Santa Clara County Behavioral Health Board Discussion Mary/Victor - - PowerPoint PPT Presentation

Santa Clara County Behavioral Health Board Discussion

Mary/Victor Ojakian BHB Sept 12 2016

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Data on California Youth Suicides

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Suicide Prevention Policy

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Santa Clara County Suicide Prevention Actions

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Youth Suicide Clusters

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LGBTQ Youth and Suicide Prevention

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Current Events

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Youth Involvement

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Current California Legislation

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Suicide Prevention Toolkit for Schools

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Questions and Answers

Mary/Victor Ojakian BHB Sept 12 2016

Excellence is the result of caring more than others think is wise, risking more than others think is safe, dreaming more than

• thers think is practical, and expecting more than others think

is possible.

• Anonymous

Mary/Victor Ojakian BHB Sept 12 2016

California children/youth (0-19 years old) suicides data (1991 – 2013):

• Total suicide deaths: 3,962
• Average annual number of suicide deaths: 172
• Youth percentage of total suicides(all ages): 5%

Source: California Epicenter database

Mary/Victor Ojakian BHB Sept 12 2016

California children/youth (0-19 years old) suicide attempt data:

• Hospitalizations (1991–2014):

 Total non-fatal injuries: almost 71,000  Average annual number of suicide attempts: About 3,000

• Emergency room visits (2006–2014):

 Total non-fatal injuries: almost 78,000  Average annual suicide attempts: about 8,600  Trending upward recently with a high of 11,779 attempts (2014)

• Youth percentage of total suicide attempts(all ages): 25%

Source: California Epicenter database

Mary/Victor Ojakian BHB Sept 12 2016

Californi rnia Childre ren/Y /You

• uth

th (0 (0-19) 19) 1991 to 2012 2012 1991 to 2012 2012 2006 2006 - 2012 2012 County Suicide de Deaths Hospi pita talizat zations ER Visits ts Los Angeles 891 17,269 11,445 San Diego County 314 5,512 4,489 San Bernardino County 253 3,956 3,785 Orange County 248 6,104 3,767 Riverside County 189 4,643 3,666 Sacramento County 179 2,000 2,573

Mary/Victor Ojakian BHB Sept 12 2016

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Questions:

• Are there prescribed student suicide policies and procedures pre-written

and available for school district adoptions?

• Have Santa Clara County public schools adopted student suicide

prevention policies and procedures (administrative regulations)?

• What should a student suicide prevention include?
• Why would a school district adopt a student suicide prevention policy and

procedures (administrative regulations)?

Mary/Victor Ojakian BHB Sept 12 2016

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The California School Board Association has templates for:

• Standard suicide prevention policy (BP 5141.52)
• Administrative regulation (AR 5141.52)

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The California Office of Education is working on a new, detailed, student suicide prevention policy

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Santa Clara County:

• Thirty-two (32) school districts and the Santa Clara County Office of

Education (SCC OoE)

• Twenty-eight (28) districts and OoE have student suicide prevention policies
• Twenty-six (26) districts have administrative regulations

Mary/Victor Ojakian BHB Sept 12 2016

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Yes, most Santa Clara County school districts have a suicide prevention policy per this schedule:

• Five school districts: SP policy & ARs prior to 2010
• Four school districts: SP policy & ARs in 2010
• Five school districts: SP policy & ARs in 2012
• Ten school districts: SP policy & ARs since June 2013
• Four school districts: SP policy & ARs since 2013
• Three school districts: no indication of any action
• One district: unique, so no request was made

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Santa Clara County Office of Education: SP policy & ARs

Mary/Victor Ojakian BHB Sept 12 2016

Alum Rock Union School District Fremont Union High School District Milpitas Unified School District Orchard School District Berryessa Union School District Gilroy Unified School District Moreland School District Palo Alto Unified School District Campbell Union High School District Lakeside Joint School District Morgan Hill Unified School District San Jose Unified School District Campbell Union School District Loma Prieta Joint Union School District Los Altos School District Mount Pleasant School District Saratoga Union School District East Side Union High School District Los Gatos Union School District Mountain View Whisman School District Sunnyvale School District Evergreen School District Los Gatos-Saratoga Joint Union H.S. District Mountain View Los Altos High School District Union Elementary School District Franklin-McKinley School District Luther Burbank School District Oak Grove School District Santa Clara County Office of Education Mary/Victor Ojakian BHB Sept 12 2016

ALPINE COUNTY UNIFIED SCHOOL DISTRICT Fairfield-Suisun Unified School District Salinas Union High School District Beaumont Unified School District FORTUNA UNION HIGH SCHOOL DISTRICT SANTA MONICA-MALIBU UNIFIED SCHOOL DISTRICT Claremont USD Gonzales Unified School District SANTA YNEZ VALLEY UNION HIGH SCHOOL DISTRICT Chula Vista Elementary School District Lompoc Unified School District SCOTT VALLEY UNIFIED SCHOOL DISTRICT Davis Joint USD Murrieta Valley Unified School District Woodland Joint Unified School District EL RANCHO UNIFIED SCHOOL DISTRICT Pleasanton Unified School District Mary/Victor Ojakian BHB Sept 12 2016

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Check the Board Policy section of your school district website

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Access Gamut (an online tool that tracks school district’s policies)

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Go to the 5000 Student section

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Check for BP 5141.52 and AR 5141.52

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Check the approval date and resources to ensure they are current and maintained

Mary/Victor Ojakian BHB Sept 12 2016

• Here are some criteria:

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Communication approaches and plan

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Education and training program to improve awareness

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Data/surveillance collection and analysis

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Interventions and Screening programs

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A peer support organization

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Crisis planning including follow-up response (i.e. crisis response team)

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Parental involvement

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Reference existing state, county, and other school district suicide prevention plans

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Timeline to implement strategies

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Funding suggestion(s)

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Distribution plan

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An annual update of accomplishments and next steps

Mary/Victor Ojakian BHB Sept 12 2016

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A policy authorize and legitimizes suicide prevention actions

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Here are some justifications:

• A critical time for mental heath conditions: the teenage years
• Suicide: the second leading cause of death for 10 – 19 year olds
• A call to have school suicide prevention strategies: Superintendent Tom

Torlakson’s January 2013 letter

• A call for a student suicide prevention policy: Superintendent Tom Torlakson’s

July 2014 letter http://www.cde.ca.gov/nr/el/le/yr14ltr0721.asp

• Parental concerns are about children mental-emotional health: Lucile Packard

Children's Health Council Bay Area parents survey(2006)

• School children do exhibit mental health conditions: Santa Clara County study -
• Every Child Has a Story: The Need For Mental Health Prevention and Early

Intervention Services (2008)

• School psychologists have concerns: National Association of School Psychologist

(NASP) Presidents’ Call To Action letter (2009)

Mary/Victor Ojakian BHB Sept 12 2016

“Even if legal liability is uncertain, however, no agent of a school board

should ignore a student’s cries for help; and no school board should ignore the possibility that a well-defined suicide prevention policy, combined with staff training and accessible higher officials, could further reduce the chances that this sort of suit will ever be considered.” (Student Suicides and School System Liability by Cindy Singer Cafaro , page 28) http://sogpubs.unc.edu/electronicversions/slb/slbsprsum00/article2.pdf

Mary/Victor Ojakian BHB Sept 12 2016

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In Santa Clara County these actions occur/occurred:

• A Santa Clara County Suicide Prevention Oversight Committee (SPOC):

 Responsible for Suicide Prevention Strategic Plan (2010) https://www.sccgov.org/sites/mhd/Providers/SuicidePrevention/Docum ents/Suicide-Prevention-Strategic-Plan-Final-Draft-for-BOS-_5_.pdf  Strategy Four: Implement Policy and Governance Advocacy to Promote Systems Change in Suicide Awareness and Prevention  Section IV: Local Needs Across the Age Span:  For children (0 - 15) and young adults (16 – 25) the following was done:  Identified Needs and Concerns  Recommended Priority Populations  Recommended Suicide Prevention Strategies  See Appendix I for details

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Produces an annual data analysis report of all county suicides

Mary/Victor Ojakian BHB Sept 12 2016

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Definition: A group of suicides or suicide attempts, or both, that occur closer together in time and space than would normally be expected in a given community. (Stephen Brock and Richard Lieberman) http://www.aacps.org/admin/articlefiles/480-

• pening%20session1.Clusters.8.30-9.45.pdf

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No one in the State of California government tracks youth suicide clusters

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In the last twelve years, there are fifteen (15) active or recently dormant teen suicide clusters in California. (There are possible more than 15)

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Newspaper coverage can have an impact. Factors contributing to teen suicides include: front-page placement; headlines containing the word “suicide” or a description of the method used; and detailed descriptions of the suicidal individual and act, including the name of the individual who died. http://www.sprc.org/news/youth-suicide-clusters-and-newspaper-coverage

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Center for Disease Control (CDC) writings, including Recommendations for a Community Plan for the Prevention and Containment of Suicide Clusters http://wonder.cdc.gov/wonder/PrevGuid/p0000214/p0000214.asp

Mary/Victor Ojakian BHB Sept 12 2016

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LGBTQ youth: increased risk for suicidal thoughts, suicide attempts, and suicide.

• A nationally study of grades 7–12 adolescents: LGB youth were more than

twice as likely to have attempted suicide as their heterosexual peers.

• A transgender youth study: about 25% reported suicide attempts.
• More information here: http://www.cdc.gov/lgbthealth/youth.htm

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Trevor Project http://www.thetrevorproject.org/

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Services in Santa Clara County for LGBTQ youth:

• Youth Space (Family and Children's Services)
• Project Outlet (Adolescent Counseling Services)
• LGBTQ Ethnic Cultural Community Advisor Committee (March 2015)

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There are suicide prevention gatekeeper trainings tailored for the LGBTQ community

Mary/Victor Ojakian BHB Sept 12 2016

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Most suicide prevention studies are limited to LGB youth with exceptions:

• The Suicide Prevention Resource Center: over 1,400 articles and studies

http://www.sprc.org/search/gay%20suicide%20

• LGBT Youth

h (CDC): C): provides insights on how schools and parents can be

• helpful. http://www.cdc.gov/lgbthealth/youth.htm
• Suicide

e risk and preventi vention

• n for lesbi

bian, n, gay, bisexua exual, l, and transgend sgender er youth h (SPRC, C, 2008) ) http:/ p://www.s .sprc.or prc.org/si site tes/ s/def defaul ult/f t/fil iles es/migr igrate te/lib ibrar ary/S y/SPRC_L PRC_LGB GBT_Yout

• uth.p

h.p df df

• Preven

venti ting ng suicida dal l behavior vior among lesbi bian, n, gay, bisex exua ual l and transgend sgender er youth: h: Develop elopin ing LGBT cultura ural competenc tence e (SPRC) C) http:/ p://www.s .sprc.or prc.org/si site tes/ s/def defaul ult/f t/fil iles es/migr igrate te/lib ibrar ary/P y/Prev reventi enting ngSui uicid idalBe Be haviorLG

• rLGBT

BTYo Youth uth.pdf .pdf

• Protec

ecti tive ve Sc School Clima mates es and Redu duced ed Risk sk for Su Suicide de Ideation tion in Se Sexual Minori rity ty Youths hs A supportive school environment can virtually eliminate the disparity in the rate of suicidal thoughts between lesbian, gay, and bisexual (LGB) youth and their heterosexual peers, according to the authors of a study that correlated Youth Risk Behavior Surveillance System data with school climate... http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935661/

Mary/Victor Ojakian BHB Sept 12 2016

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Read the Weekly Spark (SPRC) http://www.sprc.org/news-and-highlights

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Read the AFSP Daily News Clips: Alexis O'Brien AOBrien@afsp.org]

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Some recent stories:

• Parents'

' psychiatr iatric ic disease se linked to k kids' risk of suicid ide attemp mpt, violent offen endi ding ng: Suicide and violent behaviors can cluster within families, possibly because of genetics, epigenetics, and social and environmental influences. http://medicalxpress.com/news/2016-08-parents-psychiatric-disease-linked-kids.html

• Mental

l Health In S Schools: s: A Hidden Crisis s Affec ectin ing Millions s Of Students: Experts say schools could play a role in identifying students with problems and helping them succeed. Yet it's a role many schools are not prepared for. http://www.npr.org/sections/ed/2016/08/31/464727159/mental-health-in-schools-a- hidden-crisis-affecting-millions-of-students

• Bipolar Disorder

er And Addictio ion: : Teens With Mental l Health Conditio ion At Increase sed d Risk For Substance ce Abuse: Teenagers suffering from bipolar disorder are especially at risk of developing later drug problems by the time they reach adulthood http://www.medicaldaily.com/bipolar-disorder-and-addiction-teens-mental-health- condition-increased-risk-396480

• Pediatric

icians ians can help identify fy suicida dal l teens: The American Academy of Pediatrics recently updated guidelines advising pediatricians how to identify and help teenagers at risk for

• suicide. The group wants pediatricians to screen patients for suicidal thoughts and risk

factors for suicide, such as bullying. http://www.baltimoresun.com/health/bs-hs-expert- pediatric-suicide-20160824-story.html

Mary/Victor Ojakian BHB Sept 12 2016

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Directing Change Campaign

• One minute PSA videos on mental health and suicide prevention by high

school and college students

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2016 data:

• 451 films entries about mental health and suicide prevention
• 1,113 young people made submissions
• 91 high schools and 35 colleges and youth organizations participated
• 31 counties participation
• Entries

ries by S Santa Clara county schools: s: one (1)

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Information: http://www.directingchange.org/

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To watch and use films, including 2016 entries: http://www.directingchange.org/2016-winners/

Mary/Victor Ojakian BHB Sept 12 2016

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Currently 2,127 proposed bills on mental health care. http://leginfo.legislature.ca.gov/faces/billSearchClient.xhtml (Check Status tab)

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AB 1644 (Bonta): supports trauma and mental health services for young children by “rebooting” the Early Mental Health Initiative, specifically focusing

• n addressing childhood trauma and targeting services to those who have

been most impacted by exposure to trauma. http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=20152016 0AB1644 No Opposition, Referred to Senate Appropriations, Hearing 8/1, 8/1 Amended and re-referred to Senate Appropriations Suspense File, 8/9

• n Senate Appropriations Agenda for 8/11, Held under

r submissi ssion

• n in Senate

e Approp

• pria

riatio tions. s.

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AB 2246 (O’Donnell): Pupil suicide prevention policies would be required by all California school districts. http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=20152016 0AB2246 No Opposition, Amended/Referred to Senate Appropriations, Hearing 8/1, 8/1 Ordered to Senate Appropriations Suspense File, Sent to the he Governo rnor r 8/30

Mary/Victor Ojakian BHB Sept 12 2016

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These bills would seek accountability and determination of school mental health services in the wake of AB 114:

• SB 1113 (Beall): Pupil health: mental health

http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=20152016 0SB1113 Passed 3rd reading in Senate 8/18, Assembly amendments concurred in. (Ayes 39. Noes 0.) Ordered to engrossing and enrolling. 8/25; Sent to the Govern ernor

• r 8/31
• SB 884 (Beall): Special education: procedural safeguards and records

http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=20152016 0SB884 Passed 3rd reading in Senate 8/18, Assembly amendments concurred

• in. (Ayes 39. Noes 0.) Ordered to engrossing and enrolling. 8/25; Sent to the

Gover ernor nor 8/30

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AB 2017 (McCathy): proposed by Former Senator Darrell Steinberg this bill would authorize some MHSA funds be used to promote California public college/university mental health services through a matching grant program http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160A B2017 No Opposition, referred to Senate Appropriations, Hearing 8/1. 8/1 Read 2nd time, amended and Re-referred to Senate Appropriations, 8/9 on Senate Appropriations Agenda for 8/11, Sent to the Governor rnor 8/31

Mary/Victor Ojakian BHB Sept 12 2016

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SB 877 (Pan): California would provide data for the National Violent Death Reporting System http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB8 77 No Opposition, Read 2nd time, amended/referred to Assembly Appropriations and heard 8/3 then referred to Assembly Appropriations Suspense File, , on Assembly Appropriations Agenda for 8/11 Sent to the Governo rnor r 8/30

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AB 1884 (Harper): State Department of Health Care Services would be required to apply to the DMV to sponsor a mental health awareness license plate program and establish the Mental Health Awareness Fund in the State Treasury for mental health awareness and education. http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB 1884&search_keywords=mental+health Opposition: ACLU, ordered for 3rd

reading in the Senate 8/10, Sent t to the Governor rnor 8/25

Mary/Victor Ojakian BHB Sept 12 2016

Toolkit for Mental Health Promotion and Suicide Prevention K-12

Mary/Victor Ojakian BHB Sept 12 2016

1.

Promotion of Mental Health & Well-Being

2.

Intervention in a Suicidal Crisis

3.

Postvention Response to Suicide of a School Community Member

4.

Appendices:

• A. Policy and Administrative Regulations & CA Mental,

Emotional & Social Health Standards – Grades 9-12

• B. Handouts for Students and Parents
• C. Kara Grief Support

Mary/Victor Ojakian BHB Sept 12 2016

Promotion

• motion of

well-bei being ng Inte tervention rvention Postvention stvention Appendices endices

Social emotional learning (SEL) in Elementary & Middle School Means Matter Self-care & Grief Parent education & resources FAQ for teens & families HIPAA/FERPA in California Transitions Healthy sleep Green Folder

Mary/Victor Ojakian BHB Sept 12 2016

Mary/Victor Ojakian BHB Sept 12 2016

Questions and Answers

Mary/Victor Ojakian BHB Sept 12 2016

Identi tifie fied Needs and Concerns

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Inadequate sense of control in a life phase when youth have limited control

• ver their lives

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Difficulty accessing available mental health services, education and support to prevent substance abuse

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Lack of strong resiliency skills to cope with failure and disappointment, bull ying, and breakups

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Inadequate defined support, connections to community, unconditional acce ptance, and sense of communal responsibility for safety

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Low feelings are perceived as abnormal

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Lack of self‐esteem, sense of accomplishment, and sense of hope

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Lack of respect for peers, adults, and themselves

Source: Santa Clara County's Suicide Prevention Strategic Plan page 50 https://www.sccgov.org/sites/mhd/Providers/SuicidePrevention/Documents/Suicide%20Prevention%20S trategic%20Plan%20Final-2011%20Rev.pdf

Mary/Victor Ojakian BHB Sept 12 2016

Recommen ended ded Priorit rity Populatio tions

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Children and youth experiencing: Academic difficulties; changing schools; life milestones

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Immigration concerns; refugee experience; acculturation stress; linguistic and/or cultural differences

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Trauma (sexual, physical, emotional, exposure to violence)

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Suicide of friends; suicide attempts; mental illness; substance abuse

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Separation from family; homelessness

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Juvenile justice/foster care system involvement

Gender identity issues-

lesbian, gay, bisexual, transgender, queer, or questioning

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Neglect and/or without nurturing adult

Source: Santa Clara County's Suicide Prevention Strategic Plan page 50 https://www.sccgov.org/sites/mhd/Providers/SuicidePrevention/Documents/Suicide%20Prevention%2 0Strategic%20Plan%20Final-2011%20Rev.pdf

Mary/Victor Ojakian BHB Sept 12 2016

Recommen ended ded Strategi tegies es

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Accessible mental health counselors in schools

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Screenings of youth for risk of suicide and other mental health concerns

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Targeted counseling for youth who have lost a loved one to suicide

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Enhanced mental health resources, school curriculum, and parent initiatives

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Identify coping mechanisms, access points, and connectors for youth to address life challenges

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Programs to protect youth from social and geographic isolation and barriers to peer interaction

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Programs that teach resiliency

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Programs and services that enable children and youth to cope with failure and disappointment, bullying, and breakups

Source: Santa Clara County's Suicide Prevention Strategic Plan page 50 https://www.sccgov.org/sites/mhd/Providers/SuicidePrevention/Documents/Suicide%20Prevention%20Str ategic%20Plan%20Final-2011%20Rev.pdf

Mary/Victor Ojakian BHB Sept 12 2016

Recommend ended ed Strategi tegies es

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Training for those who interact with at risk youth (community leaders, clinicians , physicians, family members, police, teachers, peers, and others)

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Accessible, youth‐centered crisis line; and single, countywide access point/ telephone number for youth at‐risk

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Provide teens with support groups for youth dealing with teen suicide

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Provide prevention opportunities: Youth to become engaged in public service; school staff to be dynamic and caring; youth centers; develop students’ own skills to deal with emotional challenges.

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Educate parents and foster parents to recognize a child’s emotional needs and know the resources available to assist when child is in crisis.

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Publicly recognize individuals who connect people at- risk of suicide to resources.

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Ensure post‐incident care for individual and family after a 5150 episode (forced admission for psychiatric observation)

Source: Santa Clara County's Suicide Prevention Strategic Plan page 50 https://www.sccgov.org/sites/mhd/Providers/SuicidePrevention/Documents/Suicide%20Prevention%20Strate gic%20Plan%20Final-2011%20Rev.pdf

Mary/Victor Ojakian BHB Sept 12 2016