Suicide prevention in primary school children is a growing topic of concern for practitioners. In June, KidsMatter facilitated a webinar on this topic, and one expert panellist was Maria Ruberto, a consultant psychologist of Salutegenics Psychology. Maria provided useful insights and strategies for health and community professionals working within schools as well as those in the private sector. Health and community practitioners play an important role in supporting schools and families with implementing strategies to assist children’s development of positive mental health.

Key points highlighted by Maria included: ways to build children’s relational capacity; emotional literacy; and key questions to ask children who display concerning behaviours.

Responding to suicidal behaviours involves a holistic approach by engaging key people in the child’s life such as parents, carers, siblings, school staff and professionals. At the school level it is important to understand that:

  • Any suicide prevention in schools requires a systems response
  • Wellbeing is the responsibility of the entire school community, not one person
  • Like a child’s education, wellbeing has the best outcome when a team of people support the learning on a day to day basis
  • All schools have a critical incident process to follow – know this for your school

Knowledge of a child’s school support system, including processes and procedures for responding to critical incidents is important for health and community practitioners working with all children, but particularly those who are showing signs of mental health difficulties.

Support children to build health relationships

Key relationships in a child’s life serve as protective factors for children’s mental health. When working with children showing signs of mental health difficulties, building and fostering a strong therapeutic alliance is fundamental to implementing positive change. Practitioners also play an important role in supporting children to build solid relationships at a family and school level.

When supporting children to build healthy relationships it is important to remember:

  • Relationships in the classroom and within the school community are fundamental to student and staff wellbeing
  • Relationships are built on trust, safety and security.  Children will reach out to you if you can demonstrate on a daily basis that you offer these moments of connectedness
  • Safe relationships are a child’s highest protective factor – this enables schools to act preventatively

Children need to be emotionally literate

A key factor in mitigating against risk of suicide in children is supporting them to build emotional literacy. Teaching children to connect with, label and express emotions in a healthy way is an important protective factor.  Emotional literacy enables the identification, naming and expression of all emotions, and also:

  • reduces fear of negative emotions, and therefore reactive behaviours
  • provides expression to the internal confusion and allows children to “be seen”
  • offers validation to their experience of life and that they are important enough to be heard and to have their needs met appropriately

Suicidal talk and behaviour in children can be challenging to respond to, however it is important to develop, foster and maintain open channels of communication. Three levels of engagement to use when concerned that a child may be at risk of mental health difficulties are: questions to approach, questions to expand and statements to assist. Practitioners can support both families and schools with developing skills to engage children by asking questions relating to wellbeing.

Questions to approach

  • How are you?
  • How are you feeling?
  • How have you been lately?
  • I’ve noticed that you’ve been especially quiet, is everything OK?
  • I’ve noticed you seem distant or distracted, is that right?
  • I’ve seen lately that you have been less engaged with your work.  Are you OK?

Questions to expand

  • I care about you and your learning.  I can see that something is distracting/bothering/upsetting you
  • I care about you.  I care that you seem upset. I am happy to listen, to see if I can help you in some way
  • I know that saying things out aloud sometimes feels scary, but I can be a strong listener, and I won’t judge what you say
  • Come and find me anytime during lunch or recess and we can find a quiet place to talk.  I care about what is happening for you at this time

Statements to assist

  • This sounds distressing/upsetting for you. I can hear how hard it is.  You are an important student in this school, so we can think about how we can help you
  • Who have you spoken to about this?  Who would you like to talk to about this?  This is something that I’m not good at, but I won’t leave you alone with this.  We need to think of people who can offer you some strategies
  • My job is to make sure you are OK at school, and we are here to help you.  I can’t help you by keeping this information to myself, but I can help you by making sure that only the people who need to know will know.  Your privacy will be respected, and your wellbeing will be our priority

A holistic approach to suicide prevention in children is key. Intervention needs to involve central figures in the child’s life such as families and schools. Health and community practitioners play an important role in supporting clients at the individual, family and community level.

For more information:

Resources to support children's mental health

An approach to the prevention of suicide in children