Suicide Response (Postvention)

Understanding suicide

Talking about suicide

It is important to understand that the language we use when talking about suicide can significantly contribute to stigma and reduce the help-seeking behaviours of those impacted by and exposed to a suicide. It can also be difficult for people to know how to encourage conversations about suicide.

When talking about suicide it is critical to follow these 4 principles (National Communications Charter 2018):

• use safe and inclusive language
• do not disclose information about method and location
• present confirmed information only
• include help-seeking messages and pathways for support.

In a school context if, following a suicide, students are engaging in a discussion about suicide, they should be encouraged to do so in general terms, as this is an opportunity to encourage help-seeking behaviours and to develop or strengthen existing coping strategies. Students and staff should be offered the chance to opt out of these discussions if it triggers an emotional response.

Discussions should be limited to small groups, be time limited and, where possible, be facilitated by teams of two staff members who are comfortable and best placed to be talking about the topic.

Language guide – suicide

The National Communications Charter, launched in 2018 by Life in Mind, is a resource that promotes the safe and consistent use of language when talking about mental health, mental ill-health and suicide. It recognises that everyone has a role to play in tackling stigma and preventing harm.

The language tool is a helpful resource for schools to refer to during, before and after a suicide response that promotes the accurate and safe language regarding suicide.

The purpose is to build confidence and empower educators to engage in conversations with their students to Notice, Inquire and Plan (SAFEMinds – safety map) upon recognising changes in behaviour and/or presentation in the classroom.

About suicide

The impact of a suicide is immediate and traumatic to families, friends and communities experiencing it. When a suicide occurs, it is often unexpected and those left behind face the challenge of questions that will remain unanswered.

The ripple effect can be far reaching (WHO 2020). The ripple effect in a school community results in the exposure to suicide for student, staff and parent communities, having the potential to increase the risk of suicide among the community. Schools have an important responsibility and duty of care to respond to a suicide in a way that promotes safety and protects everyone from further harm.

The most important role a school staff member can play in assisting students with increasing levels of risk and/or deteriorating mental health is to first notice those students requiring extra support and to action appropriate referrals to a member of the school wellbeing team.

The many factors that influence the suicidality of an individual are broadly categorised as either risk or protective factors. Risk and protective factors can be conceptualised as being on opposite ends of the same mental health continuum. Risk factors, or vulnerability factors, are those factors that increase a person’s likelihood of experiencing suicidal behaviours and protective factors are those factors that reduce the likelihood that a person will experience suicidal behaviour (mental health conditions in young people – suicide).

Risk factors do not cause mental health concerns but rather increase a person’s vulnerability to them. They tend to have a cumulative effect – experiencing multiple risk factors simultaneously is likely to increase the negative mental health outcomes for the person (Beyond Blue).

Risk and protective factors can be categorised as either static (fixed) or dynamic (changeable) factors (Suicide Prevention Resource Centre and Rodgers 2011). Below are some examples of risk and protective factors that are either fixed or dynamic.

Risk and protective factors can be further differentiated across the domains of family, individual and social/environmental factors.

When identifying the risk and protective factors influencing a person’s mental health and wellbeing it is important to recognise that a person’s experience of any factor is subjective and what one person identifies as a risk factor might be a protective factor for another (WHO Preventing Suicide: A Global Imperative 2014).

Static (fixed) risk factors

• Family history of suicide
• Previous suicide attempts
• Gender

Static (fixed) protective factors

• Positive problem-solving skills
• Coping skills
• Gender

Dynamic (changeable) risk factors

• Family breakdown
• Relationship stressor
• Experiencing a recent loss

Dynamic (changeable) protective factors

• Positive personal relationships
• Social supports from peers
• Spirituality/faith

Identifying that an individual has a number of risk factors present is not enough to indicate whether they are currently experiencing, or will ever experience, suicidal ideation and/or suicidal behaviour. Rather, it is an opportunity to identify when additional support may be needed ( Everymind).

It is also critical to remember that some young people will experience suicidal ideation in the absence of any identifiable risk factor.

Many members of the school community will have, and may go on to face, any number of the risk factors identified above and, for the most part, people will manage the period of increased stress or difficulty and be okay. However, for some people experiencing one of any number of risk factors will overwhelm their ability to self-regulate using their existing coping strategies (Beyond Blue).

In addition to recognising when risk and protective factors may be present, some behaviours are warning signs that provide us with an opportunity to connect with a young person and facilitate additional support as needed.

Warning signs could include:

• withdrawing from friends, teachers and family
• talking about wanting to hurt or kill themselves
• talking about or writing about death or dying
• reduced engagement in class
• changes in their appearance and grooming
• increased risk-taking behaviours such as drugs and alcohol
• giving away possessions
• reduced eye contact
• expressing feelings of hopelessness or worthlessness
• saying goodbye to loved ones
• increased absenteeism
• noticeable changes in mood (positive or negative).

Mental health conditions are one of the strongest risk factors for suicide (Lawrence et al. 2015). Regardless of the diagnosis, some young people will develop thoughts of suicide as a result of changes to their thoughts, behaviours and ability to function in the presence of a mental health condition and any assessment of risk should always recognise changes in the context of the young person.

Supporting resources

SAFEMinds tips to notice can support educators to notice some of the warning signs in students that may indicate additional support is required.

Children (5 to 12 years of age)

Children are not immune from experiencing the impact of suicide. Children can be exposed to a suicide by attending an F–12 school, losing a parent, sibling or close community member to suicide and/or as a result of hearing people talking about suicide in person or via media. Although a rare event, children can also die by suicide. Research indicates that from 8 years of age children understand death and the concept of suicide (Mishara B 1999, Martinez M 2013).

Risk continuum

Risk can be understood as existing along a continuum – movement up and down the continuum requires different responses to mitigate the level of risk observed. Conceptualising risk in this way offers a more nuanced and appropriate consideration of risk rather than viewing it as ‘present’ or ‘absent’.

Assessing a student’s level of suicide risk is complex and requires the consideration of current and background factors, across the individual, family, and environmental domains.

An appropriately trained staff member or professional (for example, mental health practitioner, staff trained in youth mental health, SSS psychologist or social worker, Doctors in Secondary Schools Program General Practitioner (GP), an external mental health professional, their GP, a community or hospital-based doctor or psychologist) should undertake a suicide risk assessment.

Identifying young people at risk

After a suicide the main priority is to identify, monitor, refer and support students from the school community. Having a clear and collaborative process is critical to ensuring that safety is restored, and the risk of suicide contagion reduced. While everyone has a role to play in the process, members of the IMT will take the lead and the subsequent tasks required will be differentiated by role.

The table below can assist in identifying those students who may be at increased risk or vulnerability due to the relationship they had with the deceased.

• Social proximity: refers to the relationship someone had with the deceased, inclusive of those perceived relationships with the deceased. Social proximity refers to how close someone feels to the deceased.
• Geographical proximity: refers to those who are exposed to or witnessed the death or had recent contact with the deceased. This includes phone and online contact.
• Psychological proximity: refers to those who relate to/identify with the deceased. This includes cultural identification and/or shared experiences.

Young people known to be at risk

• Siblings or family members of the deceased
• Young people with a history of suicide attempts
• Young people who are already accessing support (internally at school or externally in the community)
• Young people known to have experienced a recent trauma, challenge or adversity
• Person who witnessed and/or found the deceased

Young people thought to be vulnerable

• Close friends of the deceased
• Acquaintances of the deceased, including those young people connected by sporting clubs
• Those young people who had recent contact (positive or negative) with the deceased
• Those young people who have shared experiences (same primary school or bus route)
• Friends or romantic partners of the deceased from other schools

Populations of young people who might be at increased risk

Data indicates that some population groups are overrepresented in suicide statistics. Those populations at increased risk and vulnerability to suicide include:

• community members who identify as LGBTIQ+ (Robinson et al. 2014)
• students living in Out of Home Care
• students with a disability
• Aboriginal and Torres Strait Islander students (Dudgeon et al. 2016)
• those living in rural and remote areas (Hazell et. al. 2017)
• those from culturally and linguistically diverse backgrounds (Life in Mind 2020).

Identifying as a member of any one of these population groups is not what places an individual at increased risk of suicide, but rather the experiences and adversity that can be associated with their membership of a specific population.

It is important to note that many members of these population groups will not experience a mental health difficulty or go on to develop suicidal ideation. Rather, increasing your knowledge about potential vulnerabilities that young people are experiencing may assist you in providing timely and appropriate support, reducing future difficulties.

Supporting resource

Be You can assist with coordination, resources, and support in preparing for, responding to and recovering from a suicide or suspected suicide.

Role of educators in identifying young people at risk

The role of educators is to observe and identify changes in their student’s presentation and/or behaviour that may indicate a need for additional support and to let a member of the school wellbeing team know of any concerns.

This is not to suggest that educators have a role to play in diagnosing or treating young people following exposure to a suicide, but rather to increase awareness of the things that they can do, within the boundaries of their role, that can result in a timely and appropriate response to increased distress and/or suicidal ideation in students.