Why this is important

• Schools are uniquely positioned for the work of mental health promotion, early identification, and suicide prevention (Bersia, 2022; MacPhee et al., 2021). This occurs daily through consistent, ongoing support across the tiers.
• School staff may feel uncertain about discussing suicide at school because they worry that they may say or do the wrong thing. Further learning in this area would promote awareness, skill, and readiness to act as they approach this complex topic (Hochhauser et al., 2020).
• Youth suicide is a complex issue that is connected to a wide range of variables and influences beyond the individual, which are compounded by social and racial inequities and systemic barriers and biases (Government of Canada, 2023; Hochhauser et al., 2020).

Research about youth suicide

• In Ontario, one in six students report serious thoughts of suicide.
• Although rates of self-reported mental distress have increased since 2000, the percentage of suicide attempts, and rates of death by suicide, have been relatively stable over time
• In 2016 and 2018, suicide was the leading cause of death for children aged 10 to 14 (19% in this age group), though it is still relatively rare (e.g., 48 recorded deaths by suicide in 2018 in Canada); intentional self-harm was one of the top three causes of death from 2016 to 2020. For adolescents aged 15 to 19, suicide was consistently the second leading cause of death (after accidental injury) from 2016 to 2020, but the raw numbers in this age group are substantially higher (208 in 2020 through 256 in 2018).
• By around the age of 9, many children have a thorough understanding of both death and suicide.
• Regardless of whether they understand the consequences of their actions, children may consider death as an option to end their emotional pain without fully understanding the finality of their actions.
• During public health restrictions, like school closures in the COVID-19 pandemic, media reported a 200% increase in the use of community resources such as Kids Help Phone, with volume increased from 1.9 million interactions (i.e., calls and text messages) in 2019 to 4.2 million in 2020; increases of 20% to 30% for mental health referrals to pediatric hospitals were also reported. In spite of this, there has not been an increase in reported rates of death by suicide.
• In Canada, transgender youth (aged 15 to 17 years) are five times more likely to report suicidal ideation and 7.6 times more likely to report a suicide attempt, compared to cisgender, heterosexual adolescents. For cisgender youth, same-sex attraction is associated with 2.5 times the suicidal ideation risk and 2.8 times the suicide attempt risk.
• Youth living in the poorest households were least likely to report good-to-excellent mental health and were more likely to indicate that they have seriously contemplated suicide.
• The prevalence of suicide among Indigenous Peoples in Canada is high and disproportionate to the Canadian population at large and has remained stable and in some places worsened.

How schools can help

Review your board’s youth suicide prevention policy and any procedural documents that outline intentional, evidence-informed, and compassionate strategies across the spectrum of prevention, intervention, and postvention. Your board’s mental health leader, along with school, board, and community mental health professionals, can be a resource in supporting your professional learning and that of school staff in this area.

Warning signs of suicide

Changes in typical behaviours	Issues related to pain and loss	Taking active steps
homework quality declines and grades drop daydreaming misuse of substances negative mood or signs of depression (sadness, irritability, reduced enjoyment of previously enjoyed activities) sudden mood swings neglect of personal appearance withdrawing from classroom, extra-curricular activities, and peers changes in sleeping or eating habits unexplained absences from school violent, rebellious, reckless, or thrill-seeking behavior	loss of an important relationship death of a loved one, especially from suicide loss of self-esteem (school failure, failure to achieve expectations) family disharmony (divorce, parental misuse of substances) family history of mental illness or suicide behavior rootlessness and family mobility serious physical illness physical and/or sexual abuse/assault mental illness conflict with peers, lack of social connection, and/or social vulnerability	a withdrawn student suddenly becomes outgoing giving away prized possessions talking/writing about killing oneself, including on social media, journals, or through artwork verbal or written remarks about being a failure, worthless, a burden and/or isolated collecting or possessing items that could be used for suicidal behavior (lethal means)

What to do if you’re concerned about a student

Individuals often worry that discussing suicide and asking directly about thoughts of suicide will somehow put these thoughts into a student’s mind. As a result, many caring adults avoid the topic. In fact, there is no evidence to suggest that asking someone if they are having thoughts of suicide will increase their risk of developing suicidal thoughts. Rather, talking about suicide shows that you care and that you are available to help in difficult times.

• remain calm—or try to convey calm even if you do not feel it
• name the signs/things you have observed that are making you concerned
• promise privacy but not confidentiality
• ask if they are thinking about suicide
• listen actively, allow for silence
• validate the student’s feelings but not their thoughts of suicide or plan to die
• reassure the student that there is help and they will not feel like this forever
• provide constant supervision, even for a trip to the washroom
• connect with your school administrator, as per your board suicide prevention protocol
• support the student as you wait for additional help

Here are some words you can use:

Open the conversation

• Hey, do you have a minute? I just wanted to check in and see how things are going.
• Thanks for making a few minutes to speak with me. I’ve noticed that you seem really stressed lately. Do you want to talk about it?
• I’ve noticed you haven’t been handing in your work. That’s not like you. Is everything okay?

Ask about suicide

• It seems like things are really tough right now. Do they ever get so tough that you think about suicide?
• Does it ever get so bad you think about ending your life?
• Sometimes when people are feeling really down and they don’t think it’s going to get better, they think about ending their life. Have you had any thoughts about suicide? 

Reassure the student

• That sounds so hard, especially since you have been dealing with it by yourself. But now I know, and you’re not alone anymore.
• I want the best for you and I’m here to help. Thank you for trusting me enough to tell me what’s been going on.
• I’m here to listen and I know some other people in our school who could listen, too.

If a student discloses that they have activated a suicide plan (e.g., ingested medications or substances with intent to die) this is a medical emergency and you must follow your board’s suicide protocol and call for an ambulance right away. The student should never be left alone – even to go to the washroom – unless it is unsafe for you to be with them.