How to help, from school, a child who verbalizes suicidal thoughts
One of your roles as a teacher is to look after the well-being of your students and help ensure their safety. When we talk about suicidal behavior, the first thing you need to know is that you are not alone, and the second is that you are not obligated to conduct a comprehensive suicide risk assessment of the student; that is not part of your responsibilities. However, it is your obligation to inform the student's guardians so that they can activate specialized support services.
The action plan consists of three steps that any citizen should follow in a crisis situation:
- Know
- Accompany
- Inform
Therefore, if a student tells you they want to die, your obligation is to inform those responsible for the minor, that is, their parents or legal guardians and the school principal. It's worth remembering that in the face of a risk of harm to others or oneself, everyone is exempt from confidentiality . If a student makes this confession to you, after thanking them for their trust, you must inform them that you take their distress very seriously, that it's now time to care for them, and that this involves obtaining support resources that extend beyond your student-teacher relationship. A secret of this magnitude should never be kept; it's far too dangerous.
Glòria Iniesta Guirao
Joan Roa Natividad
Below, we offer some helpful information should you feel ready to take things a step further. While it's true that once you've reported the incident, your responsibility is fulfilled, it's equally true that, beyond your legal obligations, your potential to help these teenagers is vast.
To begin, it's important to emphasize that you're not alone in your basic responsibilities, nor are you alone if you decide to go a step further. The most accessible and immediate resource is offered by specialized suicide prevention helplines. These provide care and support to individuals experiencing suicidal thoughts and to those close to them (parents, friends, teachers, professionals). Several helplines exist in Spain, for example: 024, managed by the Ministry of Health; 061, managed by the Department of Health (Catalonia); and 900 925 555 , managed by the Barcelona City Council and the Ajuda i Esperança Foundation. These helplines are free and operate 24/7, regardless of your location. They will provide support, inform you about available resources, offer guidance, and help you resolve any doubts you may have about how to respond to your situation. This information can also be very important for the child and their family; when you inform them of the situation, also inform them of these helpline numbers.
Keys to approaching dialogue with the adolescent at the moment of verbalization
There are several phases in supporting an adolescent who verbalizes suicidal thoughts, namely:
- Acceptance of the commitment
- Choose the setting
- Expression
- More information
- Performance
- Closing
Commitment acceptance phase
It's very important that you understand you have an opportunity to contribute to suicide prevention. The student has chosen you as a trusted figure to discuss a topic that is always very sensitive. They have made you part of their suicide prevention support network , and that's not your decision; it's theirs. What you decide is whether to tell them you will inform their parents and the school principal directly, or whether you can offer them a space to talk more, always within the framework of your teacher-student relationship: " Do you want to talk about what you've told me? " If the student agrees, proceed to the next step. If, on the other hand, the student declines, return to the plan outlined earlier: inform them that, as a way of supporting them, you will communicate their situation to their support network.
In that same spirit of commitment, remind yourself that you won't solve everything you hear, that things resolve themselves in their own time and process, and that's what you'll offer: a space for open communication, from which some solutions will emerge. At least the two we mentioned at the beginning: passing this crucial information on to the child's caregivers.
Setting selection phase
The first thing you need to do is find a quiet place that same day, before the student leaves school. Enlist the help of a colleague, ideally the school principal, to ensure the conversation is uninterrupted and you don't feel rushed. If you can also involve a school psychologist, you'll feel more supported.
Expression phase, attitude towards dialogue
Listen to the student with interest and concern. You know from your experience with teenagers that everything they explain might seem unimportant at first glance from an adult's perspective, or even to that same student at any other stage of their life. But at that moment, the situation they're describing seems to be overwhelming them.
A student is never "calling for attention" by verbalizing a desire for death; they are asking for help in a situation that they feel is overwhelming them.
The student is likely confused about the situation they want to describe. Be patient and don't try to understand everything. This isn't a truth-testing exam, and even if it were, you probably wouldn't have the training for it. Therefore, at this point, understanding them isn't as important as offering them a safe space to express themselves, where they can begin to organize their thoughts and put them into words.
Tips for suicide prevention in classrooms
A student's emotional reaction to a given situation is always valid ; never use invalidating expressions. Invalidating expressions are any statements that contain an imperative, positive or negative, followed by an emotion. For example: "You should be happy, you shouldn't be sad, don't get angry." Or any other statement that makes the person think their emotional reaction (always involuntary) is wrong or incorrect. For example: " How can you get angry about that? How can you be sad about that? "
Especially avoid emphasizing these expressions with well-intentioned arguments. For example: "You shouldn't be sad, you have a family that loves you...; you have friends, you shouldn't be angry...; you shouldn't think about that...; think that there are people who are much worse off..."
Try not to blame the person, don't put more pressure on them than they already have, avoid comments like: "don't you see you're going to destroy your family and your friends."
It's not your turn to speak ; we're still in the phase of facilitating the student's freedom of expression. It's the student's turn to speak . Use expressions that encourage expression, such as "I see…", "You're right, this can be difficult sometimes…", "Wow, I didn't know what you're explaining…".
In just 40 seconds, the World Health Organization (WHO) tells us how a listening environment, without feeling judged, where difficulties can be expressed, has value as a preventive intervention.
Phase of expanding information
The two essential elements at this time are student safety and the suicide prevention support network ; the two are closely related. A larger network provides greater safety, but they are not exactly the same . Therefore, it would be necessary to gather information on both.
Safety : From the moment the student expresses their suicidal thoughts, their safety is already guaranteed because you are with them at that moment, you have prepared a safe space, and you will contact their parents and the school principal. However, you can also help ensure the student's safety beyond the school. In this regard, the main protective factor against suicide is preventing access to lethal means . To this end, it can be helpful to know how far the student has progressed on the scale of suicidal behavior severity.
Suicidal behavior includes, in order of severity:
- Suicidal ideation encompasses all internal processes of evaluating the idea, up to and including the mental planning of the act.
- Verbalization and/or threats are the verbal expression of said thought content.
- Suicidal gestures are all the unequivocal and necessary preparatory acts to carry out a suicide attempt, without the sequence starting (e.g., accumulating/hiding medication or writing a farewell letter).
- Suicide attempts, the suicide attempt is defined by the first step of execution.
- Death by suicide is the attempt that ends in the death of the person.
Questions to gather more information are always asked gradually. We already know that suicidal ideation is present; the student has informed us of it, and it's the reason for this conversation. For the next steps, we can show interest by asking questions such as: "How long have you been thinking that life isn't worth living? How often do you think about it? How do you get the thought out of your head? Have you thought about how you would do it? Have you made any plans? You mentioned that you've made plans. Do you have anything hidden that could be dangerous for you?"
Remember that you don't have to do a risk assessment, just expand on information that may be useful when carrying out the actions we will see in the action phase.
Suicide Prevention Support Network : The suicide prevention support network consists of all the people surrounding the person at risk of suicide who are aware of this risk. For example, if a teenager is hospitalized for a suicide attempt, but the parents tell the school that they are undergoing medical tests, the school is part of the minor's support network, but not part of the suicide prevention support network because they don't have all the information. At this initial stage, it's important to understand the suicide prevention support network surrounding the student. For now, you know that there's you, the colleague or principal you've asked for support to have this space for dialogue with the student, and, offering institutional support, such as the suicide prevention hotlines already mentioned. To assess the extent of the suicide prevention support network available to the student, you can ask questions like : " Do your parents know about what you're telling me? Have you spoken to a psychologist? Do your friends know?"
Action phase
Once the information gathering process is complete, you must maintain a consistent course of action with what emerged during the expression and information gathering phase. Something must always happen after a person verbalizes thoughts or desires about ending their own life. Now it's time to talk , to calmly inform the student about the actions that will be taken.
It's worth making an observation before we begin. Students are generally reluctant to receive help, experiencing it as an attack on their own process of individuation, their aspiration to greater autonomy. This situation is not uncommon among people who are going through difficult times. There's a desire for things to magically resolve themselves, or to work out in their own way, but part of this unease stems from the fact that these solutions are difficult to find, because they simply don't exist.
All of this means that the person seeking help often encounters a wide range of objections and obstacles. Their situation is unpleasant, and they receive the suggestions with that attitude. Common expressions include: "I regret telling you"; "Please don't tell my parents"; or others like: "I don't want to elicit pity, but now you'll do it because I said this."
Next, we will examine three action scenarios framed within distinct objectives. In the first area, concerning the expression phase, be considerate, open to negotiation, and even accommodating to the student's request not to participate. Be comfortable and operate according to your own criteria regarding matters related to your academic competence. Because the following two scenarios, out of prudence, should be non-negotiable.
Action related to the expression phase
Reassure the student about all aspects related to their negative experiences in the school environment, focusing on those areas where you, as the teacher, can directly influence them. Namely:
- If he feels lonely or excluded, specify that actions will be taken to encourage his integration into the group.
- If you feel harassed or intimidated, inform them of the actions that will be taken to ensure their safety and the conflict mediation actions.
- If their anxiety relates to insufficient academic performance, reassure them and work on a joint feasibility plan, placing the student in a position to improve and guiding them towards alternatives.
- If it's due to excessive pressure, help to put things in perspective, demystify performance or grades, encourage diversification of activities and the multiple dimensions that make up a person.
Explain that you will implement all these actions, in addition to the fact that you will have the reference educational psychologists of your center.
In all matters that fall outside the scope of the school, inform the student that they can communicate and work on it with the relevant professionals, whether from the mental health center or from the primary school support programs.
Action related to the information expansion phase
Security
Ensuring a safe environment for the child. This means that when we inform parents of their child's situation, we must convey that the WHO recommends, always and without exception, that children be denied access to lethal methods. In our sociocultural context, nine out of ten suicide attempts in minors are due to medication overdose; therefore, parents will be advised to remove all medication from the home. If there is any resistance from the parents due to persistent myths about suicide , we can support the recommendation with an argument such as: "Your child has told us that sometimes they think it would be better to be dead. How do you think they will feel if they come home and see that everything is the same? They might think that you don't care, or that you don't take them seriously."
If, during the information phase, we have learned that the minor has stored dangerous objects or has accumulated medication, we must advise the parents to take the minor to the emergency room. This situation goes beyond the basic general recommendations just mentioned. Their safety must be ensured; these are suicidal gestures and behaviors considered high-risk. Emergency room staff will be able to guide the adolescent and the family to ensure that the dangerous objects are removed before the minor returns home.
Support network
Increase the suicide prevention support network as much as possible: let the student know that you understand how difficult their situation is, that you appreciate the trust they've placed in you, and that you won't let them down; you'll do what's best for them. If you want to clarify what you mean by "you won't let them down," you can explain that you'll follow the same rule you've often advised them to follow with their classmates and friends. That is, if they see a classmate suffering or in a risky situation, they should support them and make sure an adult is informed. Remember the three steps of any crisis intervention: understand, support, and inform. By saying "I won't let you down," you're not saying you're going to solve the problem for them—it's probably not entirely within your control—but rather that you're going to inform everyone who can offer support in this situation.
To achieve this, the first step is to strengthen the suicide prevention support network . How?
- Inform the parents of the risk situation, especially if they were unaware of it.
- Inform the school principal of the student's situation: "We have a student who is going through a difficult time and is verbalizing suicidal thoughts."
- The center director will communicate the vulnerable situation at the next meeting with the psychopedagogy team, if he cannot communicate with them that same day.
- The director will ensure that the psychopedagogy team informs the primary health care services (nurse or the designated representative).
- Inform the family and the student about the three telephone support resources mentioned above (024, 061 or 900 925 555) or any other support resource you know of in your area.
If, during the assessment of the support network, the student explains that certain classmates are aware of the situation—that is, that they are part of the suicide prevention support group—talk to them and explain that you are aware of the situation and that the entire support network has been activated. Remind them that they do not have to bear any responsibility, that the adults are taking care of it, and that if they have any questions, they should ask. They can talk to you.
Closing phase
The closing phase should always end with a firm commitment for the next meeting: "Okay, let's meet on Tuesday to continue talking. You can tell me how you're doing, and I'll tell you what I've been up to." Avoid open-ended proposals like "If you need anything, come see me anytime . " These open-ended proposals must have a firm commitment: "If you need anything before Tuesday, come see me anytime; otherwise, we'll talk on Tuesday."
Add a comment that fosters hope and connection : "What you're telling me is difficult, but we'll get through this together. You know you can count on us." Reinforcing the request for help: "I appreciate the trust you've placed in me; it can't have been easy for you."
The commitments made must be confirmed with the student, the parents and the principal must be informed, and the actions agreed upon within the school framework must be implemented.
The parents are eventually informed of the situation, with all the information that could be gathered.
You must try to encourage the student's continued engagement with school, reducing pressure and demands if necessary, being more understanding and welcoming, and mediating with classmates. Maintaining their connection to the academic environment, and preserving the greatest possible degree of normalcy, is a crucial protective factor in suicide prevention.
Remember that suicide prevention is the result of many combined actions. An intervention in just one area is not enough, but the sum of all of them together is: family, school, friends, psychological support teams, etc.
We welcome the adolescent in their moment of overwhelm, offering them a space for listening and support, informing the parents and the center director, expanding the support network for suicide prevention among minors, and offering the safety measures recommended by the WHO.
If during this process you have doubts that cause you discomfort, ask a colleague to stay with the student, explain to the student openly that you are going to make a consultation and ask for guidance on one of the telephone numbers mentioned above.
