School-Based Suicide Prevention Laws in Action: A Nationwide Investigation of Principals’ Knowledge of and Adherence to State School-Based Suicide Prevention Laws

Abstract

Suicide is the second leading cause of death for youth aged 10–24 in the USA. In response to the high rate of youth suicide, teen suicide has gained national attention and, as a result, state governments have created legislation regarding youth suicide prevention in schools. States hold the power to instruct their schools in how to address suicide prevention, but little research has explored the relationship between state laws about school-based suicide prevention and schools’ actual practice of suicide prevention or about the effectiveness of different types of laws. The current study examined this relationship by surveying a nationally representative sample of high school principals. It assesses their knowledge of and compliance with state laws about suicide prevention, adherence to best practices for school-based suicide prevention, and variables that predict their schools’ suicide prevention program comprehensiveness. Results indicated that only about 25% of principals (N = 656) accurately identified their states’ laws about school-based suicide prevention, and 66.1% reported that their schools’ suicide prevention programs are in complete compliance with their states’ laws. Principals in states with the most stringent laws reported having the most comprehensive suicide prevention programs. Having funding, perceived support, student socioeconomic status, and having a student in their current school die by suicide were all significantly related to suicide prevention program comprehensiveness. Implications for policy, practice, and research are discussed.

This is a preview of subscription content, log in to check access.

References

  1. Aguirre, R. T., & Slater, H. (2010). Suicide postvention as suicide prevention: Improvement and expansion in the United States. Death Studies, 34(6), 529–540. https://doi.org/10.1080/07481181003761336.

    Article  PubMed  Google Scholar 

  2. American Foundation for Suicide Prevention. (2014). Statewide suicide prevention initiatives. Retrieved from https://www.afsp.org/content/download/13148/222458/file/Statewide%20Initiatives.pdf.

  3. American Foundation for Suicide Prevention. (2015). State laws on suicide prevention training for school personnel. Retrieved from https://www.afsp.org/advocacy-public-policy/statepolicy/suicide-prevention-training-for-school-personnel.

  4. American Foundation for Suicide Prevention. (2016). State laws on Suicide Prevention Education for Students. Retrieved from https://www.afsp.org/advocacy-public-policy/statepolicy/suicide-prevention-education-for-students.

  5. Appleby, L., Morriss, R., Gask, L., Roland, M., Lewis, B, Perry, A., et al. (2000). Attitudes to Suicide Prevention Scale [Database record]. Retrieved from PsycTESTS. doi:http://dx.doi.org.proxy.lib.miamioh.edu/10.1037/t37756-000.

  6. Aseltine, R. H., James, A., Schilling, E. A., & Glanovsky, J. (2007). Evaluating the SOS suicide prevention program: A replication and extension. BMC Public Health, 7(1), 161. https://doi.org/10.1186/1471-2458-7-161.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Batterham, P. J., Calear, A. L., & Christensen, H. (2013). Correlates of suicide stigma and suicide literacy in the community. Suicide and Life-Threatening Behavior, 43(4), 406–417. https://doi.org/10.1111/sltb.12026.

    Article  PubMed  Google Scholar 

  8. Brock, S. E. (2002). School suicide postvention. In S. E. Brock, P. J. Lazarus, & S. R. Jimerson (Eds.), Best practices in school crisis prevention and intervention (pp. 211–223). Bethesda, MD: National Association of School Psychologists.

    Google Scholar 

  9. Center for Disease Control and Prevention. (2015). Results from the School Health Policies and Practices Study 2014. U.S. Department of Health and Human Services Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/healthyyouth/data/shpps/index.htm.

  10. Cooper, G. D., Clements, P. T., & Holt, K. (2011). A review and application of suicide prevention programs in high school settings. Issues in Mental Health Nursing, 32(11), 696–702. https://doi.org/10.3109/01612840.2011.597911.

    Article  PubMed  Google Scholar 

  11. Cusimano, M. D., & Sameem, M. (2011). The effectiveness of middle and high school-based suicide prevention programmes for adolescents: A systematic review. Injury Prevention, 17(1), 43–49. https://doi.org/10.1136/ip.2009.025502.

    Article  PubMed  Google Scholar 

  12. Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41(3–4), 327–350. https://doi.org/10.1007/s10464-008-9165-0.

    Article  PubMed  Google Scholar 

  13. Fan, W., & Yan, Z. (2010). Factors affecting response rates of the web survey: A systematic review. Computers in Human Behavior, 26(2), 132–139. https://doi.org/10.1016/j.chb.2009.10.015.

    Article  Google Scholar 

  14. Fuchs, L. S., & Fuchs, D. (2007). A model for implementing responsiveness to intervention. Teaching Exceptional Children, 39(5), 14–20. https://doi.org/10.1177/004005990703900503.

    Article  Google Scholar 

  15. Glasman, L. R., & Albarracín, D. (2006). Forming attitudes that predict future behavior: A meta-analysis of the attitude-behavior relation. Psychological Bulletin, 132(5), 778. https://doi.org/10.1037/0033-2909.132.5.778.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Greenhalgh, T., Robert, G., Bate, P., Macfarlane, F., & Kyriakidou, O. (2008). Diffusion of innovations in health service organisations: A systematic literature review. New York: Wiley.

    Google Scholar 

  17. Hayden, D. C., & Lauer, P. (2000). Prevalence of suicide programs in schools and roadblocks to implementation. Suicide and Life-Threatening Behavior, 30(3), 239–251. https://doi.org/10.1111/(issn)1943-278x.

    Article  PubMed  Google Scholar 

  18. Herron, J., Ticehurst, H., Appleby, L., Perry, A., & Cordingley, L. (2001). Attitudes toward suicide prevention in front-line health staff. Suicide and Life-Threatening Behavior, 31(3), 342–347. https://doi.org/10.1521/suli.31.3.342.24252.

    Article  PubMed  Google Scholar 

  19. Hill, N. E., & Taylor, L. C. (2004). Parental school involvement and children’s academic achievement: Pragmatics and issues. Current Directions in Psychological Science, 13(4), 161–164. https://doi.org/10.1007/978-981-287-630-0_9.

    Article  Google Scholar 

  20. Kalafat, J. (2003). School approaches to youth suicide prevention. American Behavioral Scientist, 46(9), 1211–1223. https://doi.org/10.1177/0002764202250665.

    Article  Google Scholar 

  21. Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. S., Hawkins, J., et al. (2016). Youth risk behavior surveillance—United States, 2015. Morbidity and Mortality Weekly Report Surveillance Summaries, 65(6), 1–174. Retrieved from http://www.cdc.gov/mmwr/volumes/65/ss/ss6506a1.htm.

  22. Katz, C., Bolton, S. L., Katz, L. Y., Isaak, C., Tilston-Jones, T., & Sareen, J. (2013). A systematic review of school-based suicide prevention programs. Depression and Anxiety, 30(10), 1030–1045. https://doi.org/10.1002/da.22114.

    Article  PubMed  Google Scholar 

  23. Kodaka, M., Poštuvan, V., Inagaki, M., & Yamada, M. (2011). A systematic review of scales that measure attitudes toward suicide. International Journal of Social Psychiatry, 57(4), 338–361. https://doi.org/10.1177/0020764009357399.

    Article  PubMed  Google Scholar 

  24. Kubrin, C. E., Wadsworth, T., & DiPietro, S. (2006). Deindustrialization, disadvantage and suicide among young black males. Social Forces, 84(3), 1559–1579. https://doi.org/10.1353/sof.2006.0052.

    Article  Google Scholar 

  25. Lieberman, R., Poland, S., & Cassel, R. (2008). Best practices in suicide intervention. Best Practices in School Psychology V, 4, 1457–1473.

    Google Scholar 

  26. Lorant, V., Kunst, A. E., Huisman, M., Costa, G., & Mackenbach, J. (2005). Socio-economic inequalities in suicide: A European comparative study. The British Journal of Psychiatry, 187(1), 49–54. https://doi.org/10.1192/bjp.187.1.49.

    Article  PubMed  Google Scholar 

  27. Marks, E. S. (1995). Entry strategies for school consultation. New York: Guilford Press.

    Google Scholar 

  28. McHugh, M. L. (2012). Interrater reliability: The kappa statistic. Biochemia Medica, 22(3), 276–282. https://doi.org/10.11613/bm.2012.031.

    Article  PubMed  PubMed Central  Google Scholar 

  29. McIntosh, K., Kelm, J. L., & Canizal Delabra, A. (2016). In search of how principals change: A qualitative study of events that help and hinder administrator support for school-wide PBIS. Journal of Positive Behavior Interventions, 18, 100–110. https://doi.org/10.1177/1098300715599960.

    Article  Google Scholar 

  30. Metha, A., Weber, B., & Webb, L. D. (1998). Youth suicide prevention: A survey and analysis of policies and efforts in the 50 states. Suicide and Life-Threatening Behavior, 28(2), 150–164. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1943-278X.1998.tb00635.x/abstract.

  31. Metos, J., & Nanney, M. S. (2007). The strength of school wellness policies: One state’s experience. Journal of School Health, 77(7), 367–372. https://doi.org/10.1111/j.1746-1561.2007.00221.x.

    Article  PubMed  Google Scholar 

  32. National Center for Education Statistics. (2016). Search for public schools. Retrieved September 5, 2016, from http://nces.ed.gov/ccd/schoolsearch/index.asp.

  33. Nunnally, J. C. (1988). Psychometric theory. NJ: McGraw-Hill.

    Google Scholar 

  34. Office of the Surgeon General (US, & National Action Alliance for Suicide Prevention). (2012). 2012 National Strategy for Suicide Prevention: Goals and objectives for action: A report of the US Surgeon General and of the National Action Alliance for Suicide Prevention. Retrieved from http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/full-report.pdf.

  35. Pirkis, J. E., Irwin, C. E., Brindis, C. D., Sawyer, M. G., Friestad, C., Biehl, M., et al. (2003). Receipt of psychological or emotional counseling by suicidal adolescents. Pediatrics. https://doi.org/10.1542/peds.111.4.e388.

    Article  PubMed  Google Scholar 

  36. Renberg, E. S., & Jacobsson, L. (2003). Development of a questionnaire on attitudes towards suicide (ATTS) and its application in a Swedish population. Suicide and Life-Threatening Behavior, 33(1), 52–64. https://doi.org/10.1521/suli.33.1.52.22784.

    Article  PubMed  Google Scholar 

  37. Reynders, A., Kerkhof, A. J., Molenberghs, G., & Van Audenhove, C. (2015). Help-seeking, stigma and attitudes of people with and without a suicidal past. A comparison between a low and a high suicide rate country. Journal of Affective Disorders, 178, 5–11. https://doi.org/10.1016/j.jad.2015.02.013.

    Article  PubMed  Google Scholar 

  38. Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology Review, 3(4), 223–241. https://doi.org/10.1023/a:1026425104386.

    Article  PubMed  Google Scholar 

  39. Sandler, I., Ostrom, A., Bitner, M. J., Ayers, T. S., Wolchik, S., & Daniels, V. S. (2005). Developing effective prevention services for the real world: A prevention service development model. American Journal of Community Psychology, 35(3–4), 127–142. https://doi.org/10.1007/s10464-005-3389-z.

    Article  PubMed  Google Scholar 

  40. Singer, J. B., Erbacher, T. A., & Rosen, P. (2018). School-based suicide prevention: A framework for evidence-based practice. School Mental Health. https://doi.org/10.1007/s12310-018-9245-8.

    Article  Google Scholar 

  41. Wasserman, D., Hoven, C. W., Wasserman, C., Wall, M., Eisenberg, R., Hadlaczky, G., et al. (2015). School-based suicide prevention programmes: The SEYLE cluster-randomised, controlled trial. The Lancet, 385(9977), 1536–1544. https://doi.org/10.1016/s0140-6736(14)61213-7.

    Article  Google Scholar 

  42. Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., et al. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-Year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1), 104. https://doi.org/10.1037/0022-006x.76.1.104.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was funded by the Annette Urso Rickel Foundation Dissertation Award for Public Policy and funds raised through the Hawk’s Nest Research Fund.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Mills K. Smith-Millman.

Ethics declarations

Conflict of interest

Both authors declare that they have no conflicts of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Smith-Millman, M.K., Flaspohler, P.D. School-Based Suicide Prevention Laws in Action: A Nationwide Investigation of Principals’ Knowledge of and Adherence to State School-Based Suicide Prevention Laws. School Mental Health 11, 321–334 (2019). https://doi.org/10.1007/s12310-018-9287-y

Download citation

Keywords

  • Suicide prevention
  • Schools
  • Policy
  • Best practices