.
We are incredibly grateful for the funding that Governor Lee and the General Assembly put in place to increase the number of School Resource Officers this year. As a result of this funding, Hawkins County Schools will have a School Resource Officer on every campus within the next few months. Due to the increased need for school based mental health services, we would be very interested in seeing Governor Lee and the General Assembly provide similar funding for Licensed Clinical Social Workers (LCSWs) for every school campus. In addition to providing counseling services for students in need, school level LCSWs could work with families who may be interested in parenting classes, provide additional support accessing available community services, or even assist in interventions for students identified as chronically absent. We also need direction and funding for researched based professional development that will enable our staff to better equip themselves for working with some of the social and behavioral issues we see. Educators need support at the school and classroom level, especially those in rural communities, where funding to hire additional support staff is limited.
Likewise, the lack of long-term mental health facilities for students in immediate crisis is one of the greatest challenges we see. Often students who are suicidal and in need of in-patient mental health treatment are not able to get stabilized long-term before returning back home or back to school due to insurance approval and lack of provider facilities.