King asserts that the very day of the suicide, the principal needs to inform all teachers there will be a face-to-face session the following morning, ensuring that staff have the facts correct.
Each first period teacher the following day, has a duty to announce the death of the student, and inform students as to where and when counseling is available. "A straightforward announcement of the death," King suggests, "offering sympathy toward the surviving family members" should be offered. Returning to regular scheduled classwork as soon as possible is important, as well.
Psychological assistance. Counselors and other mental health professionals "should be made available" throughout the school - for staff and students - and if that means bringing in counselors from other schools, then that should be done. Earlier mentioned research - restated in King's paper - has shown that those close to the suicide victim tend to receive a great deal less support for their grief than do those close to victims of other kinds of death.
Do not glamorize suicides. Are big memorial services a good idea? King says absolutely not: "Many suicidologists consider special memorial services to be a glorification of suicide." With that in mind, schools should avoid any pressure to plan such an event, because "glamorizing the incident" could - and does - lead to cluster suicides. Adolescents, King suggests, "are more vulnerable than other age group to cluster suicides," so, it makes sense to present a more low-key type of event to pay homage to the victim. King believes the following ideas, gleaned from his own research, should be avoided: a permanent memorial, such as planting a tree is his or her honor, tends to glorify the act of suicide; or, making a plague to be placed in a place that is visible, is also undesirable; even the establishment of a scholarship fund - which could be done in a seemingly sincere way, would be highly inappropriate.
What then, would be appropriate for a suicide victim? "Some researchers suggest...a moment of silence at the start of the school day" - or a photo in the yearbook, or even a "fund-raiser for suicide-prevention programs" - would be far more appropriate, according to King's literature.
Outreach to parents. Another move the postvention team needs to make, King continues, is to make sure all parents of students receive the facts of the suicide, either through phone calls from PTA committees, or through other means. Further, "concerned parents should be encouraged to phone the principal's office to receive the facts surrounding the incident, and voice any concerns" they may have.
Making the right media moves. Who should respond to the media, following a student suicide? "One official spokesperson, and only one, should deal with the press," King writes. That person should be a mental health professional and a member of the postvention team. Moreover, the newspaper should be informed that cluster suicides - according to empirical data - are more likely to occur "when the story is placed on the front page in large headlines."
Good communication. The school board should also be officially notified of all facts of the suicide by the postvention team, through a written and an oral presentation. They should also be brought up-to-date on precisely how the postvention system has worked, when it went into place, and the effect it had on the school and the students.
Follow-up. Findings from authoritative research show suicide following a person's exposure to another suicide "was 2 to 4 times higher among 15-19-year-olds than older age groups," King reports. Hence, continuing sessions in groups or one-on-one are important, to allow students to fully express their ongoing feelings about the tragedy.
And, following the playing out of all the elements of a well-rehearsed and professionally-implemented postvention program, there nevertheless needs to be a formal follow-up ("post-mortem" is an inappropriate phrase in this instance) to assess how effectively the plan worked. Team members should be asked, and should think deeply about questions like: "What helped and what did not help?"
More ways to avoiding cluster suicides after an actual suicide
In a research article he published two years after the previously featured piece (King, 2001), King discusses the intervention that is necessarily in the event a student attempts - though doesn't carry out to completion - suicide. This is useful information for schools, if, following an actual school suicide, other youths become threats to perform cluster acts. King advises, when a student threatens suicide, then first of all, "Ensure student safety," and secondly, access that student's suicidal risk. There are three levels of risk, he notes: "extreme risk," "severe risk," and "moderate risk." In the "extreme" case, that student likely has a specific plan, either with a gun or another weapon, and "will not relinquish the dangerous instrument" willingly - at least initially. In this case, the school professional "should remain with the youth, stay calm, and encourage the student to talk and express feelings." The professional should not attempt to take the "lethal means" away, but instead should ask the student to voluntarily relinquish it. Once the weapon is securely out of the hands of the student, appropriate care for the student is the first order of business.
Identifying others who may become cluster candidates
One testing procedure which is being used by schools to determine, after a real suicide, if others may feel compelled to join the victim, is the two-stage screening and assessment process of the Suicidal Ideation Questionnaire (SIQ) (Eckert, et al., 2003). First, students are administered a class-wide, or school-wide, self-report SIQ screening survey. Any student who scores above "clinically significant levels" on the self-report measure then will receive individualized interviews with professionals, to further determine the risk for suicide. Does it work? Eckert writes: "Initial research into this area [self-report and individual interviews] has been promising."
Not all scholars agree on the success of postvention
The Journal of Crisis Intervention and Suicide Prevention ran an editorial (Goldney, R.D., & Berman, L, 2003), commenting on a research article by Jay Callahan, "Postvention in Schools: Affective or Effective?" In their publication. As to the effectiveness of postvention, the editorial states that "there have been few systematic studies of [postvention] effectiveness." And while they do acknowledge that "suicide is tragic and needs to be explained" and "survivors need to be comforted, and it feels right to do so," editors state that until further "stringent laboratory controlled demonstration of efficacy" studies are completed, "such programs should be utilized with caution."
Help for grieving parents: an important part of postvention
On a more positive note, the American Association of Suicidology's Web site has a number of links to educational and advocacy-related sites regarding suicide, and prevention, albeit few dealing with postvention. But one link is particularly poignant, as a possible avenue of closure for parents of student suicide victims: the link is presented by "Parents of Suicides 'A memorial to our Precious sons and daughters'." On the site, parents whose children committed suicide can post online memorials to their children, with heart-rending biographies and photos. One parent entry, for a daughter named "Trena," explained that "...She began her struggle with depression two years before her death," and that, tragically, "her family and friends did not know how ill she was." Meantime, in their book, Suicide and its Aftermath: Understanding and Counseling the Survivors, editors Dunne, McIntosh and Dunne-Maxim, offer simple advice to survivors - and in the context of postvention, a few of their points are offered as a sampling of available literature: "1) Know you can survive. You may not think so, but you can; 2) Struggle with 'why' it happened until you no longer need to know 'why' or until you are satisfied with partial answers; 3) Know you may feel overwhelmed by the intensity of your feelings but all your feelings are normal; 4) Anger, guilt, confusion, forgetfulness are common responses. You are not crazy, you're in mourning." And #11 is simple, yet profound, in capturing postvention themes: "Give yourself time to heal."
Postvention healing has not come easily for Dr. Thomas Edward Bratter (Bratter, 2003), a psychotherapist who has lost three adolescent patients to suicide. Jeremy, the first patient Bratter suffered the loss of, was president of his class, captain of the football team, and had been accepted "Early Decision" at Harvard University. "I was devastated," Bratter writes, in the International Journal of Reality Therapy, adding that Jeremy "gave no warning." And yet, "I doubted my worth, wondering if I had selected the right profession." That was over thirty years ago. Today, Bratter feels "purged of the ghosts who haunt me late at night which make sleep impossible." And yet, he says "having officiated at three funerals, I am more passionate, intense, and idealistic now than ever before."
Passion," indeed, should be an operative word when describing the energy which must go into the postvention planning process at schools. When implemented…