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School Crisis Toolkit

Please note that this toolkit is a working draft for stakeholder review and input. It should not be considered final.

About

This toolkit is designed to ensure that Colorado's schools are prepared to be readily available and responsive to students and school communities that are experiencing a mental health crisis by providing timely crisis assessment, intervention, and postvention strategies and support tailored to meet the unique needs of individual students, families, and the school community.

How to Use the Toolkit

The school crisis toolkit is divided into three main sections: Prevention, Intervention, and Postvention. Each section contains several pause-points to consider to plan and prepare for the event of a school or student mental health crisis. The items listed under each pause point are crucial to ensure that all responding school staff understand the individual student and their presenting concern well enough to respond in a meaningful, cultural- and trauma-informed way to a school or student mental health crisis. These pause points can be used and implemented proactively to address any barriers to an effective response. The school crisis toolkit website contains supporting resources corresponding with each pause point to enhance the school’s and professionals’ understanding of and access to support and resources available.

School Crisis Prevention Banner

Pause Point #1: Education, Training, and Professional Development

The following components support staff and community members in learning how to identify and support someone who may be having thoughts of suicide.

  1. Focus on promoting a positive school climate and establishing relationships between students and trusted adults.
  2. Mental health and suicide prevention is embedded in health and wellness education. The Colorado Safe Schools Resource Center recommends that students have at least three suicide prevention curricula opportunities in elementary, middle, and high school.
  3. Establish a care team that includes an administrator.
  4. Identify which staff will provide mental health and suicide prevention education.
  5. All teachers and school staff understand their role and expectations as mandated reporters.
  6. Ensure all teachers and school staff are educated on FERPA.
  7. All school staff (teachers, administrators, janitorial, etc.) have received information about the necessity for school-based suicide prevention efforts and participate actively in these.
  8. All school staff have been trained to recognize students in crisis and suicidal despair and know how to respond and refer.
  9. Ensure your school or district has licensed mental health providers: counselors, social workers and psychologists who have been trained to assess, intervene, and refer students in crisis and suicidal despair. If your district does not have licensed school mental health providers, utilize school counselors to partner with your Community Mental Health Center to assess.
  10. Ensure all school staff are aware of suicide prevention policies and procedures, including knowing the trained staff who will assess, intervene and refer. Create a list of these staff members and their contact information so that staff can quickly refer to trained staff.
  11. Ensure all school staff understand suicide risk assessment and threat assessment policies and procedures, including knowing the trained staff who will assess, intervene and refer. Create a list of these staff members and their contact information so that staff can quickly refer to trained staff.

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Pause Point #2 Parent, Guardian, and Community Engagement

Suicide prevention is a community issue. The more a school can work with parents, guardians, and the greater community, the better the supports are for young people.

  1. Develop a method and protocol for educating parents, guardians, and community members about suicide and related mental health issues.
  2. Develop creative ways to increase levels of participation in programs to educate parents, guardians, and community members.
  3. Develop a mental health community provider resource directory that lists the provider name, specialty, geographic distance to the serving school, and accepted insurance that can be available and provided to parents.
  4. Develop a list of helpful resources for parents (example: ParentGuidance.org)

Resources

1. Recommended trainings include: 

2. Parent Guidance​​​​​​​

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Pause Point #3: Universal or Targeted Screening for Mental Health

  1. Select evidence based screening tools using data about the needs of your student population (depression, anxiety, self-harm risk, etc.). (See SHAPE System for screening library). Behavioral health screening most often requires active parental consent versus social emotional screening.
  2. Conduct district readiness assessment prior to beginning universal screening. Refer to the National Center for School Mental Health for more information on screening readiness.
  3. Establish partnerships with community mental health services.
  4. Identify which staff will be tasked with conducting screenings and assessing the results.
  5. Provide evidence-based training on screening implementation protocols and procedures to targeted staff.
  6. Determine when and how often students will be screened (Fall, Winter, Spring).
  7. Identify students with risk factors that may necessitate a screen, such as a recent hospitalization, recent community or widely known suicide, returning from a facility school, etc.
  8. Develop a process to review and evaluate screening results, including how results will be flagged for needed referrals and follow-up.
  9. ALL students who have a positive screens for suicide risk or students that report or indicate thoughts of self harm to receive a full assessment. (See Intervention: Pause Point #1)

Resources

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School Crisis Intervention Banner

Pause Point #1: Assessment

  1. Identify trained school staff (or trained contact in your region) to conduct a full suicide and risk assessment on all students that have a positive assessment for suicide risk.
  2. Develop a form to complete and score the assessment for the degree of risk using evidence-based risk assessment questions and considerations.
  3. Have a clear process in place to conduct the full suicide and risk assessment with specific steps to take after the assessment is completed (refer, safety plan, follow-up).
  4. ALL students who have a positive assessment for suicide risk to receive collaborative safety planning and lethal means counseling (Pause Point #2).

Resources
  1. CSSRC
  2. SBIRT - Screening, Brief Intervention and Referral to Treatment
  3. The CRAFFT - substance use screening tool for adolescents aged 12-21
  4. The Columbia - Suicide Risk Assessment suitable for all ages
  5. The PHQ9 - Quick depression assessment ages 12 - 18
  6. The GAD7 - Assessing for Anxiety ages 13+
  7. Other interventions should focus on building trust and can incorporate non-traditional treatment approaches including but not limited to assistance in meeting basic needs, teaching and practicing de-escalation and calming techniques, using art and other creative therapy approaches, engaging in culturally relevant conversations and practices, the use of somatosensory approaches, and incorporating peers in recovery conversations with the young person and/or family.

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Pause Point #2: Collaborative Safety Planning and Lethal Means Counseling

  1. Engage Colorado Crisis Services (or local mobile support line) when the risk assessment indicates a concern for suicide.
  2. Determine who and when will make the call. Identify who will provide safety planning and lethal means counseling and provide evidence based training for those staff.
  3. Conduct a mock drill for safely, sensitively, and collaboratively completing a safety plan that addresses at home, school, and community supports and risk factors.
  4. Work collaboratively with the student and guardian to create a safety or coping plan.
  5. Follow school policy to contact guardians and provide counsel on strategies to keep the home safe during periods of crisis.
  6. Hospitalization is always a last resort, if efforts at safety planning and referral fail to mitigate risk.
  7. Identify and label where all necessary forms such as M-1 Mental Health Hold and Evaluation forms, for hospitalizing suicidal students will be kept.
  8. Identify who will sit with the student while waiting for transport to the emergency department if necessary.
  9. Conduct a mock drill for safely and sensitively working with and potentially hospitalizing a student only as a last resort.

Resources
  1. CALM Training
  2. Utilize the Safeguard Your Home brochure from the Office of Suicide Prevention
  3. Utilize Lock2Live (English and Spanish)
  4. Utilize firearm storage map provided by the Colorado Firearm Safety Coalition to
  5. Identify community-based options for out of home storage

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Pause Point #3: Intervention Considerations

  1. Colorado Safe Schools Resource Center and 20-point assessment. (add link)
  2. Level of intervention and triage should be based on the results of the full assessment.
  3. Consider if there are other assessments or tools that would be relevant for the student and family in order to best match the intervention with the needs of the student and family.
  4. Identify any risk factors that need to be addressed.
  5. Identify strengths and protective factors.
  6. Determine if the student is diagnosed with or expressing symptoms of Intellectual and Developmental Disabilities (IDD) or Traumatic Brain Injury (TBI) and provide them with supports related to these needs.
  7. Consider if the student in crisis is pregnant, trying to conceive, or pregnant in the last year and the result of the pregnancy.
  8. Focus on brief intervention.
  9. Consider who else will need support and skills during and after the student’s crisis (educators, family, natural supports).
  10. Consider other current or needed child-serving system involvement (Child Protective Services, Juvenile Justice/legal involvement, etc.).

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Pause Point #4: Referral and Care Coordination

  1. Have a systematic referral process in place using a form or online system to make and track the referral.
  2. Develop a mental health community provider resource directory that lists the provider name, specialty, geographic distance to the serving school, and accepted insurance.
  3. If possible, have MoUs or written agreements in place with community providers that establish agreed upon referral procedures and ensure safe, effective, and timely mental health services.
  4. Develop a referral feedback process with an assigned mental health provider. Identify the school staff person who will make the referral and notify the provider to contact the student or family. Develop a post-referral process with the assigned mental health provider to obtain an RoI in order to receive updates about student safety relevant to the school setting.
  5. Identify who will make the referral and who will notify the provider to contact the student or family.
  6. Complete ROIs for all involved child-serving agencies to ensure continuity of care.

Resources
  1. Conduct a mock drill for calling Colorado Crisis Services and identifying community supports.
  2. Community Mental Health Centers 
  3. Second Wind Fund
  4. CAMS - Identify community providers who have been trained in evidence based suicide care models
  5. Colorado Safe Schools Resource Center
  6. The Children and Youth Mental Health Treatment Act (CYMHTA): If the child/youth (under 18) has private or no insurance (can’t have Medicaid) the parent/legal guardian can contact the Administrative Services Organization for an assessment under CYMHTA. CYMHTA can assist with funding for ongoing behavioral health services. Provide the family with the ASO CYMHTA Liaison contact information, documentation/collatrotate information, etc. 
  7. Colorado’s System of Care/COACT Colorado using High Fidelity Wraparound with peer support services can support a child/youth (0 through 21 years) with complex behavioral health needs and multiple system involvement and their caregivers with an evidence based care coordination model. Caregivers can use the COACT Colorado to see if services are offered in their area.
  8. The Momentum Program at Rocky Mountain Human Services (RMHS) Eligibility criteria for children and adolescents(under age 21) include the following: Psychiatric admissions greater than two weeks, or three or more psychiatric hospitalizations within the last year. Psychiatric hospitalizations of three weeks or more with multiple-system involvement (e.g. juvenile justice, child welfare, school detention/suspensions, IEP) within the last year. 
  9. Community Center Boards (CCBs) Case Management Services for children with intellectual and developmental disabilities can assist a person in accessing necessary services and supports to meet his or her needs. Services include intake, eligibility determination, service plan development, arrangement for services, delivery of services, service and support coordination, monitoring, any safeguards necessary to prevent conflict of interest between case management and direct service provision, and termination and discharge from services. 
  10. Below the Surface/Colorado Crisis Services: Share resources from the State's youth-focused Below the Surface campaign, which highlights the Crisis Services’ text line

 

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School Crisis Postvention

Pause Point #1: Policies and Protocols

  1. Develop a written protocol for supporting a student’s return to school after a suicide attempt or mental health crisis.
  2. Develop written protocols with pre-established communication messages for each of the following:
    • Responding to a suicide attempt within the school community
    • Responding to students after a suicide attempt on school property
  3. In these written communication messages, consider the impact on student and school staff mental health, as well as student or school staff confidentiality. Ensure communication is trauma informed and avoids any retraumatization.
  4. Develop school specific guidance for community mental health or private practitioners around clarifying role and supporting students after a suicide attempt.
  5. Create a policy for memorials.

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Pause Point #2: Providing Support After Death from Suicide in the School Community

  1. Develop a written protocol for responding to the suicide of a student or other member of the school community.
  2. Develop written protocols with pre-established communication messages for responding to the suicide of a student or other member of the school community.
  3. Familiarize and train school community and staff on After a Suicide: A Toolkit for Schools (2nd ed).

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