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The Manchester School District recognizes the importance of the overall well-being, safety, and mental health of its students. Mental health diagnoses and suicidality are prevalent problems among youth that impact academic performance, personal health, and social development. Therefore, the school district must ensure that each school is prepared to deal with threats of suicide, attempts at suicide, and actual suicide. Preparation includes being familiar with and complying with administrative rules from the New Hampshire Department of Education (see ED 306.14 Guidance) that require school boards to guarantee that each school has a written plan for guidance and counseling programs. These plans must provide for the “identification and referral of students in need of special services, including suicide prevention and psychiatric referrals.”

A suicide protocol (known as the “safety Intervention Protocol”) shall be available at all schools in the event of a suicide threat, attempt, or actual suicide. All schools will assist students, parents, and community services with the implementation of this protocol.

The protocol will assist schools to:

• Identify and share best practices around issues relating to suicide

• Increase the likelihood of a consistent response

• Clarify roles and expectations between systems and organizations

• Increase communication and trust between schools, families, and social service agencies

SAFETY INTERVENTION PROTOCOL

The following is the Manchester School District procedure to follow when a student expresses a verbal or nonverbal suicidal intent. This document is intended to be used by the school guidance counselor, school psychologist, school administrator, student assistance program (SAP counselor), school social worker, or school nurse. These people will be referred to as “designee” in the following protocol.

Each principal must designate one or more professionals employed by the school district to respond to reports of students who may be at-risk of suicide. The principal may designate school counselors, nurses, Student Assistance Program counselors, school psychologists or other appropriate professionals.

Any sign or verbalization of suicidal intent or ideation must be shared immediately with a school designee.

The school designee will conduct an initial interview to gather relevant information.

An administrator will be contacted as soon as possible, to be informed about the decision to call parents/legal guardians concerning a suicide risk.

Designated school professionals must notify a parent or legal guardian if a child may be at risk of suicide. Parent contact must be made as soon as possible. The designee must complete the Parent/Guardian Contact Form.

If parents/legal guardians cannot be contacted or are unable or unwilling to respond, an administrator will be notified. The administrator will be responsible for parental location and notification. If the administrator is unable to contact the parent the administrator will call 911 to request emergency assistance.

It is the responsibility of the parent or legal guardian to transport the child from the school to a family physician, a hospital emergency room, the Greater Manchester Mental Health Center, or other medical provider to be assessed for suicide risk. The school may secure emergency services if the parent or guardian cannot be reached or if the parent or guardian does not take action.

If a parent/legal guardian refuses immediate responsibility and follow-up emergency assessment, a report will be filed with the NH Division of Children, Youth and Family Services (DCYF). Manchester area: 668-2330; State of New Hampshire: 1-800-894-5533.

Parents/legal guardians will be strongly encouraged to contact the school concerning the return of their child to school.

Parents/legal guardians will be strongly encouraged to provide appropriate school professionals with documentation regarding the assessment or other follow-up information.

MANCHESTER SCHOOL DISTRICT

Safety Intervention Protocol

Parent/Guardian Contact Form

Form completed by: ___________________________________________________

Date of contact: ______________________________

Position: Psychologist Nurse Guidance Counselor SAP Other

Student’s Name: _______________________________________________________

First Middle Last

DOB:________________

School: _________________________________________________

Grade: _______________

Student referred by:_____________________________________________________

Nature of Incident: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Parent or Guardian Contact______________________________________________

Date and time: ____________________________________________________________

Method of contact: ________ phone ________in person

Person contacted: _____mother _____father _____ guardian other

________________________________________________________________________

Response/Outcome:____________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________

Form must be filed in a location other than the cumulative file designated by the school principal.

MANCHESTER SCHOOL DISTRICT

Safety Intervention Protocol

Parent Notification Form

I/we _________________________, the parent or guardian of____________________________

(Name of parent/guardian) (Name of child)

was/were contacted by _________________________________________ on _____________.

(Name of school staff and position at school) (Date)

I/we have been informed that my child has expressed some form of suicidal thought or intent. School staff have advised me to seek an immediate assessment for suicide through my child’s doctor or the Greater Manchester Mental Health Center (668-4111). The school staff have also notified me that referral information is also available through the NH Help Line (1-800-852-2388) and that in an emergency I/we should call 911.

Depending on the outcome of the medical evaluation, I understand that I may choose any or all of the following options:

Contact ________________________ to notify the school when my child will return to school (School Contact Person)

Schedule a meeting for my child and myself with appropriate school staff prior to re-entry to school

Provide the school contact person with written documentation of any emergency services that have been rendered or other plans for services that have been made. If this written information is provided, it will be filed with the student’s health record

Sign a release of information with mental health and/or other appropriate medical professions to allow them to communicate information with specified school staff

Signature below indicates receipt of this form:

________________________________________________________________

Parent or guardian’s signature Date Time

______________________________________________________________________________

Parent or guardian’s signature Date Time

______________________________________________________________________________

School Personnel Title Date Time

______________________________________________________________________________

School Personnel Title Date Time

Notes: ______________________________________________________________________________

______________________________________________________________________________

Copy: Parent

Principal

Form must be filed in a location other than the cumulative file designated by the school

ADDENDA

New Hampshire State Board of Education

New Hampshire Department of Education

Adopted Rule October 21, 1996

Ed. 306.14 Guidance

The school board shall ensure that each school develops and implements a written plan for the school’s guidance and counseling program which shall be developmentally appropriate and designed to address the educational and career needs of all students.

For each school, this plan shall provide for the delivery of the following:

• Career, occupational, and educational information;

• Student appraisal activities;

• Placement services; and

• The identification and referral of students in need of special services, including suicide prevention and psychiatric referrals.

For each high school, this plan shall also provide for the delivery of career and college counseling.

LINK: Guidance

TITLE XV

EDUCATION

CHAPTER 200

HEALTH AND SANITATION

School Health Services

Section 200:34

200:34 Special Examination. – Every child with a presenting problem and found to need further evaluation, after due consideration and evaluation by the appropriate school authority, shall be referred by the school physician or school administrator to the parents or guardian of said child for examination, and evaluation by an appropriate practitioner and if said parents fail or neglect to have said child so examined and fail to present the recommendations from said examiner within a reasonable period after the referral by the school to said parents, then said child may be examined by the school physician, or other qualified personnel.

Source. 1971, 499:1, eff. Sept. 4, 1971.

LINK: Gen Court

TITLE XV

EDUCATION

CHAPTER 193-F

PUPIL SAFETY AND VIOLENCE PREVENTION

Section 193-F:3

193-F:3 Pupil Safety and Violence Prevention. –

I. Each local school board shall adopt a pupil safety and violence prevention policy which addresses pupil harassment, also known as ‘bullying’, and which is consistent with the provisions of this chapter.

II. Any school employee, or employee of a company under contract with a school or school district, who has witnessed or has reliable information that a pupil has been subjected to insults, taunts, or challenges, whether verbal or physical in nature, which are likely to intimidate or provoke a violent or disorderly response shall report such incident to the principal, or designee who shall in turn report the incident to the superintendent.

III. The remedy required in paragraph II shall be defined by the local school board. The local school board may provide opportunities for educators to have the knowledge and skills to prevent and respond to acts covered by this chapter.

IV. A school employee, or employee of a company under contract with a school or school district, who has reported violations under this chapter to the principal, or designee or who has intervened under paragraph II, shall be immune from any cause of action which may arise from the failure to remedy the reported incident.

Source. 2000, 190:1, eff. Jan.1, 2001.

LINK: Gen Court

Safety (No Harm) Contracts

Despite their widespread use, little research has been done on the effectiveness of safety contracts with suicidal clients. Research studies that have examined the use of safety contracts in clinical practice have been unable to determine any statistical significance of their effectiveness. (For more information see the New England Journal of Medicine.)

Willingness to “contract for safety” should not be itself be a substitute for a full assessment and evaluation conducted by a trained professional. Neither does it take the place of developing a comprehensive safety plan that identifies and involves community resources and key individuals for the youth. It is also important to note that the presence of a signed “safety contract” in and of itself does not release liability.

Many clinicians use safety contracts as a component of risk assessment and disposition planning. Used in its proper context it can assist in gathering important information about judgment and help seeking behavior (eg. What will you do if you are feeling like hurting yourself again?) Knowing if a client is unwilling or unable to agree to seek help, or keep themselves safe is an important piece of information to have.

Duty to Protect Duty to Warn

Duty to protect In Loco Parentis: While children are in school or at school activities the school stands in the place of the parents which includes the duty to protect, discipline and take care of the child. This requires any school employee to take action to prevent harm from befalling a student. For example if one student has threatened to harm another student, you should take steps to protect the child who has been threatened. You should consult with your supervisor, administrator or legal counsel regarding specific situations where this may apply.

Duty to Warn: Under NH law, licensed mental health professionals and (psychiatric nurse/practitioners) have a duty to protect an individual against harm if a threat has been made against them by a client. This is commonly referred to as a “Tarasoff Warning.” Typically a warning may include direct notification of the threatened individual, and/or direct notification of the police, and/or civil commitment of the individual making threats (with information provided to the institution where committed). Non licensed practitioners in NH are not necessarily held to the same standard, however warning an individual under the guidelines of this statute or general Tarasoff practices might be a reasonable and prudent action to take. In any of these situations, it is best to consult with a supervisor, administrator, or attorney before proceeding.

330-A:35 Civil Liability; Duty to Warn –

I. Any person licensed under this chapter has a duty to warn of, or to take reasonable precautions to provide protection from a client’s violent behavior when the client has communicated to such.

Guidance

References:

ED 306.10(a)(2)(d)

ED 306.14(a)(16)

RSA 200.34

RSA 194-F:3

RSA 220-A:35

Revised from 8/8/05

First Reading Coordination: 10/10/12

Second Reading and Adoption by BOSC: 11/13/12