Background: Current social service prevention and interventions in suicidal distress follow a biomedical logic. Recently, critical suicidology and mad studies frameworks have criticized this single-fold approach for limiting the capacity of suicide prevention/intervention to respond to the range of human needs. Aims: The aim of this study was to uncover how people with history of suicidal distress understood their experience of distress, in particular the responses they find helpful and unhelpful. Methods: 4 participants were recruited for semi-structured interviews themed for conceptions of suicidal distress, the experience of ‘reaching out’, and mental health systems change. Results: The findings concluded that participants’ conception of suicidal distress differs from biomedical model paradigms. While practitioner’s responses rely on a notion of suicidal distress as discreet and de-contextual, participants explained suicidal distress as ongoing and based in life circumstances, advocating for a model of suicidal prevention/intervention highlighting the importance of relationships and empathy. / Thesis / Master of Social Work (MSW)

While research studies have investigated suicide prevention and intervention in secondary schools, there is very limited research that explores this support specifically at the elementary school level. This paper reviews the prevalence and associated risk factors of youth and adolescent suicide in the United States and best practices of school counselors providing suicide prevention and intervention in schools. The theory of adolescent suicide and social cognitive theory's self-efficacy will frame the discussion of the literature to provide a holistic picture of the elementary schools' needs of implementing suicide prevention and intervention. This research study is designed to fill a gap in the reviewed literature that shows the need for providing prevention and intervention in elementary school and the education that is currently being provided, as well as the level of self-efficacy among elementary school counselors providing suicide intervention to students at-risk. The following research questions guide the study: 1. What percentage of elementary education school counselors in the surveyed districts report having implemented suicide education as prevention in their elementary school with 4th and 5th graders, and what do these programs entail? 2. What are the perceptions of school counselors regarding the necessity of suicide education programs in elementary school? 3. What is the level of self-efficacy reported by school counselors regarding managing a crisis event of suicidality, such as a suicide attempt or student who died by suicide, as measured by the King Instrument? 4. To what extent are (a) years of experience in the field, (b) suicide education training in graduate school, (c) participation in professional development activities and/or in services, and (d) previous experience with a student expressing suicidal thoughts predictive of a counselor's self-efficacy for providing suicide education in the elementary school? Responses from 98 elementary school counselors employed within three school districts in the mid-Atlantic region were surveyed to examine the current suicide prevention programs in place and explore counselor self-efficacy related to providing suicide intervention for at-risk students. The King Instrument (King, 1999) was adapted for elementary school counselors and used to answer the research questions. A total of 7 of participants reported providing suicide prevention to the upper elementary grades. A much larger number of this sample, 83 (84.7%), perceived that it is the role of the school counselor to identify students at risk of suicide. Participants reported high overall self-efficacy for providing suicide interventions. Only one variable, graduate school training (B=0.249, p<.01), was found to significantly predict self-efficacy. A review of the current study will discuss implications for school counselors and counselor educators, and provide suggestions for future research. / Ph. D.

For youth between the ages of 10 and 24, suicide is the third leading cause of death. School-aged youth that struggle with suicidal thoughts often express their feelings to peers and some trusted adults. Generally, these trusted adults work in school settings. Potentially, teachers and staff can serve as vital gatekeepers to identify and support students who struggle with suicide ideation. In particular, paraeducators, who are often seen as less of an authority figure, become easier to approach due to the personal relationships created in small groups and one-on-one interactions with students. If trained in suicide prevention, paraeducators, who work closely with students and are part of the local community, could become an important gatekeeper. The current study sought to investigate paraeducators' perceptions of the following questions: (a) Are paraeducators approached by students with suicide ideation? and (b) How are paraeducators currently responding to suicidal students? The final purpose of this survey was to collect information that informed and supported the implementation of training for paraeducators in the area of school-based suicide prevention and intervention. This study's survey was distributed in an urban Utah school district to 854 paraeducators. Of the 854 surveys, 77 surveys were completed by paraeducators (9% participation rate). Of the participating paraeducators, 32% reported being approached by a student who expressed suicidal thoughts. Paraeducators indicated that their most frequent response to suicidal students was to provide counsel (39%), whereas to tell supervising teachers or administrators was listed as their third or fourth response option. Most paraeducators (97%) perceived that their role included reporting a student at-risk for suicide, however most (67%) reported having no suicide training or being unsure of what training was available. This lack of training is problematic due to the number of paraeducators being approached by students expressing thoughts of suicide. Additionally this research supports the need to train school support staff.

Suicide has immediate and long-term negative effects on surviving family members and adverse effects in the school and community. Suicide rates for children and adolescents have increased in the United States since 2009. As part of suicide prevention efforts, information about risk factors and warning signs are typically addressed in schools, private organizations, and communities. In addition to academic literature for professional audiences, various therapeutic resources are available to assist those who grieve the suicide of a loved one. In particular, practical and easy-to-implement interventions are needed by those who offer support to suicidal individuals and survivors of suicide. Practical resources are needed to address suicide prevention, intervention, and postvention needs. This study is based on a questionnaire that was given to 250 registered individuals at an annual state suicide prevention training conference. Of those attending, 60 (24%) completed the questionnaire. Participants who did not have experience working with suicidal youth did not participate, so the actual participation rate was influenced by this factor. Questions explored the recommendations of mental health professionals (N=60) who worked with (a) suicidal youth, (b) siblings of youth who completed suicide, and/or (c) youth whose parent completed suicide. More specifically this study investigated specific strategies and resources for working with these three specific groups of survivors. Findings from this study indicated that mental health professionals recommend a variety of suicide prevention resources and strategies such as implementing evidenced-based prevention programs, accessing community resources, offering individual and group counseling for survivors, involving or creating support systems, and listening to the affected youth. Also, recommended therapeutic approaches should include an action plan where students are able to receive appropriate mental health services. Based on this study, mental health professionals may be more effective as they acquaint themselves with available resources such as counselors, school psychologists, and community services to comprehensively care for struggling individuals. Mental health professionals, educators, and staff members should obtain relevant information and utilize effective intervention models in order to better address the prevention, intervention, and postvention needs of surviving individuals.Recommendations are made for future research in identifying the combination of resources that are most helpful. Recommendations are also made regarding specific content and training strategies to more effectively prepare and equip professionals to engage more fully in effective and supportive suicide prevention efforts.