In Canada, youth suicide is the second leading cause of death (behind motor vehicle accidents) for individuals between the ages of 15 and 19.1 Each year, nearly 300 youths in Canada die from suicide. Many more attempt suicide. It is estimated that for every suicide completed, between 10 and 100 suicides are attempted.2 While youth complete suicide at a lower rate than many other age groups, the dramatic upward trend in their rate over the past forty years has made this group a special concern.3
In October 2011, 15 year-old Jamie Hubley, son of Kanata South Councillor, Allen Hubley, and his wife, Wendy Barber, committed suicide after battling years of depression and bullying for being the only openly gay teenager at his high school. Friends and family members remember Jamie as a very happy boy, always smiling and giving people hugs. On the inside, however, Jamie was a very sensitive young man who was dealing with the sting of verbal and physical bullying. He vividly documented his struggles with depression on his blog right up to the day he took his own life.
Other recent suicides, such as 17 year-old Christopher Howell, 16 year-old Ben Nelson, 17 year-old Jesse Graham, and 14 year-old Daron Richardson, the daughter of Ottawa Senators assistant coach Luke Richardson, shocked communities across the nation. All of these youth were known to be outgoing and happy teenagers who battled with bullying and depression. Parents saw signs of distress, but attributed it to normal teenage angst. By contrast, each of the youths thought death was the only way out. Further reflection after the suicides revealed a lack of mental health education, and other warning signs, which, had they been recognized by the community and addressed, could have prevented such devastating results.
In response to these tragic events, on November 30, 2011, the Ontario Government introduced Bill 13, the Accepting Schools Act, 2011 (see page 14). Under the proposed legislation students who bully could face possible expulsion and school boards will be encouraged to ensure there is early intervention to stop aggressive behaviour. If the legislation is passed, it will create legal obligations for school boards to address bullying prevention and intervention, progressive discipline and equity and inclusive education.
The recent surge of suicides has forced communities and schools all over Canada to face the truth about the issues surrounding teen suicide and mental health. In a school context, system and school leaders need to design better prevention strategies, and be able to identify the warning signs earlier and remove the stigma surrounding suicide and mental health issues.
A number of questions arise. What is the role of school administration and system leaders in providing support and assistance to students with mental health needs and suicidal tendencies? What strategies can be used to identify the capabilities and knowledge among school staff and outside agencies to support these students? What steps can be taken in working with parents and families to identify community structures and resources that can complement the school supports provided to the students?
The purpose of this article is to provide a framework for educators in assessing the capacity of the school, home and the community to respond appropriately to suicide and mental health issues and to create a school culture that is responsive and supportive of students facing such challenges.
TEENAGE SUICIDE AND WARNING SIGNS
Suicide is a tragic and confusing phenomenon that eventually, in one way or another, touches the lives of most communities and schools in Canada. The recent increase in youth suicides has called for new directions in research that can assist health care workers and school administrators, as well as policy makers, in the development of more effective preventative strategies and intervention techniques.
Adolescence is a time of dramatic change and can be complex and challenging. Youth often feel tremendous pressure to succeed at school, at home and in social groups. Mental health problems commonly associated with adults, such as depression, also affect youth. Some studies indicate the beginning and the end of the school year is a particularly high-risk time for vulnerable youth.4 Identifying the warning signs and hearing the cries for help can be challenging, and there are no simple solutions. But everyone, from friends to family to community groups to school staff, has an important role to play.
Although the reasons for suicide are difficult to define, the Canadian Mental Health Association, which has taken a very active role in teen suicide prevention programs, has set out certain warning signs in recognizing when there is a problem.These warnings include the following:
- drastic behaviour or mood swings (positive or negative);
- lack of interest and energy;
- dropping out of hobbies, sports, school, or job;
- isolation and withdrawal from friends and social groups;
- increased in drugs and/or alcohol use;
- changes in eating habits or sleeping patterns;
- lack of interest in future plans;
- giving away prize possessions or personal items;
- a sudden elated mood following a time of depression;
- making jokes about death or suicide; and/or
- a previous suicide attempt.
LEGAL DUTIES AND OBLIGATIONS
Under paragraph 265(1)(j) of the Ontario Education Act, the principal has a duty to give assiduous attention to the health and comfort of pupils under his/her care.5
Canadian courts have held that the standard of care owed to a student by a school board, its principals and teachers is that of a reasonably careful or prudent parent in the circumstances.6 The courts have held that educators have a duty to protect students from reasonably foreseeable risks of harm.
In the 1998 case, R. v. M. (M.R.)7 the Supreme Court of Canada recognized that teachers and principals are placed in a position of trust that carries with it onerous responsibilities. The Court stated:
"When children attend school or school functions, it is they who must care for the children's safety and well-being. It is they who must carry out the fundamentally important task of teaching children so that they can function in our society and fulfill their potential."8
The Provincial Code of Conduct,9 which was issued on October 4, 2007 by the Ontario Ministry of Education, sets clear provincial standards of behaviour. The Code of Conduct provides that a positive school climate exists when all members of the school community feel safe, comfortable and accepted.
The Code of Conduct states that all students have the right to be safe and feel safe in their school community. With this right comes the responsibility to contribute to a positive school climate.10
The Ministry of Education has defined a positive school climate as "the sum total of all of the personal relationships within a school."11 In its policy, the Ministry states that when "these relationships are founded in mutual acceptance and inclusion, and modelled by all, a culture of respect becomes the norm."12
The Ministry has also recognized that providing students an opportunity to learn and develop in a safe and respectful community is a "shared responsibility" in which school boards and schools play an important role.13
In light of these legal requirements, school board policies should include a comprehensive prevention and awareness-raising strategy that includes student mental health and suicidal behaviour. These policies should also include effective prevention and intervention strategies to support students who are at risk or in crisis.
Mental health problems adversely affect a student's ability to learn. An educator who becomes aware of a student's mental health problems and/or suicidal thoughts or behaviour has a duty to take appropriate steps to support the student in question. The nature of this action will depend on the individual circumstances and facts in each case, including the student's history, health and age.
STRATEGIES TO SUPPORT THE MENTAL HEALTH OF STUDENTS
Educators can take a number of proactive steps to support the mental health of students and students dealing with suicidal thoughts.
The following strategies are recommended:
- take steps to be informed about suicide and the warning signs;
- educate and discuss openly with the students, parents, and the community about teenage mental health issues;
- actively observe students and note any behavioural changes;
- initiate discussions with students demonstrating signs of distress;
- be supportive, understanding, and take the time to listen to the student and understand his/her needs;
- encourage peer support and counselling;
- make sure that students know that there is a process in place and encourage them to discuss with school staff members any concerns about another student in distress; and/or
- take steps to be informed about outside mental health programs, help lines, support programs, peer counselling, and other guidance programs available to students, and inform students of these options.
School administration needs to develop a clear written protocol, policy, and/or program for dealing with students with mental health issues or suicidal behaviour. In assessing the capacity of school board personnel, school leaders should consider their training and experience in supporting students with mental health issues or suicidal behaviour and their ability to work collaboratively with other members of the school team.
School administration should encourage prevention techniques to be implemented in the schools. Dr. Barry Garfinkel, Director of Child Adolescent Psychiatry at the University of Minnesota, has designed questionnaires eliciting information on depression, which he has administered to over 15,000 students annually
for several years. A student scoring positive on the questionnaire is sent to a guidance counsellor or school psychologist. This strategy has gained approval in Canada, specifically in Québec,
where the problem of teenage suicide is particularly acute.14
Another successful tool has been peer discussion groups. Particularly in view of suicide clusters, this method is seen as a crucial aspect of prevention. Students and teachers get together with focussed discussions on mental health issues and the prevention of suicide. A.B. Lucas Secondary School in London, Ontario formed a breakfast club after the suicide of a student to focus their grief. The club has grown to over 260 students and branched out into orientation programs that help Grade 8 students to make the transition from junior high school to high school.15
School administration should also identify knowledge and capabilities among parents and community members, such as outside agencies and counselling services, in providing support for students in need. Among other things, school leaders should assess the resources and expertise that parents and community members might contribute in assisting these students.
The reality is that educators cannot, by themselves, effectively support a student who is facing mental health issues or suicidal behaviour. It is important to initiate discussions with the student's family and work with them to determine appropriate solutions. Counselling, medication, and guidance programs can help students recover from mental health issues and thoughts of suicide.
There may be circumstances where parents or students are not co-operative in supporting recommended treatment or counselling. In this regard, it may be of value to bring into the discussion a person who the family or student may trust, such as a school board professional or outside expert, to speak to them about the benefits and value of certain treatment or counselling.
STRATEGIES IN DEALING WITH THE AFTERMATH OF A SUICIDE
An attempted or completed suicide can have a powerful effect on the staff and students in a school, and the community as a whole. Schools should have a coordinated crisis management plan in place to deal with a suicide in the school community. Immediately after the suicide of a student, the following strategies are recommended for educators:
- obtain as much information as possible about the incident and should inform the teachers and staff as soon as practicable;
- maintain open communication lines with the community. A collaborative approach allows for the sharing of information and coordination of strategies;
- ensure there is consistency in the information provided to the students;
- give the students an opportunity to discuss the incident, express their feelings, and ask the teachers questions;
- inform the students about the available counsellors and guidance programs within the school and outside the school; and
- have extra counsellors available.
In the ensuing months, and even years, individuals close to the person who has passed away may continue to suffer with the loss. Schools should consider further guidance and monitoring plans for months after the crisis. Schools should also consider implementing suicide awareness programs, training for teachers on skills for identifying and responding to students with mental health issues, and school-based suicide prevention programs.
Educators, while one part of the larger community, play a significant role in the support network for students facing mental health issues. With early identification, sharing of relevant information, consultation with specialized school services, access to outside professionals and collaboration with the student's family, school leaders can work to ensure that appropriate services and resources are provided to support students with mental health needs.
1 Statistics Canada, Suicide and suicide rate tables (Ottawa: StatCan, 16 November 2010) online:< http://www.statscan.gc.ca >.
2 Library of the Parliament, Teen Suicide in Canada by Megan Furi & Alain Guimont (Parliamentary Research Branch Canada, 2003).
3 Minister of National Health and Welfare, Suicide in Canada: Update of the Report of the Task Force on Suicide in Canada (Ottawa: Nation Task Force on Suicide in Canada, 1994).
4 Erin Anderson, "Teen suicide: We're not going to sit in silence" The Globe and Mail (24 September 2011) online:< http://www.theglobeandmail.com >.
5 R.S.O. 1990, c.E.2.
6 Myers v. Peel County Board of Education (1981), 123 D.L.R. (3d) 1,  2 S.C.R. 21.
7 (1998), 166 D.L.R. (4th) 201, 129 C.C.C. (3d) 261, (S.C.C.), affg. 7 C.R. (5th) 1, 157 N.S.R. (2d) 321 (C.A.).
8 Supra, at paragraph 35.
9 Ontario Deputy Minister of Education, "Policy/Program 128: The Provincial Code of Conduct and School Board Codes of Conduct" (Toronto: Ministry of Education, 2007).
10 Ibid., at p. 2.
11 Ontario Deputy Minister of Education, "Policy/Program Memorandum No. 144: Bullying Prevention and Intervention", (Toronto: Ministry of Education, 2009).
12 Ibid., at p. 1.
14 Government of Canada, Teen Suicide BP 236-E by Andrea Shaver (Ottawa: Political and Social Affairs Division, 1990).
15 Ibid.About BLG
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