According to the American Academy of Child & Adolescent Psychiatry (AACAP) “each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds.”
In New York Magazine’s “The Leap,” Jesse Green revisits the February 2009 suicide of Teddy Graubard, a 17-year-old at the Dalton School on Manhattan’s Upper East Side.
In social circles, on message boards, and in the comments section of the article, Mr. Green’s work has raised numerous opinions and questions about the mental health community, psychiatric drugs, the Dalton School, cheating, privacy, diagnoses, protocols/policy for dealing with suicides at schools, etc. At its most instructive level, the article raises the controversial topic of impulsive suicides, which may be blamed for 10 percent of suicides, and pits some “public-health types” against “mental-health types” on the topic.
Mr. Green cites Scott Anderson’s, “The Urge to End It All” from the New York Times.
As the article, by Scott Anderson, pointed out, impulsive suicides are seldom accompanied by the classic warning signs, such as prior attempts, diagnosed mental illness, or drug or alcohol abuse. The act is sudden, unrehearsed—and is thus especially common among young people, who are naturally impulsive to begin with. Among 153 young survivors of nearly fatal suicide attempts interviewed in a 2001 University of Houston study, “70 percent set the interval between deciding to kill themselves and acting at less than an hour,” Anderson reported, “including an astonishing 24 percent who pegged the interval at less than five minutes.”
Given the alarming statistics on suicide in general, and these risks involving impulsivity, we recommend that schools and districts continue to craft and develop their prevention and crisis policies. We also recommend that parents learn how to talk about and deal with this topic with their children, particularly if their children have been exposed to any media coverage on this topic.
From a prevention perspective:
- How do schools communicate difficult and challenging information?
- Who and how will this info. be communicated to students and parents?
- Is there a uniform or flexible policy?
- If a child has done “something wrong,” who communicates the information and how is the information communicated?
- Is a developmental, child-centered perspective used?
- Does it take into account the sensitivity of the child?
- Does the school environment matter (e.g., high performing students in competitive schools, whose grades will be affected)?
- Does the student’s family environment matter? (e.g., will there be “severe” consequences for the child at home?)
- Does the school take into account the child’s level of impulsivity?
- What is the staff training on mental health? Are social/emotional topics incorporated in curricula?
From a crisis perspective after a suicide:
- Who is/are the best person(s) to to deliver the news? How many people?
- At what point, and how, are parents included?
- How are medical treatments, law enforcement, supervision of students handled?
- Depending on the size of the school, does a mental health team have to be hired?
- If and how is it talked about in assemblies, school programs, classrooms, etc.?
- Should students be banned from congregating? Why is that important or not important to policy?
- What happens if there are siblings in the school?
- What needs to be documented from a legal and law enforcement perspective?
- Who will and won’t speak with the media? Does the school have a general policy on how families and student’s interact with the media?
- How are social media policies handled (e.g., memorial page on Facebook)? Does the school have a general social media policy?
- How are these overall policies different or similar to peer schools?
- How does the school view the grieving process?
- How will anniversaries and memorials be handled?
One of the most important things that a school will need to consider is the possibility of “copycat,” “contagion,” or “cluster” suicides. How will schools handle this? Is there a prevention policy in place? For those who are not familiar with this concept, here is an example from CBS News about four high school students who committed suicide in Palo Alto, Calif. within a six month period (The Palo Alto Unified School District just recently (05/10) developed a formal policyfor dealing with suicide threats or attempts and how respond if another suicide happens):
Other examples of this phenomenon, occurred at NYU during the 2003-4 academic year, with 4 suicides that year, and most recently at Cornell University which had 6 suicides during the 2009-10 academic year.
Teddy Graubard’s case reminds us of the complexity and the difficulty of dealing with this topic on so many levels. Our warmest condolences go out to the Graubard family and the Dalton community.
For parents who have not thought about or dealt with this topic, we hope that you will start, particularly if your child has been exposed to any media coverage on this topic. A helpful resource for parents is from the American Foundation for Suicide Prevention.
For schools that have not crafted and developed a prevention and crisis policy, we hope that you will start. If the national statistics are correct (for additional data, see: The TeenScreen National Center at Columbia University), the time is now to begin the discussion.
About the Author: Shamur A. Khen, Ph.D., is the Founder & Publisher of the NYC Firm Schools Blog.