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San Carlos ESD |  E  5141.52  Students

Suicide Prevention   

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EXHIBIT A: San Carlos School District Suicide Assessment Protocol

1. Stay with the child and remain calm

2. If possible, designate someone to contact one or more of the following to conduct an initial Suicide Risk Assessment

a. Principal

b. Assistant Principal

c. Aftercare Site Coordinator

d. School Counselor

e. School Psychologist

f. Nurse

g. Other staff member

3. Stay with the child and remain calm

4. If possible, identify a person on site who has a relationship with the child to support the person, or take over. Please note: on site personnel are responsible for conducting the initial assessment. They are not responsible or qualified to initiate the actual 5150/5585. A certified professional (School Resource Officer or member of our District's Child Crisis team/staff members or a previously identified and vetted vendor) must be called in to conduct a second, official assessment if the student is deemed at risk.

5. Complete Suicide Risk Assessment

6. Assess risk factors: Suicide Inquiry (thoughts, plan, intent, access)

7. Assess for child abuse

8. Assess protective factors

9. Use clinical judgment and contact School Resource Officer for official assessment if deemed at moderate/high risk (650) 363.4911 or (650) 802.4277

10. Complete District's established Safety Plan

11. Offer District's established Safety Resources

12. Continue to stay with the child

13. Designate someone to notify the School Principal and/or Aftercare Site Coordinator

14. Designate someone to call a School Resource Officer to conduct an official assessment (650) 363.4911 or (650) 802.4277

15. Give details of assessment and concerns Suicide Risk Assessment

16. Designate someone to call the parents/caregivers, if child abuse by a parent has been ruled out

17. Provide Safety Resources

18. Staple the Suicide Risk Assessment and the Safety Plan together and make a copy for your own file

19. Provide a copy of Suicide Risk Assessment and Safety Plan (if able to complete) to the following team members:

* School Principal (The school principal will store original forms in a student file within a locked cabinet in the school principal's office.)

* Afterschool Site Coordinator

* School Counselor

* School Psychologist

* Resource Officer, if requested

20. Provide parents/caregivers with Safety Plan and Safety Resources

21. School sets up re-entry meeting with parents/caregivers to discuss support plan for student prior to student return to school

22. Upon re-entry, student to check-in with school counselor, school psychologist, or Marriage and Family Therapist (MFT) trainee/intern

23. Student placed in school-based support group

24. Student and family provided ongoing support

Exhibit SAN CARLOS ELEMENTARY SCHOOL DISTRICT

version: June 15, 2017 San Carlos, California