The Edina, Minnesota, school crisis response team.
A Crisis Steering Committee and the Crisis Team worked together on the project. Members of the Crisis Steering Committee include an administrator, two school psychologists, a school counselor, and a school nurse. They initially researched and developed the Crisis Plan. The plan includes Crisis Prevention, Intervention, and Postvention. The Steering Committee meets six times per year to maintain continuity, review situations, make recommendations, and plan an annual inservice for the Crisis Team. They receive support from a child and adolescent psychiatrist who has done research on adolescent suicide.
Members of the Crisis Team include building administrators, psychologists, school nurses, social workers, counselors, the athletic director, the chemical coordinator, the Early Childhood Special Education Coordinator, the before- and after-school Kids' Club Director, and the Community Education Family Center Director. Each member has completed an orientation and will respond immediately on request to a potential crisis to assist other team members. Crisis Team inservice with a focus on education and training is essential. The inservice renews commitment, builds cohesiveness and trust, and provides data for reviews and revisions.
CRISIS PREVENTION/INTERVENTION GUIDELINES
School staff, parents of students, other students, and sometimes students themselves provide the main referral sources for students (or staff) at risk for possible suicide. The Edina Public Schools implemented a plan that identified three levels of "at-risk" students/staff.
Level 1: The Imminent Life-Threatened Person
1. A person has the means to commit suicide or is already hurt and has placed himself/herself in an imminent life-threatening situation.
a. Immediately call 911 and follow their instructions.
b. Contact another member of the Crisis Prevention/Intervention Team.
c. If it is a student, make parental contact. If it is an adult, contact spouse or other person designated as the contact in case of emergency. Parental contact and permission are always sought, but should not delay efforts to secure immediate emergency intervention for the student. The school has responsibility to inform parent(s) of reasonable concern for suicidal risk. Parents have the responsibility to act on information provided by the school.
d. Contact the school building principal or assistant principal if the principal is not present.
The Crisis Prevention/Intervention Team members are responsible for a follow-up contact with each student referred to the team and his/her parent(s) within two weeks of the intervention to:
a. Determine family response to intervention and the present status of the student.
b. Make recommendations, such as private therapy.
c. Help initiate the first step to the recommendation.
d. Report status of student to referring person.
Crisis Intervention personnel involved in an intervention must document specifics of the intervention on a standard form provided by the school district. Documentation must include facts about the parental contact regarding details of the incident and parents' plans for follow-up. It is important to ascertain and document whether a continuing concern exists about the student feeling suicidal. All intervention documentation is forwarded to the district office and kept in a central file. Thus, when an intervention occurs, it is possible to note previous incidents with the student/staff member.
Level 2: The At-Risk Person
1. Actual evidence exists of intended suicide by the person.
a. Whomever received information about a student/staff member with suicidal thoughts immediately contacts a member of the Crisis Prevention/Intervention Team. That member meets and stays with the student/staff member while summoning another member of the Intervention Team, who assists with the intervention. Steps taken in the intervention process include:
1) Listening to what the student/staff member says, taking them seriously and avoiding panic.
2) Assessing risk factors.
3) Making parent contact if a student. If a staff member, contact the person designated as the emergency contact person. If parent(s) cannot be reached or they deny the risk factor, the local crisis intervention center is contacted. A referral to Child Protection Services also may be appropriate.
4) Informing the school building principal.
5) Beginning documentation of the intervention process.
6) Calling the district office to check the intervention file for previous incidents. Documentation and follow-up procedures follow the same format as previously described.
Level 3: The Suspected Suicidal Person
1. The individual provides a self-report of suicidal thoughts or others express concern for the person.
a. Provide an opportunity to talk privately in a safe place.
b. Contact another member of the Crisis Prevention/Intervention Team.
c. Offer emotional support.
d. Communicate hope and optimism.
e. Contact the parent or other person designated to be contacted in case of emergency.
f. Inform school principal or assistant principal.
g. Check intervention file at district office to see if previous intervention has been documented.
Documentation and follow-up procedures follow the same format as previously described. All documentation data assist the Steering Committee to assess staff inservice needs and assess students curriculum needs.
CRISIS POSTVENTION GUIDELINES
The school district should take the following actions regarding the death of any student or faculty member.
Notification of the Incident
1. Procedure includes notification of superintendent, all building principals, Crisis Intervention Steering Committee, Crisis Teams, and school staff in building.
2. The building principal decides on a media procedure.
Early Morning Staff Meeting/Afternoon Follow-up Meeting
1. The principal reviews the facts verbally and in writing to dispel rumors.
2. The Crisis Team discusses possible student reactions, the role of the team, availability for support, and referral process to the team.
3. A room is designated for students to come and talk during the day.
4. Crisis Team members attend the class of the student and discuss the incident.
5. An outside expert may be called to assist students and staff.
6. A letter is sent to students' homes.
7. A staff meeting is held at the end of the day to process, review, and plan.
1. Crisis Team members monitor "high-risk" students.
2. Teachers are informed of funeral arrangements.
3. Memorial requests are reviewed for appropriateness.
4. A staff meeting is held after a week to review actions taken.
Dealing with children and adolescents in crisis can be confusing and frightening. Decisions need to be made quickly and effectively. The Edina Schools team approach is used at the building, district, and community levels. At the building level, two team members meet with the student in crisis. Even in situations where the threat or message is vague and questionable, it works best to handle the situation with the team approach by working in a team. Colleagues can support and consult with each other and make important decisions together.
When a crisis situation occurs, district support from the Crisis Steering Committee is available. They meet with Crisis Team members, sometimes as many as 20, at the school or site. The Team determines what specific steps need to be taken. This meeting allows people to freely express their concerns. Within the Crisis Steering Committee, members gravitate to tasks which are their strengths. In a total team effort, people need to feel comfortable to disagree and reevaluate a situation to provide support to the students/staff involved in the crisis. Teams meet frequently following a crisis to consult and question what needs to be done.
Outside the school organization, the Crisis Team has a liaison with the local law enforcement agency to inform the superintendent or a school representative when a crisis has occurred. The initial contact allows the Steering Committee to contact Crisis Team members quickly to prepare for a thoughtful response. The initial telephone call activates a telephone tree. The Crisis Team also extends into the community. Members reach out to the family, and the Steering Committee collaborates with local religious organizations to provide education for their youth leaders. Religious leaders are notified when a crisis occurs. They can offer support to students in their organizations at their own settings.
Much remains to be done in recognizing and understanding depression and in responding to crises within schools. The need to maintain a support network in the school environment is a priority. The support circle needs to increase. Collaborative efforts with parents and community are essential links. Together, all can foster a nurturing environment sensitive and responsive to individuals in stressful and challenging circumstances.
Berit Peterson, MPH, RN, RHEd, Health Services Coordinator, Edina Schools, 5701 Normandale Road, Edina, MN 55424; Paul Andress, BA, MA, School Counselor, South View Middle School, 4725 South View Lane, Edina, MN 55424; Lily Schroeder, BS, MA, Principal, Kindergarten Center and French Immersion School, Edina Kindergarten Center, 5701 Normandale Road, Edina, MN 55424; Bruce Swanson, BA, MS, LP, School Psychologist, Edina High School, 6754 Valley View Road, Edina, MN 55439; and Lillian M. Dolan Ziff, BS, OTR, MA, School Psychologist, Valley View Middle School, 6750 Valley View Road, Edina, MN 55439. This article was submitted January 15, 1993, and accepted for publication March 29, 1993.
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|Author:||Peterson, Berit; Andress, Paul; Schroeder, Lily; Swanson, Bruce; Ziff, Lillian M. Dolan|
|Publication:||Journal of School Health|
|Date:||Apr 1, 1993|
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