Suicide Among Gifted Children and Adolescents- Second Edition

To help prevent the suicides of students with gifts and talents, our focus will be on the contribution that schools can make. The primary reason to focus on schools is because virtually all of these students attend schools and can be reached within this institution. A second reason for the school-based emphasis is the fact that schools have considerable resources to bring to bear. There is also the invaluable potential of peers and faculty and staff to provide important services on behalf of the potentially suicidal student. The final reason is that schools are replete with friendship groups. Other students often have information about a potentially suicidal student before the adults do. For a comprehensive system to be created, people in all of these roles must participate.

A number of school-based suicide prevention programs are available on the market (see Katz et al., 2013 for a review of 16 prevention programs). Prevention programs are intended to reduce the prevalence of all suicidal behaviors, from ideation to attempts and completions. Some programs approach this goal by enhancing awareness about suicide. This can be done with students and/or staff. Participants learn how to recognize the signs of distress and what to do when they are present. These programs can be very effective in getting students to the right helping resources, but are not aimed at reducing their suicidal ideation (Katz et al., 2013).

Few prevention programs have empirical evidence of their effectiveness, but there are some with a strong research base. One strongly supported program, The Good Behavior Game (GBG), significantly reduced suicidal ideation and attempts among nearly 2,000 high school students who had training 15 years earlier when they were in the first and second grade. By teaching students how to avoid engaging in aggressive and disruptive behavior at an early age, they were half as likely to experience suicide ideation and less likely to attempt suicide than students in the control group when they were 19 to 21 years old (Wilcox et al., 2008). Other prevention programs have a similar focus on helping students develop coping, problem-solving, and other life skills.

Based on our experience, we can make recommendations for how to create a customized approach to suicide prevention. To be most effective, schools need to create an overt, comprehensive plan for the entire school. Gifted students will benefit from a whole-school program that includes attention to their unique needs as one component. The plan should begin with a steering committee representing all of the stakeholders. As stakeholders themselves, older students may be included in the steering committee. Specific goals and objectives should be delineated that can be measured from year to year to prevent slippage with the influx of new students and changes in school personnel. As the example of the GBG program and our School-based Psychosocial Curriculum Model (SPCM; described in Chapter 9) suggest, effective supports can be developed at a very early age. A comprehensive plan can include elementary, middle, and high schools. The goals and objectives should be developmentally appropriate and should be established for each stakeholder group. Ideally, the suicide prevention plan would be a significant part of an overarching plan to create a caring community.

Caring communities attempt to help all students thrive in all aspects of their school lives. To begin, thriving must be defined. From its definition, indicators can be developed. For example, thriving might be defined as “students will demonstrate psychological well-being, appropriate levels of academic achievement, and reasonable levels of physical fitness.” The metrics used to consider these areas would be both normative and idiosyncratic. Students should be measured against their school population (normative), but with consideration for individual differences (idiosyncratic). This guarantees both a sociological and individual perspective. Because suicidal behavior is predicted by environmental and phenomenological factors, both perspectives are needed to prevent it. Efforts to enhance the protective factors listed in Table 10 (see p. 27) will promote thriving among all students, including those with gifts and talents. All students can benefit from “individual coping, self-soothing and problem-solving skills,” but providing an “appropriate academic challenge” will require special attention for gifted students. Even “interpersonal connectedness/belonging” can be a challenge for students who have few or no peers in the school with similar intellectual abilities or interests. In a caring community, all members will be concerned with the social and academic aspects of the environment that foster personal thriving.

To reach the goals and objectives established, information will have to be heard, understood, and internalized, and behaviors will have to be changed. To that end, significant ongoing training is required. Training should be tailored for the various stakeholder groups and at varying degrees of sophistication. For example, because everything planned would be under the goal of thriving, some specific knowledge about suicide (e.g., prevalence, risk factors, warning signs) would necessarily be included strategically for the greatest impact. Teachers, administrators, and counselors should receive an introduction to the unique experience of gifted students and how to meet their needs. Knowledge of their different lived experiences may make it easier to identify distress among students with gifts and talents.

In addition to the basic goals established to create a caring community in which everyone thrives, officials would also need to identify characteristics and expectations of the community. Some characteristics might include open communication, personal responsibility, community responsibility, candor, and no bullying. Another aspect of a caring community wherein everyone thrives is the inclusion of stakeholders across decision-making groups in an effort to share power. The most important outcome of embracing these community characteristics should be the creation of trust. Trust provides a guarantee that a caring community can exist and be maintained. An important underpinning of a caring community is that the adults will be appropriately trained to gain enough knowledge and expertise to provide the awareness, guidance, and decision making needed to create a safe, caring community. Good will, absent of significant training, can actually contribute to a less safe environment. For example, adults are prone to believe some of myths associated with suicide and gifted students (King, 1997), like those in Table 12. Many of these myths are widely held and assumed to be true for all students. These false beliefs can make it difficult to create a caring community wherein all students thrive. Education of the realities about suicide must be taught and school employees will need to be held accountable to know them.

Table 12
Common Myths Associated With Suicide and Gifted Students

Myth #1	Suicide occurs without warning.
Myth #2	Gifted and talented youths who talk about suicide are not serious about committing suicide.
Myth #3	Educating gifted students about suicide can lead to an increase in suicide ideation among this population coupled with more knowledge about ways of being successful in their suicide attempts.
Myth #4	If a gifted young person wants to commit suicide, very little can stop him or her.
Myth #5	Only trained counselors or mental health professionals are capable of intervening with suicidal gifted youths.

An effective way to create comfort among educators relative to suicide is to address their self-imposed concerns on three fronts: (1) some educators believe that no student is serious about completing suicide, (2) some educators avoid any contact with the issue out of fear they are unprepared to make even the most elementary assessment of students being in distress, and (3) some educators believe that talking about suicide will increase the likelihood of it happening. One way to attend to all of these concerns/fears is to share with educators that they should not expect to operate as experts of suicidal behavior per se, as that is the domain of a clinical psychologist or psychiatrist (for the most part). Instead, their goal should be merely noticing students in distress. When they realize this is a more appropriate expectation for their involvement, educators tend to become willing to be part of a team that is trying to reduce suicidal behavior. Most educators develop an eye for noticing students in distress and the additional training helps them know how to expand their knowledge, while at the same time learning about additional steps they can take to be helpful. Many educators fear suicide to such an extent that they avoid getting involved. Others do not know what to do, and a small group worries about being made a fool by students trying to manipulate them. By emphasizing the goal of discerning distress in students, educators feel more comfortable and become more active in the process.

In a school-based suicide prevention program at the middle-and high-school level, educators and students would receive training in the basics about suicide, including its definition, prevalence rates, correlates, risk and protective factors, and so forth among the general population. Ideally, parents would be included, as well. School administrators and counselors would be trained in the most current knowledge about suicide and about students with gifts and talents. Teachers would receive important information about suicide, gifted students, and distress and what to do next. This information might emphasize how to identify distress and when and how to make referrals.

Other schoolwide information should include the importance of taking steps to help students in distress and the fact that suicide can be prevented, even among those who are already suicidal. In some cases, developing a positive mantra can be helpful. Tracy was part of a team that was able to initiate this change during the postvention subsequent to the three suicides of students involved with the Academy. He later directed the Academy and worked toward institutionalizing these important changes. He took his cues from the group most knowledgeable in schools about students in distress: the students. A cross-current that sometimes exists in schools is a belief among students that telling adults someone they know is struggling would be “ratting them out.” In some environments, ratting a peer out to adults is to be avoided at all costs. The mantra that all students at his residential school heard was that it is better to have a live enemy than a dead friend (Cross et al., 1996). Adults often overlook students’ awareness of their peers’ emotional states. Consequently, including students in organizing and steering committees will help in the creation of effective communication processes that lead to trust. Without this element, the school environment may not be as safe.

Training to create a caring community includes an emphasis on the need for the school to be made up of people who see the value of helping the school reach the goals set for it. Of course, school goals can take many forms and cut across a large number of areas. For example, in addition to the mental health aspect of the school, academics, sports, and other extracurricular aspects of the school can be pursued. Nutrition and exercise are important to all of the aforementioned goals, but are seldom included in this process. As noted, an essential aspect to obtaining support across all groups is the inclusion of all groups in the process. Consequently, pulling everything under the diversity topic makes good sense here. Because schools tend to be microcosms of communities, they tend to reflect considerable diversity. When aspects of diversity that are salient in schools are added to the mix, the stakeholder groups should take on the form of the diversity represented. This inclusive practice bodes well for the creation of a caring community wherein trust is the defining characteristic. Facilitators are utilized to assist groups focusing on topics ranging from educational needs, to needs related to ethnicity, to mental health matters. All are respected as part of the community, and none are held in disdain, contempt, or fear. Implicit in a caring community is the need to also be a learning community. To function in the increasingly complicated world, it is essential that all parties continue their educations. This aspect of the caring community guarantees the trust and high levels of expertise needed to address serious problems such as preventing suicides. When an appreciation for the need for continuous learning is missing from the numerous aspects of the caring community described, suicide prevention is treated in a manner that tends to further isolate people while exacerbating distrust.

Several recommendations for an effective suicide prevention program involve modifications or additions to the school curriculum. Schools may wish to consider including a unit on suicide prevention as a part of the mental health curriculum, beginning as early as middle school. The mental health curriculum should consider strategies that incorporate common needs of students, including their need for acceptance, companionship, and self-understanding. Students play a crucial role in recognizing other adolescents who are suicidal (Delisle, 1990), and the more educated they are about suicide, the more of an asset they become. Eckert, Miller, DuPaul, and Riley-Tillman (2003) described curriculum programs for students that attempt to (a) heighten awareness regarding suicide, (b) train them to recognize signs of suicidal behavior in order to help others, and (c) provide students with information about various school and community resources. Although research suggests proceeding cautiously when implementing suicide curriculum programs, it has been shown to be an effective approach for intervening in school settings (Eckert et al., 2003).

Reynolds’s model (as discussed in Eckert et al., 2003) includes a two-stage screening and assessment process. The process identifies potentially suicidal students and could be used as schoolwide practice for suicide prevention. In the first stage, a classwide or schoolwide screening takes place, in which all students complete a brief self-report measure to identify those who may be at risk for suicide. The second stage involves doing individual interviews with all students who score above clinically significant levels. This is where the expertise and manner of professional school counselors or psychologists can be very helpful. Although promising, screening is not 100% effective. Screening tools tend to report false positives for some young people while missing others who are at risk (Eckert et al., 2003). Consequently, educators are encouraged to employ a screening tool more than once.

Schools involved in suicide prevention should create an environment that promotes and reinforces positive social relationships (Fleith, 1998). In this setting, students feel comfortable sharing their concerns and are encouraged to dream and use their imaginations. In essence, according to Fleith (2001), schools should encourage activities that nurture students’ interests, strengths, and abilities.

Suicidologists representing the dominant paradigm claim that suicidal behavior beyond ideation is not evidence of youths working through difficulties in their life. Rather, it is illustrative of people struggling with some form of mental illness (Pelkonen & Marttunen, 2003). This is an important consideration when deciding what facets to include in a schoolwide suicide prevention program (e.g., screening, counselor involvement, outside resources). School-based prevention programs risk alienating those students considering suicide by sending messages that can be misconstrued as equating suicidal ideation with mental illness. Ideation is quite common and widespread among people, while those actually attempting to take their own lives is a very small subset of the overall group of ideators. Consequently, while it is important to challenge students who engage in suicide ideation, it is also important not to conflate it with serious mental heath problems, as it may cause them to go underground and not pursue the help they need. On the other hand, describing suicide to students as a reasonable response to adolescent problems could inadvertently facilitate the expression of suicidal ideas. For this reason, educators must be aware of the potential to contribute to the idea that suicide is a viable option when experiencing stress. The myth that talking about suicide can promote suicidal behavior may have its roots in this delicate balance between trying not to paint students engaging in suicidal ideation as mentally ill, so as to support struggling students, while acknowledging the very real role of mental illness in actual attempts. These issues illustrate the importance of effective communication across the various stakeholder groups when implementing this type of school-based intervention.

The importance of creating a caring community in school cannot be overstated. In such an environment, myriad mental health issues are prevented, improved upon, and/or effectively monitored with the appropriate referrals made. The day-to-day activities of the stakeholders are carried out among community members who are dedicated to every person’s wellness. People look after each other, feeling a personal responsibility. All stakeholder groups have considerable knowledge about distress, depression, frustration, and suicidal behavior. This type of environment creates protective factors that can help prevent suicidal behavior. In our opinion, all schools should create a caring community—the accumulation of benefits to the well-being of their students (and their faculty and staff) will be very important in enhancing positive mental health and, likely, academic success. To prevent suicides among students who are gifted, we must collaborate by drawing on the most up-to-date research available. This book can be used to begin the process of education about suicidal behavior in general and among our students with gifts and talents more specifically.

KEY POINTS

images Schools can help prevent the suicide of students for a number of reasons: virtually all students attend schools and can be reached within the institution; schools have considerable resources; schools have an invaluable potential of peers, faculty, and staff to provide important services on behalf of the potentially suicidal student; and schools are replete with friendship groups.

images School-based suicide prevention programs are available in the marketplace, with varying degrees of empirical support of their effectiveness.

images To be most effective, schools need to create an overt plan that includes a steering committee representing all of the stakeholders.

images Ideally, the suicide prevention plan would be a significant part of an overarching plan to create a caring community.

images Good will, absent of significant training, can actually contribute to a less safe environment, which is why adults in the caring community should be appropriately trained.

images One of the common myths associated with suicide and gifted students is that suicide occurs without warning.

images The realities about suicide must be taught and school employees will need to be held accountable to know them.

images An effective way to create comfort among educators relative to suicide is to reduce their self-imposed expectations that they need to be able to evaluate the potential for imminent harm. Instead, they need only to learn to recognize students’ distress and how to respond.

images Including students in organizing and steering committees will help in the creation of effective communication processes and a safe school environment.

images It is better to have a live enemy than a dead friend.

images Schools may wish to consider including a unit on suicide prevention as a part of the mental health curriculum, beginning as early as middle school.

images Researchers and clinicians representing the dominant paradigm among suicidologists claim that suicidal behavior beyond ideation is not evidence of youths working through difficulties in their life, but of young people struggling with some form of mental illness.

images In a caring community, myriad mental health issues are prevented, improved upon, and effectively monitored with the appropriate referrals made.

images To prevent suicides among students who are gifted, we must collaborate by drawing on the most up-to-date research available.