1. SUICIDE PREVENTION BOARD POLICIES AND ADMINISTRATIVE REGULATIONS FOR SCHOOL DISTRICTS Joe Balabis, MPH San Mateo County Behavioral Health and Recovery Services

2. Today’s Discussion Suicide and hospitalization data – CA and SMC Roles of schools in suicide prevention Current Suicide Prevention Policies SP Policy Template and Components Strategies for implementation Discussion on potential barriers and solutions

3. Youth Suicides in California & SMC Youth and transition-age youth (age 5-24) deaths by suicide (2004 – 2012) California: Total suicide deaths: 3,797 Average suicide deaths per year: 422 San Mateo County: Total suicide deaths: 63 Average suicide deaths per year: 7 43% of total suicides were in 5-19 age group. Data Source: As cited on kidsdata.org, California Dept. of Public Health, Office of Statewide Health Planning and Development, Patient Discharge Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 1990-1999, 2000-2010, 2010-2060; CDC, WISQARS (Jun. 2014).As cited on kidsdata.org

4. 2004 to 20122004-2012 CountySuicide Deaths (ages 5-24) Self-Inflicted Injury Hospitalizations (ages 5-20) Alameda County127960 Contra Costa County110576 San Francisco County56248 San Mateo County63547 Santa Clara County1531,106 Comparisons to Bay Area Counties Data Source: As cited on kidsdata.org, California Dept. of Public Health, Office of Statewide Health Planning and Development, Patient Discharge Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 1990-1999, 2000-2010, 2010-2060; CDC, WISQARS (Jun. 2014).As cited on kidsdata.org Commonly reported methods for self-injury include: poisoning, cutting and piercing.

5. Self-Inflicted Injury Hospitalization Rate: 2004 to 2012 Definition: Number of hospitalizations for non-fatal self-inflicted injuries per 100,000 children/youth ages 5-20. Data Source: As cited on kidsdata.org, California Dept. of Public Health, Office of Statewide Health Planning and Development, Patient Discharge Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 1990-1999, 2000-2010, 2010-2060; CDC, WISQARS (Jun. 2014).As cited on kidsdata.org

6. Depression-Related Feelings, by Grade Level: 2008-2010 Definition: Percentage of students in grades 7, 9, and 11, and non-traditional students, reporting whether in the past 12 months, they had felt so sad or hopeless almost every day for two weeks or more that they stopped doing some usual activities. Data Source: As cited on kidsdata.org, California Department of Education, California Healthy Kids Survey (WestEd).As cited on kidsdata.org

7. 2014-2015 Adolescent Report The San Mateo County Youth Commission conducted a wellness study with over 5,000 San Mateo County students. The report found: More than 70% of San Mateo County students felt depressive symptoms. Approximately 38% of high school girls and 28% of boys have had suicidal thoughts.

8. Why is this important for school staff and administrators? School staff are in contact with youth for most of their days. School staff may be in a position to see warning signs of suicide or non-suicidal self-injury. Suicide ideation, threats or attempts may happen on campus. School staff may be in a position to intervene and help a student in crisis. Other students will be affected by a suicide attempt or completion. School staff should know how to prevent, respond to, and recover from a suicide attempt or completion.

9. Why Board Policies and Administrative Regulations? They provide official steps for addressing suicide prevention, intervention and postvention at a district level. Recognizes and prioritizes the issue of suicide and suicide prevention. Standardizes approaches at all schools within a district. Reassures school personnel in the event of suicide ideation, attempt or completion.

10. Current Board Policies (BP) and Administrative Regulations (AR) In San Mateo County, 8 school districts have adopted policies (BP 5141.52) that address suicide: Belmont-Redwood ShoresWoodside Elementary BurlingameSan Mateo Union High Hillsborough CityCabrillo Unified Redwood CitySouth San Francisco Unified 6 school districts have adopted regulations (AR 5141.52): Belmont-Redwood ShoresWoodside Elementary BurlingameSan Mateo Union High Redwood CitySouth San Francisco Unified 17 school districts, and County Office of Education, have yet to adopt a BP or AR for suicide

13. Opportunity for all districts to have BP and AR in place Letter from State Superintendent Tom Torlakson encouraging all school districts to adopt BP/AR focusing on suicide. School districts within SMC and in neighboring counties have already adopted similar policies and procedures. Support from county agencies and community allies (e.g. suicide prevention, crisis collaboration, education) Resources in state and nationally to assist with the creation of the BP & AR California School Board Association The Trevor Project Recent suicides among young people in the County.

14. Santa Clara County Results Alum Rock Union School DistrictFremont Union High School DistrictMilpitas Unified School DistrictSan Jose Unified School District Berryessa Union School DistrictGilroy Unified School DistrictMoreland School DistrictSaratoga Union School District Campbell Union High School DistrictLakeside Joint School DistrictMount Pleasant School DistrictSunnyvale School District Campbell Union School DistrictLoma Prieta Joint Union School DistrictMountain View Los Altos High School District Union Elementary School District East Side Union High School DistrictLos Gatos Union School DistrictOak Grove School District Evergreen School DistrictLos Gatos-Saratoga Joint Union H.S. DistrictOrchard School District Franklin-McKinley School DistrictLuther Burbank School DistrictPalo Alto Unified School District Santa Clara County Office of Education

15. Some Other California Counties Have A Suicide Prevention Policy ALPINE COUNTY UNIFIED SCHOOL DISTRICTFairfield-Suisun Unified School DistrictSalinas Union High School District Beaumont Unified School DistrictFORTUNA UNION HIGH SCHOOL DISTRICTSANTA MONICA-MALIBU UNIFIED SCHOOL DISTRICT Claremont USDGonzales Unified School DistrictSANTA YNEZ VALLEY UNION HIGH SCHOOL DISTRICT Chula Vista Elementary School DistrictLompoc Unified School DistrictSCOTT VALLEY UNIFIED SCHOOL DISTRICT Davis Joint USDMurrieta Valley Unified School DistrictWoodland Joint Unified School District EL RANCHO UNIFIED SCHOOL DISTRICTPleasanton Unified School District

16. Components of a suicide BP and AR 1. Prevention a)Staff education and training - should specify type and frequency (Youth Mental Health First Aid) b)Prevention programs for students (peer support, integrated into health education, community collaborations) c)Parent training 2. Intervention a) Assessment and referral b) Crisis response and notification (crisis line, law enforcement, parents) c) Staff response support

17. Components of a suicide BP and AR 3. Postvention a) Re-entry procedures b) Notification of school community c) Support for students and staff affected Board Policies and Administrative Regulations should be made known and accessible to school staff. Source: Model School District Policy on Suicide Prevention, The Trevor Project, American Federation for Suicide Prevention

18. Support for Implementation BHRS & COE to work on BP and AR templates to include SMC-specific resources. SMC Suicide Prevention Committee to suggest crisis response protocols based on situations. BHRS currently provides FREE Youth Mental Health First Aid training to all school-based staff (Measure A). State and local programs exist to increase student mental health awareness. County crisis collaboration team to improving prevention, response and postvention resources and protocols.

19. Group Discussion What barriers or challenges may prevent or delay adoption of these BP and AR by school boards? How can we overcome these barriers and challenges? What key people or allies should we involve when approaching a school board about this? What concerns do you have regarding these policies and regulations?

20. Questions Joe Balabis jbalabis@smcgov.org (650) 573-3474 Suicide Prevention Committee meets every 4 th Wednesday of the month from 1:30pm-3:00pm