In a recent period of less than two weeks, three Philadelphia students completed suicide. While the incidents all took place away from their schools and appeared to be unrelated, they focused attention on how the schools and the city deal with the fallout when these occur.
In an interview, Kamilah Jackson, a psychiatrist who is the city’s Deputy Chief Medical Officer for Child and Adolescent Services in the department of Community Behavioral Health/Department of Intellectual disAbility Services discussed the issue. Following are edited excerpts from her remarks.
Is school-age suicide becoming more of a problem locally and/or nationally?
Well, it’s the third leading cause of death among people between 10 and 24. We don’t have a large number, though any number is one too many with regard to a child dying by suicide. What we do know is that even if you have a small number, you may have a greater number who may be having thoughts.
(Data from the Philadelphia Health Department and other sources show that while there might be about 20 suicides by school-age children a year, roughly 14 percent report suicidal thoughts).
Are these suicides usually away from the school?
Yes, you rarely hear of a suicide on school grounds.
Tell me a little about how you respond to a case of a school-aged child.
Our role is to supplement the School District’s Student Support Office. We are usually alerted by them in cases where they need additional supports for their prevention and intervention teams. If they need a master’s level clinician, for example, we can supply that through the Student Assistance Program available to all schools.
And of course that team works with school counselors and psychologists. Nothing can substitute for a trained professional who is already familiar with the children.
As children in families naturally reach out to their caregivers in times of stress, in school environments those who are familiar to children are the best resources for support and to refer the young people they have concerns about for more specialized assessments.
As a professional, it’s very difficult to walk into a situation where the children don’t know anyone.
Is this any different from past years?
One difference is the Network of Neighbors. Starting last year, we’ve trained over 100 community members in responding to incidents of trauma and violence, which includes student suicides. We often include network members in our response teams.
We have also re-invigorated the department’s Suicide Prevention Task Force, which serves the county and also partners with the Children’s Hospital of Philadelphia Suicide Prevention task force that was formed in the last few years.
What do you do when you get there?
Obviously a lot depends on the age of the children. The youngest may have no idea of what suicide is. It also depends on how much the children already know, whether details of the suicide have been in the media.
You have to be particularly careful with children who may have known the victim. Children can be prone to “magical thinking” and believe they are somehow responsible for the death. Or they may see similarities between their lives and that of the victim.
What are the biggest mistake we sometimes make in dealing with student suicides?
One is not following up with those children who have been most seriously affected. The after-effects of a student suicide can linger long after the crisis team is gone. That’s why it is important to equip the adults who remain in the building to be able to recognize the signs of when to seek more support for a young person.
The other mistake is not doing enough on the preventive end. Fortunately the District is has increased suicide prevention training in recent years in keeping with state requirements.
The Mental Health First Aid program is open to both educators and community members, helping them deal with immediate mental health crises but also including instruction on recognizing the signs of a young person prone to suicide whether or not they are openly talking about it.