Schools and Suicide: Understanding Suicide Contagion and Strategies To Prevent It

The U.S. Department of Health and Human Services has developed a concise, direct, plain English definition of suicide contagion:

Suicide contagion is the exposure to suicide or suicidal behaviors within one’s family, one’s peer group, or through media reports of suicide and can result in an increase in suicide and suicidal behaviors. Direct and indirect exposure to suicidal behavior has been shown to precede an increase in suicidal behavior in persons at risk for suicide, especially in adolescents and young adults.

It is vital to emphasize that, according to the HHS and other experts in the field of suicidology, adolescents and young adults are particularly susceptible to the affects of suicide contagion. Understanding both the warning signs as well as strategies to prevent suicide contagion is crucial in the aftermath of the death by suicide of a student or other young person.

Suicide Contagion in a School Setting: Proactive Tactics for Educators and Others

There are specific tactics for educators and others to adopt and employ in an effort to address suicide contagion in a school setting. The major components of those tactics are presented here, with the notation that this list is not necessarily exhaustive. The development of techniques and practices to prevent or stem suicide contagion in a school setting is ongoing. With that said, these tactics include:

• Establishment of responsible practices for the media in reporting death by suicide
• Understanding signs that an individual is at danger for suicide
• Understanding underlying suicide risk factors
• Implementing protective factors that lessen the danger of suicide
• Collaboration between school and community providers

Suicide Contagion and the Media

Research demonstrates that the manner in which the media reports a death by suicide can and oftentimes does play a significant role in the creation of a setting ripe for suicide contagion. The United Kingdom Department of Health has been on the forefront of developing and recommending media practices that are designed to lessen the odds of contagion following the death of a person by suicide, particularly a young person. What has been developed in the U.K. is worthy of replication elsewhere, including in the United States.

The U.K. Department of Health has made the following recommendations to media outlets and press professionals in regard to the manner in which deaths by suicide are reported. The thinking is that the broad implementation of these recommendations will play a significant role in reducing the incidence of suicide contagion. The U.K. Department of Health has recommended the following to media outlets and professionals:

• Avoid the use of language that either normalizes of sensationalizes a death by suicide
• Avoid the use of language that presents death by suicide as a solution to problems
• Avoid prominent placement of stories about death by suicide
• Avoid unnecessary or undue repetition of stories about death by suicide
• Avoid explicit description of the method used in a death by suicide or in an attempt
• Avoid detailed information about the site of a death by suicide or an attempt
• Exercise (extreme) caution in the use of photographs and video
• Take particular care and precautions in reporting the death by suicide of a celebrity

Understanding the Primary Signs a Person Is a Suicide Danger

One of the most fundamental elements associated with a strategy to prevent suicide contagion in a school setting and among young people is being well-versed on the danger signs that a student (or anyone, for that matter) might present a suicide risk. The most prominent suicide warning signs are:

• Talking about suicide
• Talking about death and dying with frequency
• Looking for a manner in which to take one’s life
• Talking about feeling hopeless
• Talking about feeling there is no reason to live
• Talking about feeling trapped
• Taking about being in unbearable pain
• Stating that one is a burden to others
• Increased use of alcohol
• Increased use of other drugs
• Acting anxious
• Acting agitated
• Behaving recklessly
• Unusual sleep habits (sleeping too much, sleeping too little)
• Withdrawal from others
• Social isolation
• Showing rage
• Talking about seeking revenge
• Demonstrating significant mood swings

Understanding Suicide Risk Categories

In addition to understanding warning signs, in order to take a proactive stance in preventing or controlling contagion, an understanding of suicide risk categories is also necessary.

Larry Berkowitz of the Riverside Recovery Center maintains that there are upward to 60 different potential suicide risks (perhaps even more). This conclusion is supported by relevant professional literature on the subject as well. For the purposes of developing a meaningful, effective strategy to prevent suicide contagion in a student population, as well as in other cohorts, Berkowitz has categorized suicide risk factors into a set of 10 broad categories:

• Family history
• Previous attempts
• Medical factors
• Demographic factors
• Cognitive style
• Access to means
• Psychological factors
• Clinical factors
• Substance abuse or addiction
• Exposure to suicide

Implementing Protective Factors To Reduce the Danger of Suicide

There is a set of protective factors that have been demonstrated effective in reducing the danger of suicide among peers who lose a member of their cohort to death by suicide in a school setting. These are:

• Family support
• Peer support
• Connectedness to the school
• Connectedness to the community
• Healthy problem-solving skills
• Easy access to mental health services and support
• Easy access to medical services

Collaboration Between School and Community Providers

The establishment of firm partnerships between schools and local community mental health agencies and associated resources is paramount. This type of solid collaboration best ensures that students (and others in the broader school community) have the ability to receive needed mental health services in a timely manner.

In addition to these specific components of a broad strategy to prevent suicide contagion as proactively as possible, a truly important factor in establishing and maintaining a school environment where students and staff alike feel safe. A school should be a place where all stakeholders – from students to teachers to parents and others – feel safe and protected.