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Home » Student Success » Health & Safety » Mental, Social, & Behavioral Health » Youth Suicide Prevention, Intervention, & Postvention

Youth Suicide Prevention, Intervention, & Postvention

Back to School Mental Health Supports

Below are back to school mental health supports for students and staff:

Crisis Lines

Mental Health Crisis Lines

Suicide Prevention

Contact Information

Suicide Prevention

Behavioral Health and Suicide Prevention Program Supervisor
Behavioral Health and Suicide Prevention Program Specialist

In Washington state, suicide is the second leading cause of death for teens 15 to 19 years old. According to the Washington Healthy Youth Survey (2018), 32% of eighth graders, 40% of 10th graders, and 41% of 12th graders felt so sad or hopeless for 2 weeks or more that they stopped doing their usual activities. 16% of 8th graders, 18% of 10th graders, and 18% of 12th graders reported making a suicide plan. Most students who reported feeling sad or hopeless said they have an adult to turn to for help, however, 13% of 8th graders, 16% of 10th graders, and 15% of 12th graders report there are not adults for them to turn to when feeling sad or hopeless.

Comprehensive suicide prevention planning informs all adults in schools and communities about how to intervene with a young person exhibiting warning signs for suicide. There is a place for everyone in suicide prevention. OSPI strives to provide resources and support to help inform educational service districts, school districts, and schools in the development of Suicide Prevention Plans

Suicide Postvention in Schools

The grief associated with a death by suicide can be quite overwhelming. When a school community experiences a loss by suicide the effects can be felt on various levels. Using protocols that follow model guidance and knowing where to turn for help is critical.

OSPI, in partnership with Forefront Suicide Prevention and Washington state’s Educational Service District (ESD) Behavioral Health Navigators, created the Suicide Postvention Guide for Schools in Washington State. This guide gathers best resources from materials that already exist and provides resources to enhance a school’s ability to respond with resources specific to their distinct ESD.

Also see: Suicide Postvention Guide for Schools in Washington State PPT slides and Suicide Postvention in Schools Handout. To request an editable version of the PPT slides, that can be localized for your district, please email Tayler Burkhart.

Introduction to the Student/Youth Mental Health Literacy Library

The Student/Youth Mental Health Literacy Library gives any teacher, school counselor or other staff member a comprehensive resource of professionally vetted curricula and school presentations to easily and quickly compare available programs at their fingertips. The site has three very important features.

  1. A detail of every listing, along with an inventory of defined Mental Health Literacy Components. Each detailed listing also includes an inventory of six Mental Health Learning Standards as currently described by the Washington State Office of the Superintendent of Public Instruction as a comparison metric.
  2. Each entry is backed with all available existing evidence and data surrounding the listing, as well as links to all available studies for both quick reference and in-depth review.
  3. A Quick Reference Table is provided for fast, convenient comparison for all listings so that a choice can be made with ease and links followed to access and implement a chosen program.

In addition to these three important components, the University of Washington SMART Center has prepared an Implementation Guide Toolkit featured on the site that provides best practices for program implementation. This toolkit has a wealth of information to aid teachers with any facet of their teaching program across any subject matter, but is intended as a tool to help implement Mental Health Literacy with ease. The toolkit also provides resource links for more in-depth exploration in this area.

Behavioral Health Coordinator/Navigators

The Children’s Behavioral Health Workgroup, formed in 2016 by the legislature, was tasked with identifying barriers to children’s behavioral health services. The workgroup's recommendations to the legislature included strategies for improving access and coordination in early learning, K–12 education, and health care systems. One of those recommendations created the OSPI Children’s Regional Behavioral Health Pilot Project, authorized by RCW 28A.630.500. In December 2019, a Legislative Report was written to provide an overview of the learnings of the Pilot Project.

HB 1216 included funding, in the 2020 budget, to establish Behavioral Health Coordinator/Navigator positions in all nine of Washington's Educational Service Districts (ESDs). Below is a list of resources related to these positions as well as contact information for each of the Navigators.

Regional ESD Behavioral Health Navigator Discussion

Four Regional Behavioral Health Navigators convened to discuss elements of their daily work in increasing and sustaining behavioral health care access for our Washington students. This recorded discussion will provide viewers with an understanding of the work Navigators engage in across their regions. 



CARE is a research-backed, web-based course to provide educators and other school staff guidance to help students who may be going through difficult times. The program is designed to give educators the tools and confidence to identify students who may be at risk for emotional or behavioral distress, including suicide, substance use, violence, and sexual abuse. CARE will help all school staff understand when and how to intervene and make referrals to counselors and mental health professionals, based on their district’s policy and procedure.


CARE is available to everyone who works with students in Washington State, from administrators to support staff.

Counselors, psychologists, social workers, and nurses can take the course, but it does not meet the course requirement for certification or recertification. Those courses can be found on the Professional Educator Standards Board website.

Joining the Course

The course is a free, one-hour, online module that meets the criteria set forth by RCW 28A.320.127 which requires educators receive training on how to recognize and respond to students experiencing emotional or behavioral distress.

CARE may be taken individually or in a group, and a Facilitator Guide is provided to guide staff through the specific examples, discussion questions, additional resources, and role play exercises.

Know the warnings and take action if you see:

  • Talking or writing about suicide or death
  • Giving direct verbal cues, such as "I wish I were dead" and "I'm going to end it all"
  • Giving less direct verbal cues, such as "You will be better off without me," "What's the point of living?", "Soon you won't have to worry about me," and "Who cares if I'm dead, anyway?"
  • Isolating themselves from friends and family
  • Expressing the belief that life is meaningless
  • Giving away prized possessions
  • Exhibiting a sudden and unexplained improvement in mood after being depressed or withdrawn
  • Neglecting his or her appearance and hygiene
  • Dropping out of school or social, athletic, and/or community activities
  • Obtaining a weapon (such as a firearm) or another means of hurting themselves (such as prescription medications)

Bullying Prevention SSHB 1163 (2011)

Adds mental health and suicide prevention to the essential academic learning standards in health and fitness RCW 28A.230.095

Troubled Youth ESHB 1336 (2013)

School counselor, psychologist, social worker, and nurse to receive suicide prevention training.

RCW 28A.410.226

Issues of Abuse course content include recognition, screening, and response to emotional or behavioral distress in students, substance abuse, violence, and youth suicide.

RCW 28A.410.035

School districts must adopt a plan for recognition, screening, and response to emotional or behavioral distress in students: substance abuse, violence, and youth suicide.
RCW 28A.320.127

OSPI to develop and maintain a Model School District Plan for Recognition, initial screening, and response to emotional or behavioral distress.
RCW 28A.320.1271

Requires that each Educational Service District develop and maintain the capacity to train on youth suicide screening and referral, and student emotional and behavioral distress.
RCW 28A.310.500

K-12 Schools Suicide Prevention SSB 6431 (2014)

OSPI to assist schools in implementing youth suicide prevention activities.
RCW 28A.300.288

Sexual Abuse Response Plans HB 2597 (2016)

School districts plan must also include training for recognition of sexual abuse, notification requirements, and staff response procedures.
RCW 28A.320.127,
RCW 28A.320.160,
RCW 28A.400.317

The purpose of a prevention plan is to protect the health and well-being of all students by having procedures in place to prevent, assess the risk of, intervene in, and respond to students in crisis. Prevention of youth suicide, violence, substance use/misuse, and the early identification and treatment of behavioral health disorders are most effective when students, staff, parents, and community members have access to prevention information and resources.

OSPI Resources for Comprehensive Suicide Prevention

Guides and Examples of Comprehensive Suicide Prevention

Training for School Professionals

The Professional Educator Standards Board (PESB) maintains the list of approved trainings required for school nurses, counselors, psychologists, and social workers. Contact an ESD Prevention Director to find out about their training schedule or see the PESB Website for other training options.

School-based Programming

The Suicide Prevention Resource Center Page for Resources and Programs has a searchable database of evidence-based programs and practices for education, screening, treatment, environmental change that can be filtered based on intended population.

School staff have day-to-day contact with many young people, some of whom experience mental distress or illness that could result in feelings of hopelessness that could lead to suicidal behavior. Those who work in schools are well-positioned to observe students' behavior and act when they suspect that a student may be at risk of self- harm and/or suicide.

Specific steps should be followed in order to identify and help young people at risk, including a referral to someone in the school who has been trained to assess suicide risk. School systems should include efforts to recognize the warning signs, refer students to appropriate resources, and create reentry plans for students coming back to school after a crisis that coordinate with mental health treatment plans.

Warning Signs that require immediate action:

  • Talking or writing about suicide or death
  • Giving direct verbal cues, such as "I wish I were dead" and "I'm going to end it all"
  • Giving less direct verbal cues, such as "You will be better off without me," "What's the point of living?", "Soon you won't have to worry about me," and "Who cares if I'm dead, anyway?"
  • Isolating themselves from friends and family
  • Expressing the belief that life is meaningless
  • Giving away prized possessions
  • Exhibiting a sudden and unexplained improvement in mood after being depressed or withdrawn
  • Neglecting his or her appearance and hygiene
  • Dropping out of school or social, athletic, and/or community activities
  • Obtaining means such as a firearm or prescription medications

Responding to the Warning Signs:
It takes time and courage to reach out to students on a personal level, but your interest can be a lifeline to a child in crisis.

Intervention Resources

Warning Signs that may indicate a youth is at risk and needs to be referred for screening:

  • A sudden deteriorating academic performance. Teens who were typically conscientious about their school work and who are now neglecting assignments, cutting classes, or missing school altogether.
  • Self-mutilation. Some young people resort to cutting their arms or legs with razor blades and other sharp objects to cope with emotional pain. Self- mutilation is an unmistakable sign that something is wrong.
  • A fixation with death or violence. Teens may express this fixation through poetry, essays, doodling, or other artwork. They may be preoccupied with violent movies, video games, and music, or fascinated with weapons.
  • Unhealthy peer relationships. Teens whose circle of friends dramatically changes, who don't have friends, or who begin associating with other young people known for substance abuse or other risky behaviors may signal a change in their emotional lives.
  • Volatile mood swings or a sudden change in personality. Teens who become sullen, silent, and withdrawn, or angry and acting out. Conversely, and teen sullen by nature may start to behave uncharacteristically cheerful. Both internalizing and externalizing behaviors warrant a conversation to determine if the student is at risk.
  • Indications that the student is in an unhealthy, destructive, or abusive relationship. This can include abusive relationships with peers or family members. Signs of an abusive relationship include unexplained bruises, a swollen face, or other injuries, particularly if the student refuses to discuss them.
  • Risk-taking behaviors. Risk-taking behaviors often co-occur and are symptomatic of underlying emotional or social problems. Such behaviors as unprotected sex, alcohol or other drug use, driving recklessly or without a license, petty theft, or vandalism can be an indication that something is wrong.
  • Signs of an eating disorder. An eating disorder is an unmistakable sign that a student needs help. A dramatic change in weight that is not associated with a medically supervised diet may also indicate that something is wrong.
  • Difficulty in adjusting to gender identity. Gay, lesbian, bisexual, transgender, queer, and intersex teens are a vulnerable population and have higher suicide attempt rates than their heterosexual peers. While coming to terms with gender identity can be challenging for many young people, LGBTQI youth face social pressures that can make this adjustment especially difficult, particularly if they are not in a supportive environment.
  • Bullying. Children and adolescents who are bullied, as well as those who bully, are at increased risk of depression and suicidal ideation. (Bullying and Suicidal Ideation and Behaviors: A Meta-Analysis Melissa K. Holt, Alana M. Vivolo-Kantor, Joshua R. Polanin, Kristin M. Holland, Sarah DeGue, Jennifer L. Matjasko, Misty Wolfe, Gerald Reid
    Pediatrics Feb 2015, 135 (2) e496-e509; DOI: 10.1542/peds.2014-1864)
    • Ask the Tough Questions: Do not be afraid to ask a student if they have considered suicide or other self-destructive acts. Research has shown that asking someone if they have contemplated self-harm or suicide will not increase that person's risk. Rather, studies have shown that a person in mental distress is often relieved that someone cares enough to inquire about the person's well- being. Your concern can counter the person's sense of hopelessness and helplessness. However, you need to be prepared to ask some very specific and difficult questions in a manner that doesn't judge or threaten the young person you are attempting to help. For example:
      1. Sometimes when people feel sad, they have thoughts of harming or killing themselves. Have you had such thoughts?
      2. I've noticed you are going through some rough times. Have you ever felt your life is a burden on others? Do you ever wish you could go to sleep and not wake up?
      3. Are you thinking about killing yourself?
    • Be Persistent: The person you are contacting may feel threatened by your concern. They may become upset or deny that they are having problems. Trust your instinct and be consistent and firm, and make sure that they get the help they need.
    • Be Prepared to Act: You need to know what to do if you believe a student is in danger of harming themselves. Know the school's procedures from the crisis response plan for this situation and explain to the student the steps you will be taking.
    • Do Not Leave a Student at Imminent Risk of Suicide Alone: If you have any reason to suspect that a student may attempt suicide or otherwise engage in self-harm, you need to remain with the student (or see that the student is in a secure environment, supervised by caring adults) until professional help can be obtained.
    • Get Help When Needed: If you believe that the student is in imminent danger, you, or another member of the school staff, should call 911 or (800) 273-TALK (8255). Tell the dispatcher that you are concerned that the person with you "is a danger to themselves" or "cannot take care of themselves." These key phrases will alert the dispatcher to locate immediate care for this person with the help of police. Do not hesitate to make this call if you suspect that someone may be a danger to him- or herself. It could save that person's life.
    • Use Your School's Support System: School districts have crisis plans for working with students who are experiencing emotional or behavioral distress Familiarize yourself with these plans and use them when appropriate.
    • Connect with Parents or Guardians: Do not promise confidentiality to anyone when it comes to issues regarding their safety. If a student opens up to you about their feelings, talk privately with them about putting the steps of the school's crisis plan in place, and include them in the conversation. Follow the school's communication plan for contacting parents or guardians when a student is at risk. If you believe that contacting the parents or guardian may further endanger the child (if, for example, you suspect physical or sexual abuse), contact the proper authorities. School staff are mandated reporters and are required to report suspected child abuse.

For Parents

Suicide is a public health issue. Media and online coverage of suicide should be informed by using best practices. The way media cover suicide can influence behavior negatively by contributing to contagion or positively by encouraging help-seeking. See the following resources for best practices when reporting on a death by suicide: Reportingonsuicide.org

Social Media Campaigns that Promote Help-seeking

Crisis Lines

  • National Suicide Prevention Lifeline provides immediate assistance to individuals in suicidal crisis by connecting them to the nearest available suicide prevention and mental health service provider through a toll-free telephone number: (800) 273-TALK (8255).
  • Ayuda en Español
  • Lifeline Crisis Chat provides online emotional support, crisis intervention, and suicide prevention services. The chat specialists listen and support you through whatever difficult times you may be facing.
  • Crisis Text Line: Text HEAL to 741741 from anywhere in the USA, anytime, about any type of crisis. A live, trained Crisis Counselor receives the text and responds quickly.
  • Trans Lifeline 877-565-8860 This line is primarily for transgender people experiencing a crisis.


  • A Friend Asks Don't be afraid to ask for help for a friend or yourself.
  • MY3 Lets you stay connected when you are having thoughts of suicide.
  • Suicide Safe from the Substance Abuse and Mental Health Administration, this suicide prevention app will help providers integrate suicide prevention strategies into practice and address suicide risk.


Articles & Research

National Resources on Suicide and Suicide Prevention