Educator effectiveness in identifying symptoms of adolescents at risk for suicide

Journal of Instructional Psychology, Sept, 2004 by Jo Anne Hamrick, Renitta L. Goldman, Gary L. Sapp, Maxie P. Kohler

This study examined educators' capabilities to identify symptoms of adolescents at risk for suicide when influenced by the adolescent's race, gender, and socioeconomic stares. Participants were 882 regular and special educators in a southeastern state who completed mailed questionnaires presenting hypothetical vignettes of adolescents at risk for suicide. Vignettes were varied according to the adolescents' gender, race, and socioeconomic status. Respondents rated 35 behaviors selected from the DSM III R as either covert or overt signs of suicidal behavior. Multivariate analysis of educator responses revealed no significant difference between the capabilities of regular and special educators to identify these symptoms, either covert or overt. However, all participants experienced some difficulty in accurately identifying these symptoms. Relationships among race, gender, and highest degree attained by educators were also identified. Implications for an expanded role of educators in the identification process of youth at risk for suicide are suggested.

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Research examining factors influencing suicidal behavior of adolescents in school settings is limited. Studies of the suicidal behavior of students with emotional problems are few and those investigating suicide in the general school population are almost nonexistent. (1) Although most suicidal attempts and completions occur away from a school setting, schools are logical settings for crisis and suicide intervention because students spend as many waking hours in schools as with their families. (2) Educators are in a critical position to consistently observe children and youth, (3) but they are often overlooked as a key source of information regarding student behavior. Often educators and peers are more sensitive to behavioral precursors of suicide than are members of the victim's family. (4) Suicidal youngsters may communicate poorly with their families and reveal more of their distress to peers, teachers, or both.

The criteria for intervention with suicidal youths in educational settings depends on the degree of lethality exhibited by the youth and the immediacy of risk. (4) Educators must be knowledgeable regarding identification, intervention, referral, notification of parents and guardians, and follow-up. The legal responsibility of school personnel is to be vigilant in identifying suicidal students and responding immediately. Negligence is a legal concern and prudence is recommended in terms of assessment, referral, and notification. (4)

One salient aspect of suicide in adolescents is its link with depression. Adolescents with depressive disorders are substantially at risk for suicidal behavior (5, 6, 7) and, while information regarding the prevalence of depression in those who receive special education services is limited, depression among adolescents with learning and behavior disorders is more prevalent than indicated in the general population. (8, 9) A related study found that 50% of adolescents referred for possible placement in special education met the criteria for a diagnosis of depression. (10)

Unfortunately relatively few students are referred for assessment even when symptoms of depression are evident. (11, 12) Gifted students with depression, along with students who do not exhibit symptoms of any other disorder, are likely to be overlooked in the identification and referral process. (11) Stark (12) used interviews and checklists in a "multiple gate" process to identify depressed students in school and found that fewer than 5% of the students who presented symptoms of depression had been classified by the schools as emotionally disturbed.

Assessment of indicators of adolescent suicide requires an extensive knowledge of relevant risk factors and observable symptoms. Given their intensive and long-term contacts with adolescents, educators are in an advantageous position to identify significant signs and symptoms of adolescents at risk for suicide. Hence, they could play a critical role in the dynamics of adolescent suicide. To date little research focusing on educators' ability to identify at risk adolescents has been conducted, and the literature often portrays educators as a part of the intervention process rather than the identification process. (13, 14)

This study examined the knowledge and skiffs of professional educators in the southeast in relation to assessing hypothetical adolescents at risk for suicide. Professional educators were further identified as male or female, regular or special educators at both elementary and secondary school sites. The primary purposes of this study were (a) to assess educators' capabilities to identify signs of adolescents at risk for suicidal behavior when influenced by the adolescent's race, gender, and socioeconomic status and (b) to examine how educators' characteristics predicted their capabilities to identify at risk adolescents.

Methods

Samples

Two groups of 186 special educators and counselors and 691 regular educators served as participants in the study. Questionnaires were sent to 1,500 subjects through the school's mailing system and 882 (58.8%) were returned. The gender of the subjects was 763 females and 119 males. Race was combined into two groups of 203 African-American and 679 Caucasian/others. Four hundred and twenty of the respondents were under the age of 40 and 463 were over 40. Two hundred and thirty five had attained Bachelor's Degree and 644 a graduate degree. All data were gathered during the 1993-1994 school year.