Your practicum placement is at a high school in a suburban community. Located in the western U.S., the school was entirely remote for 1.5 years during the COVID-19 pandemic. While some students did well with remote learning, many students’ academic performance suffered with the loss of structure and in-person supports. Even more alarming was the increase in mental health needs. Emergency room visits for suspected suicide attempt and/or active suicidal ideation increased more than 40 percent in the county where the school is located, and completed suicides were up more than 30 percent. After the son of a city councilmember died by suicide last year, news reports described parents’ beliefs that youths’ disconnection from school and activities is increasing suicide risk. You know from your own social circles that there has been a significant increase in anxiety and depression among young people, including in this community.
Now that school is back in session, your field instructor wants to develop and implement interventions that can prevent youth suicide. You have been tasked with supporting this effort as part of your placement. As you are acclimating to the school and your position, the community is hit with the tragedy of a suicide of a student at a neighboring school. Students at your school set up a large memorial to the deceased student near the entryway, and several students come to your field instructor’s office the following day. Individually and in small groups, students express their grief and fears. They want to know what the school will do to support them. Parents also call the school—some with specific concerns about their child and a demand to be notified immediately if their child visits the social worker, and others with broader questions about how families and schools can keep students safe. Your field instructor also receives calls from the news media, who want to talk about youth suicide, the school’s liability if warning signs are missed, and whether reductions in school budgets for supportive services are to blame for the tragedies.
School’s concerns and goals:
- The school’s primary objective is to prevent student suicide. The principal heard a podcast about suicide “contagion” and is worried that “copycat” attempts will endanger students’ lives.
- The school is concerned about negative media attention and the risk that this will turn public opinion further against the school, particularly as there are still resentments following the extended remote arrangement.
- Because the school is also concerned about getting students back on track academically after the pandemic disruptions, any interventions conceived and/or developed would have to work around academic expectations and obligations.
Youths’ concerns and goals:
- Many students at the school have friends who are or have been suicidal, and some of the youth who come to your field instructor’s office are themselves struggling with suicidal ideation.
- Individual students share that they feel isolated, depressed, and often scared about their futures and the state of the world.
- With many students reporting conflicts with their parents and relatively few strong relationships with teachers or other adults, they want the school to provide support for those who are experiencing or at risk of suicidal ideation. They also want the school to acknowledge that their mental health is a crucial foundation for academic success and to stop pressuring them to succeed in classes, athletics, and postsecondary accomplishments.
Other constituencies’ concerns and goals:
- The community mental health center wants to partner with the school and offers to provide information about mental illness, youth suicide, and effective interventions. At the same time, they are grappling with funding shortages and increased need for mental health care in all demographics. They express some concern that an increased number of referrals from the school may lengthen their already long waits for provider appointments.
- Parents are insisting on their rights to be involved in anything the school does with or on behalf of their students. Some are also concerned about the messages that will be shared with students and with the media.
Questions to consider:
- What do you need to know about the research on effective interventions in youth suicide? Where can you begin such an inquiry? What are the evidence-based principles that will inform your search for approaches? What would be required to translate evidence-based models to your school and specific student body?
- What does the research say about protective factors that prevent youth suicide? How can your proposed intervention not only respond to risk, but also amplify the strengths on which youth can draw?
- Considering the multiple layers of trauma students may have experienced, what do you need to do to ensure that your program design and implementation are trauma-informed? Outline steps you could take to incorporate trauma principles into your work.
- How might the school’s response need to differ for different types of students, including those who hold identities that are often marginalized?
- Who are the key constituencies who should be part of program planning? How can you use your social work skills to reconcile conflicts in priorities and effectively facilitate this work?
- What would be your first steps in this case? Outline how you might proceed on multiple levels—individual, group, and organizational. Then, select one of the levels of practice and outline steps in the helping process: engagement, assessment, intervention, and evaluation. Where would you begin?
- How can you use your understanding of organizational dynamics to design an intervention that can win support from the school? What might you portray about relationships between student performance and overall well-being, to win administrative support for investment in suicide prevention programming?
- As is the case in most social work practice in non-social-work settings, this work is interprofessional and interdisciplinary. How will your social work values guide your work, and how might that perspective differ from others’ priorities? How can you use supervision to navigate the complications and potential conflicts of working with those who come with different professional perspectives?
- Because social media is such a powerful force influencing young people, you want to incorporate some element of social media engagement in your intervention. What does research suggest about how social media can contribute to youth’s risk of and protection from suicidal ideation? How can your social work skills contribute here? What ethical dilemmas might you encounter in leveraging social media as part of a youth suicide prevention program?
- To secure additional funding to implement a more substantial suicide prevention effort at the school, you will likely need to articulate clear goals that will define success and the outcome measures by which you will assess this progress. Measuring outcomes is particularly challenging in prevention programs, where it can be difficult to know for sure if the intervention is the reason something did not happen. Identify at least three outcomes for this prevention program and an indicator you could measure for each. Whose priorities do these outcomes elevate? How might others define “success” differently?