Strategy 11: Establish and Maintain Crisis Response Teams
Establish and maintain trained, responsive, school and community crisis response teams (CRT) to help minimize the likelihood of suicide contagion in schools.
The primary audience is current and prospective school and community CRT members. A secondary focus is other community members who play an important role in facilitating the work of a school CRT. These include: school administrators, school counselors, teachers, social workers, psychologists, mental health providers, religious/ spiritual leaders, bereavement counselors, hospital representatives, trained gatekeepers, parent groups, survivor groups, media representatives, crisis service providers, treatment providers, law enforcement, and emergency medical personnel.
RATIONALE AND EFFICACY
Exposure to the suicides of family members, friends, or others may increase the risk for youth and young adults already at high risk of self-destructive behavior. Suicide clusters (groups of suicides occurring closer in space and time than would normally be expected) and copycat suicides are rare events, but adolescents and young adults seem particularly vulnerable to such contagion. Estimates indicate that the percentage of adolescent suicides identified as cluster-related may range from less than 1% to 13%.46
Schools and communities should be prepared to respond quickly to minimize the likelihood of suicide contagion following one or more youth suicides.
The advisability of a crisis response plan to manage the risk of multiple youth suicides is widely accepted by experts. In the absence of a crisis, it is difficult to evaluate the adequacy of response plan interventions.uick and appropriate
Unfortunately, no evaluations exist on the effectiveness of crisis response team interventions on youth suicide behavior.16
No matter how well developed a CRT plan might be, it will not work effectively if community stakeholders are not aware of the content of the plan or supportive of it. To ensure a coordinated, cooperative response in the event of a tragedy, school staff and community members should be educated about the role of crisis response teams in suicide prevention.16
CRT plans should specify a process for helping team members reduce stress resulting from interventions that prevent a suicide. Team members report significant benefits from participating in these critical incident debriefings.47
In addition to school-based and school/community-based CRTs in many communities, Oregon counties have access to National Office of Victim’s Rights (NOVA) teams to respond to crises. An informal survey by the Oregon Department of Education in the fall of 1998 showed that most Oregon school districts have a crisis response plan that includes post-suicide intervention. However, many of the plans had not been updated within two years, and only about 25% of school districts had provided any kind of annual staff training in crisis response and crisis response planning. These two types of training were identified as the areas of greatest need.48
Suicidal behavior among high-risk youth may also be precipitated by accidental death or homicide or by other significant losses in schools and communities. The use of CRTs after these events should therefore be considered.
SAMPLE IMPLEMENTATION ACTIVITIES
-Establish CRTs in areas without existing teams.
-Incorporate CDC Recommendations for a Community Plan for the
Prevention and Containment of Suicide Clusters into new and existing CRT plans.49
-Involve local CRT members in community youth-suicide prevention efforts.
-Educate community stakeholders about the role of a CRT in the aftermath of youth suicide and solicit their support and utilization of a CRT when appropriate.
-Coordinate crisis response activities with existing community resources.
16 Greenblat M, Robertson M. Life styles, adaptive strategies, and sexual behaviors of homeless adolescents. Hosp Community Psychiatry. 1993; 44(12): 1177-80.
46 Gould M, Wallenstein S, Kleinman M, et al. Suicide clusters: An examination of age-specific effects. American Journal of Public Health. 1990;80:211-212.
47 Neely K, Spitzer W. A model for a statewide critical incident stress debriefing program for emergency services personnel. Prehospital Disaster Med. 1997;Apr-Jun;12(2):114-9.
48 Lenssen J. Personal Communication. Oregon Department of Education. 1998.