Presentation on theme: "School Crisis: Ethical and Legal Issues for Best Practices"— Presentation transcript:
1School Crisis: Ethical and Legal Issues for Best Practices Dr. Scott PolandCo-Director of the Suicide and Violence Prevention OfficeNova Southeastern University
2NASP Principles for Professional Ethics: Revised 2010 Respect dignity and rights of all personsHonesty and integrity in professional relationshipsResponsibility to schools, families, community, the profession and societyProfessional competence and responsibility
3NASP Principles: Key Concepts School psychologists consider children to be their primary responsibility and act as advocates for their welfare.We also understand the public policy process to assist us in our efforts to advocate for children.At the very least we do no harm.
4Legal Cases ReviewThere are many legal cases that have implications for crisis intervention and school psychologistsSchool psychology literature about legal and ethical issues in school crisis is lackingThe following cases highlighted in a lessons learned format are all cases that I was personally involved in
5Civil Lawsuits Against School Personnel: Common Questions Did an injury occur?Did the school owe a duty to the student?Was there a breach of duty?Is there a causal relationship between the injury and a breach of duty?
6Choquette vs. Onstedt Schools Elementary age students on school bus viewed a suicide victimParents were called immediately and a group activity provided next day for all bus riders (grades 1 to 6) by psychologist and counselorOne family did not want their 1st grade daughter to be told truth and later pulled her out of school and suedThe suit for 10$ million claimed she had PTSD as a result of intervention provided
7Activity What do you think of the merits of the Choquette lawsuit? How would you defend the school psychologist and counselor?Was is it appropriate to conduct one intervention for bus riders grades 1 to 6?Should parent permission have been obtained prior to the intervention for students?
8Landmark CasesWyke v Polk County School Board in Florida 11th Federal Circuit Court found the district liable for not offering a suicide prevention program, providing inadequate supervision of a suicidal student and failing to notify parents when their child was suicidal
9Landmark CasesSzostek v Fowler and the Cypress-Fairbanks School District 189th District Court found the school had not negligently disciplined the student who died by suicide and were entitled to sovereign immunity. This case does highlight school discipline has been a common precipitating event for suicide.
10Hope Witsell TragedyMiddle school teen endured months of taunting after she sent a topless photo to a fellow studentThe day before her suicide, she met with a social worker who had her sign a no suicide contractNo other school staff nor the parents were notified and parents found the contract after she hanged herselfDo you see a defense in the lawsuit and how do we prevent tragedies like this?
11Parent Notification Issue: Suicidal Student Maryland school psychologist believed a student to be suicidal and notified parents. Student was allowed to walk home per parent request. Student died by suicide that night and the parents filed a lawsuit against the school and the psychologist.
12Parent Notification Case: White Pass, WA. Sixteen year old male studentReferred to school counselor after he wrote a suicide note and gave it to a friend and there were rumors about a suicide pactStudent denied suicidal ideation or plans when interviewed by counselorPlease consider whether or not you would call parents after you review the following pieces of information that he shared with the counselor
13Shared with Counselor New to school had been there 5 weeks Sad as his best friend at new school who he was rumored to be in a pact with attempted suicide todayUnder stress as facing felony chargesGets along well with grandmother (who he now lives with) but not his mother as she hates himHis mother tried to kill herself last yearHe reports his mother thinks he will probably kill himselfHe reported he used to drink but has been sober for two weeks
14U.S. Eastern District Court Lance v Lewisville ISD 9 year old boy M. hung himself in the school nurses bathroom in 2010Special education student with Speech, Learning Disabilities and ADHDIn 2008 his parents referred him for psychological evaluation due to their concerns that he was suicidalARD in 2008 identified him with Emotionally Disturbed
15The district does not have the psych evaluation that qualified M with ED They have BASC raw data only that documents suicide/depressionHe received special education counseling but there is no documentation that service provider ever talked with him about suicidal ideationFrom the start of the school year and his death on 1/21/10 there were 30 behavioral incidents that resulted in him seeing the AP
16The AP viewed each incident as conflict not bullying as that would have required the incidents to be written up and sent to the SuperintendentNo evidence that the AP reviewed his IEP or his BIPM saw the nurse on 16 occasions that year and on 7 of those occasions had physical injuries suffered at schoolOn 12/18/09 five students assaulted M in and he pulled a pocket knife from his pocket but did not open itM was sent to the DAEP for 10 days and no MDR was held
17His parents appealed the DAEP in writing first to the Principal and then to the Assistant Superintendent stating that he had been bulliedThe appeals were deniedThe DAEP was not notified that M was a special education studentM was suicidal at the DAEP and a high school counselor interviewed him and called his father but failed to fill out paperwork as per district protocol and did not notify his home elementary school of his suicidal ideation
18M was in trouble on his second day back at his home campus and he hung himself in the nurse clinic bathroomThe nurse had known for two years that she did not have a key to unlock the bathroom door and M and other students had been known to lock themselves in the bathroom and she had to call custodian for helpNo one ever told the nurse that M was known to be suicidalThe day after he died a new lock was installed and the nurse was provided a key to the bathroom
19Legal Term: Special Relationship “In loco parentis doctrine” raises the question of whether a special relationship exists between school officials and students as students are released by parents for control and supervision by school officialsCritical issues are the age and existence of disabilities for a student and whether or not the district placed the student in harms way
20Lance Case: OutcomeCourt dismissed the case and placed emphasis on the 2012 Doe v Covington case decided by the Fifth Circuit CourtNo Special Relationship existed as he was not incarcerated, involuntarily committed, nor in foster careHe was not discriminated against as the AP failed to implement the bullying prevention policy for all students
21Bullying and SuicideChildren who have been bullied have reported a variety of behavioral, emotional and social problems.Suicide is the third largest cause of mortality in children and adolescents.Studies reported positive associations between all bullying types and suicidal risks.Children who have been bullied have reported a variety of behavioral, emotional and social problems, including: bed wetting, sleep difficulties, anxiety, depression, school phobia, feelings of insecurity, and unhappiness at school; they may also have low self-esteem, loneliness, isolation, and somatic complaints.Suicide is third leading cause of mortality in children and adolescent in the United States of America and around the world.According to a review of 37 studies completed by Kim & Leventhal (2008), most of the studies reported positive associations between all bullying types and suicidal risks.21
22What does the research say? Kaminsky (2009) victimization by peers is associated with greater reporting of suicidal ideation and behavior.Klomek, Sourander & Gould (2010) found that bullies also have been reported to have an increased prevalence of suicidal ideation and suicide attempts.Kim & Leventhal (2008) discussed that any participation in bullying increases the risk of suicidal ideation and behaviors, with the strongest risk for suicide was in Victim-Perpetrators.Kaminsky (2009) victimization by peers is associated with greater reporting of suicidal ideation and behavior. The study controlled for differences in age, sex, race/ethnicity or depressive symptoms.Klomek, Sourander & Gould (2010) found that bullies also have been reported to have an increased prevalence of suicidal ideation and suicide attempts than those not involved in bullying behaviors.Kim & Leventhal (2008) discussed that any participation in bullying increases the risk of suicidal ideation and behaviors, with the strongest risk for suicide was in Victim-Perpetrators, both in the general population of children and adolescents and in the population with special needs (behavioral problems or LGB sexual orientation). Victim-perpetrators (also known as aggressive victims) experience more psychopathology, as well as problematic family and academic functioning compared to other victims.22
23Klomek, Sourander & Gould (2010) reported that the associations between bullying behaviors and suicidality have been found in children of all ages.D’Augelli and colleagues (2005) found that increased sexual orientation-based verbal victimization, as well as psychological abuse from parents predicted suicide attempts described as ‘‘gay related.’’Traditional bullying and cyberbullying have been found to be related to suicidal ideation in similar ways (Klomek et al., 2008; Hinduja & Patchin, 2010).Klomek, Sourander & Gould (2010) reported that the associations between bullying behaviors (whether victim or bully) and suicidality have been found in children in elementary, middle and high school.D’Augelli and colleagues (2005) found that increased sexual orientation-based verbal victimization, as well as psychological abuse from parents predicted suicide attempts described as ‘‘gay related.’’Traditional bullying and cyberbullying have been found to be related to suicidal ideation in similar ways (Klomek et al., 2008; Hinduja & Patchin, 2010)23
24SPRC Brief: Suicide and Bullying Both victims and perpetrators are at higher risk than peersPersonal characteristics such as internalizing problems; low self-esteem; and low assertiveness increase the risk of being bullied and these factors are also associated with risk for suicideChildren most at risk for suicide are also at risk for being bullied and it is difficult to control all the risk factors to determine if being bullied was a proximal cause to a youth suicide
25SPRC ContinuedPersonal risk factors alone do not cause a child to be suicidal as other key components are family, mistreatment, domestic violence, parental depression and a school environment that lacks adequate support and supervision along with inconsistent disciplineRelationship between bullying and suicide is the strongest for LGBTQ youthPromotion of social support, mental health services and connectedness at school is recommended
26Bullying and Suicide Prevention: Common Strategies Promote a positive school environmentEducate parents about warning signs and increase their involvementKey is to build relationships with all studentsIdentify students and families in need of services and obtain services for them
27Suicide PostventionMares v Shawnee Mission Schools Kansas the school system settled out of court after being sued following the suicides of two brothers. The district failed to implement suicide postvention procedures after the first death.
28State of Montana v Justine Winter 20/20 Season 31 Episode #50 Nighttime car accident resulted in two deathsJustine survived but has extensive medical injuries including brain damage and has no memory of the accidentJustine was 16 years, one month at the time of the accident and had texted her boy friend about crashing her car 6 minutes before the accidentShe was tried in adult court on two counts of deliberate homicideHow might you defend her and does this case fit the pattern of youth suicide?What do you want to know about Justine?
30Lawsuit over Self Injury Notification Coulter Vs. Washington Township, N.J.IssuesStudent deposition/insight into factorsParent depositionCounselor deposition
31Snohomish, WA Case9th grade female student M (late April) told her friend K who was angry at her boyfriend that she would stab K’s boyfriend for herHer friend reported threat to the school counselorSchool emergency expelled her and told M and her mother that M would need to get psychiatric care before she would be readmitted
32School Records and Knowledge M seen as quiet, good student but grades declined 2nd semester 9th grade year and no history of any discipline incidents8th grade counselor’s notes say M talked about cutting, sexting and wanting to be raped9th grade counselor heard M might be cutting in Dec. that year and met with herChecked with her mom in Jan. and found out M was in private counseling
33ContinuedSchool counselor on date of threat in April without a release called the private psychologist to share M had thoughts of suicide and killing family membersM was evaluated by a psychiatrist for homicidal and suicidal thoughts and hospitalized for 5 days in a partial programDiagnosis was Major Depression and Generalized Anxiety, M was already on an anti-depressant that was working but was guarded in treatment, not homicidal or suicidal at discharge
34ContinuedPsychiatrist stated in writing that M was safe to return to school and was continuing in out patient treatment (only records school received)School held re-entry meeting on 5/5 with school staff, M and her mother and alternative school was mentioned but declined by M and momFocus was largely academic and how to support M and behaviors to watch forNo behavioral concerns reported before end of school except PE teacher noted cuts legs
35Continued Fall Next Year Meeting 9/22 with counselor, teachers, M and her momMom reported M still in therapy and using skills learned and had a future orientationTeachers shared largely academic concerns but M had talked of drugs, made at least one student uncomfortable and patted one student too hard, had done a paper on a serial killer and one on managing stress
36Stabbing IncidentOct. 25th M who still continued in twice a month counseling and medication, hid in the restroom listening to violent music, with knives she had taken from her step-fatherShe waited for RR to clear then stabbed the last two girls in the RR, one of which nearly died, M did not know either girlPlaintiff’s sued the treatment clinic that provided outpatient treatment , the hospital and the school
37Plaintiff’s Criticism of School M should have been placed in alternative school or not allowed to return, should have been evaluated for Special education, there was no wraparound program on return from hospital, school should have insisted on more information from the hospital and clinicSchool threat assessment in April was inadequate, M should have been searched every morning or escorted everywhere including to the RR or M should have been seen by school counselor every morning,
38More QuestionsWhat else do you want to know about the treatment that M received at the clinic and hospital?Is the law suit warranted against the school, clinic and hospital?When a psychiatrist does a safety assessment what does that really mean?Did the psychiatrist miss psychotic features to M’s illness?Can schools force records to be released to them?
39Case Discussion Questions What do you think of the case against the school? Can schools force the release of records?Are school personnel in a position to question a safety letter from a psychiatrist?What constitutes a thorough threat assessment and how good are we at predicting violence? How often do female adolescents attempt homicide and what is the relationship between homicide and suicide?
40Structured Assessment of Violent Risk Youth (SAVRY) Risk viewed as “dynamic” subject to change not just as “static”Improvement noted in clinicians’ ability to distinguish violent individuals, now better than chance accuracyPrevious assessment has been unstructured purely “clinical”
41SAVRYSystematic risk assessment with checklist of risk factors related to violence for 12 to 18 year oldsSystematic risk assessments perform better than unstructured onesDynamic risk factors especially significant for adolescentsSAVRY has 4 domains and 30 items all items rated low medium or high
42SAVRY DomainsHistorical risk factors such as history of violence, early initiation of violence, past supervision failure, history of NSSI or suicide attempts, exposure to violence in home, childhood maltreatment, parental criminality, early caregiver disruption, and poor school achievement
43SAVRY DomainsSocial/Contextual risk factors such as peer delinquency, peer rejection, stress and poor coping, poor parental management, lack of personal/social support and community disorganization
44SAVRY DomainsIndividual/Clinical Risk factors such as negative attitudes, risk taking/impulsivity, substance abuse, anger problems, low empathy/remorse, ADHD, poor compliance and low interest/commitment to school
45SAVRY DomainsProtective factors such as pro-social involvement, strong social support, strong attachment bonds, positive attitude towards intervention and authority, strong commitment to school and resilient personality traitsAvailable from Psychological Assessment Resources
46How Can School Personnel Protect Themselves from Liability? Maintain Liability InsuranceSeek supervision and consultationKeep good recordsDocument training on crisis interventionProvide Best Practices responses
47How Can School Psychologists Make A Difference? Advocate for prevention programs in schools and communitiesCollaborate with school administrators and relevant agenciesIncrease the circle of care when students are known to be at riskKeep up with best practices in crisis intervention
48More Information firstname.lastname@example.org www.nova.edu/suicideprevention New book, Suicide in schools by Erbacher, Singer and Poland, Routledge Dec. 2014