Suicide prevention, intervention and postvention 

Suicide is one of the most tragic and concerning issues of our time. It is important that school leaders understand the prevalence of youth suicide and take a proactive approach to prevention and intervention. 

What the research tells us 

• In Ontario, 1 in 6 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 third leading cause of death for children aged 10 to 14. For adolescents aged 15 to 19, suicide was consistently the second leading cause of death. 
• By around the age of nine, many children have a thorough understanding of both death and suicide. 
• Regardless of whether or not 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. 
• 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. 
• Recent data (2022) suggests that the rate of suicidal thought and behaviour among Black youth is also increasing.

Why this is important 

• Schools are uniquely positioned for the work of mental health promotion, early identification and suicide prevention. 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. 
• 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. 

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. 

Prevention 

• Mental health promotion is an essential component of a comprehensive approach to suicide prevention. Your school’s work at Tier One is part of suicide prevention. 
• Careful thought must be given when considering more specific suicide awareness activities within school boards. This area of work is extremely complex and carries many risks. Consult with the mental health leader or a school mental health professional at your school and be familiar with School Mental Health Decision Support Tool: Student Mental Health Awareness Initiatives – Version for School Administrators. 
• Decision-making should consider the best available research, resources available, clinical judgment and other (cultural) ways of knowing. Consider the unique needs of students, using a culturally responsive and identity-affirming stance, which, when aligned with evidence-informed programming, will lead to not only meeting student needs but also improved outcomes for students. 

Intervention 

• When you become aware of a student experiencing suicidal thoughts or ideation, follow your board procedure. If your concern is urgent (e.g., suicide risk or risk to others/imminent danger), act immediately to activate school protocols. Never leave the student alone. 
• A trained mental health professional is responsible for conducting a comprehensive risk assessment, but a school administrator can provide the calming support needed to ensure that the student and others are safe. 
• If a comprehensive risk assessment is conducted, work alongside the mental health professional, student and family to create a plan to address short- and long-term safety. 

Postvention  

• When a student dies by suicide or makes a serious attempt to die by suicide, it is a unique kind of tragic event requiring specific, intentional and thoughtful action (often called postvention) at the system and school levels. 
• Board procedure can assist in ensuring that your response is aligned with best practices for school communities coping with the death of a student by suicide. 
• A Canadian study confirmed that young people (aged 11 to 18) are particularly susceptible to the idea of suicide and that those who know someone who has died by suicide are much more likely to consider or attempt suicide themselves. This is why we sometimes see clusters of suicidal behaviour in a school or community. 
• After a death by suicide, school communities are at risk for more suicidal behaviour for up to two years. These concerns of contagion highlight the need for intentional, well-thought-out postvention strategies responsive to the individual school needs. Postvention collaboration involves schools, parents/caregivers, community mental health agencies, hospital, cultural and religious partners working together. 
• Memorialization after the death of a student requires thoughtful consideration. Decisions regarding memorialization should balance the desire to acknowledge grief as well as future impacts on students and staff. Permanent memorials are not recommended. 

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 taking 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. 

Working together for student safety and well-being 

Preventing suicide and supporting student mental health is a shared effort across the school community. By working together as educators, families, students and community partners, we can build caring, connected environments where students feel seen, supported and comfortable to reach out for help when they need it most.

Resources to support youth suicide prevention

• Classroom resource
• External resource
• Guide/tool

Life Promotion Toolkit and supporting resources

• Available in print
• Guide/tool

National Guide for Suicide Prevention and Life Promotion in Schools: A national guide for system leaders

Tragic events

Tragic events, like accidents, natural disasters, violence and hate crimes can affect individuals, classes, schools, communities and beyond. Your school board has processes in place for dealing with critical incidents and tragedies. You will be supported as you help your school community through times of uncertainty, tragedy and loss. 

Why this is important 

• News and information, both factual and speculative, can cause students to experience a wide range of emotions and can affect students’ ability to learn and how they interact at school. 
• Tragic events or situations can compound existing challenges for students, staff and parents/caregivers who may already be coping with ongoing injustices and harms or losses. 
• A calm and supportive classroom environment and predictable routines of school can be helpful to students following a tragic event or during times of uncertainty. 

Common reactions to tragic events 

How students react to events will vary. Developmental stage, physical or emotional proximity to the event, and prior experience with traumatic circumstances can affect how students respond. Reactions can last for days and sometimes weeks.  

Reactions may include: 

• absenteeism 
• anger or irritability 
• anxiety 
• fatigue 
• lack of focus 
• physical complaints 
• sadness 
• social distancing 

Typically, they subside over time as we help students talk through feelings, reassure them that they are safe and protected, and help them to gain perspective. 

How schools can help 

Lean on the guidance and resources from your board’s mental health leadership team and critical-incident response team as you work through times of uncertainty and tragedy. Here are some general considerations for you and your team. 

Maintain a calm classroom environment 

• During challenging times, the reactions of adults will set the tone for students. 
• Set a calm pace for learning, extending deadlines as needed. 
• After students have had time to absorb the news and process/ seek support, try to maintain regular, predictable routines. 
• Reduce the emphasis on and duration of formal lessons. 
• Consider whether any sensitive curriculum content might need to be delayed/changed. 
• Use learning activities that allow you to float and check in with students. 
• Create quiet spaces for student reflection and dialogue within the classroom. 
• Encourage students to take breaks from the news and social media. 

Support students as they work through strong feelings after a tragic event, in the course of daily school life 

• Rather than starting a discussion at a class level, invite students to initiate conversations when the time is right for them. 
• Listen well and notice how students are viewing the situation. 
• Keep explanations of situation or events age-appropriate and factual. 
• Calm worries, reaffirm safety procedures, and reassure students that they are safe. 
• Validate feelings of sadness, anger, anxiety, etc., and note that it may take time to work through these emotions. 
• Encourage students to draw on their faith, usual supports, self-care skills, and other sources of strength. 
• Model compassion, positive coping, and self-care skills. 
• Help students to notice quiet heroes and signs of hope. 

Notice when a student is struggling and may require additional support 

• Make a list of students who may be at risk given proximity to the tragic event. 
• Monitor these students more closely, checking in with them each day. 
• Be mindful that there may be students without an obvious link or vulnerability who may experience difficulty. 
• Watch for changes in student behaviour or emotions that are excessive in duration and intensity. 
• Watch for signs that student behaviour or emotions are interfering with day-to-day functioning at school. 
• If you have concerns, record your observations and consult with the school mental health professional assigned to your school. 
• Discuss your concerns with the student in a compassionate and age-appropriate manner. 
• Use regular school/class protocols to connect with parents/caregivers to discuss your observations and concerns. 

Offer additional classroom support, as needed 

• Welcome students who may be more at risk in a calm, caring, and intentional way each day. 
• Let students who are struggling know about available school supports and how to access them. 
• Create opportunities for quiet check-ins and dialogue. 
• Maintain academic expectations, but soften these if a student seems overwhelmed. 
• Help students to complete school tasks by chunking assignments, pairing them with another student, etc. 
• Offer more time to complete tests and assignments, as needed. 
• Allow students to cue you if they are struggling and want to talk or need to step back from a task for a time. 
• Help students to engage in activities that may assist with healing (e.g., write a card, make a donation). 

Help students who are struggling and their families access more intensive supports, as needed 

• Know about available supports at the school, board, and community level. 
• Know your local pathway to access services. 
• Work with the school team to describe available supports to the parent/caregiver and/or student. 
• With parent/caregiver consent, share your observations to assist with referrals and treatment planning. 
• Continue to provide classroom accommodations to students struggling after a tragic event. 
• Use classroom strategies recommended by the service provider. 

Take care of yourself and your team 

• Recognize that grief reactions can last for many days or weeks. 
• Take the opportunity to process the situation and your feelings with your friends, family, and colleagues. 
• Try to keep regular schedules and routines. 
• Remember to eat, sleep, play, exercise, and laugh. Give yourself permission for down time. 
• Practice positive ways of coping with sadness, fear, anger, and worry. 
• Ask for help. You don’t have to face this experience alone. Help is available for you through your employee assistance program, or you may wish to consult with your family physician or contact a local helpline. 

Resources about supporting students after tragic events

• Info sheet

Ways to Help Students in Response to World Events