If you or anyone you know is struggling with thoughts of self-harm or suicide, help is available. Call or text 988 to reach the confidential National Suicide Prevention Lifeline or check out these resources from the American Foundation for Suicide Prevention.
The country’s largest school district is training its 1,500 school nurses in suicide prevention best practices as America’s youth increasingly struggle with mental health problems and as suicide rates among young adults rise.
The New York City school district this academic year launched a new partnership with the city’s health department and the JED Foundation—a national nonprofit that focuses on suicide prevention and youth mental health—to develop a standardized suicide prevention course for health professionals in the district that serves nearly 1 million children in kindergarten through 12th grade.
By the end of October, all 1,500 of the city’s public school nurses will complete the 90-minute online course, designed to bolster their ability to identify students at risk for suicide, conduct a screening test to determine their risk level, and refer them to other supportive services.
“Our schools aren’t just places where our children go to learn—they’re where they go to grow up, to find themselves, to make friends, and to have the support they need to get through whatever’s going on in their lives,” Camille Joseph Varlack, chief of staff to New York Mayor Eric Adams, who oversees the two city departments involved in the training initiative, said in a statement. “With this new partnership, we’re making sure that our school nurses have the training they need to identify warning signs of suicide and get at-risk young people the help they need.”
The training better positions school nurses to aid other school-based mental health professionals like counselors and psychiatrists in supporting students in need—a tall order as approximately 9 percent of the city’s public high school students reported a suicide attempt in the past year, according to a report from the city’s health department.
If successful, JED hopes to replicate the school nurse training initiative for other districts that are interested, which could help bolster much-needed support systems, said Tony Walker, JED’s senior vice president of academic programs.
Nearly 40 percent of U.S. high school students last year reported feeling so sad or hopeless for at least two consecutive weeks in the previous year that they stopped engaging in their usual activities, according to the most recent U.S. Centers for Disease Control and Prevention’s biennial Youth Risk Behavior Survey. Suicide is the second leading cause of death for people aged 10 to 14. Nationally, 9.5 percent of high school students in 2023 reported attempting suicide in the past year, according to Youth Risk Behavior Survey.
“At the end of the day, nurses really are just perfectly positioned as one of those very first bases for mental health services, so we want to make sure that they are trained and know exactly what to do and what procedures to follow to support students,” Walker said.
“Oftentimes, when school district leaders are having this conversation around school mental health, they think of the school counselors and psychologists and nurses are left out of the equation, and that’s unfortunate because we know nurses are often the very first places pre-K through 12th grade students turn when hurting either physically or emotionally.”
Kate King, president of the National Association of School Nurses, agreed that nurses are often students’ first contact when they’re struggling with mental health problems.
Most school nurses have “foundational education in mental health,” she said in a statement, but “ongoing education for current and evidence-based practices is important for school nurses to continue to provide the best possible mental and behavioral health services for students.”
The training equips school nurses to serve as a front line of mental health support
The JED partnership with New York City schools was prompted by the variability in the confidence of the district’s school nurses to administer a suicide screening, according to Walker. The screening is a brief set of questions that determines a person’s risk level for self-harm and suicide. Some were very comfortable with the concept, while many others were asking district leaders for help and guidance because they were unfamiliar.
So the organization, school district, and city health department partnered to develop a standardized training. It includes modules that outline the current landscape of youth mental health challenges and common problems, as well as defining the nurse’s role in supporting students; identifying suicide prevention liaisons in the school and community; recognizing the signs of a student in distress; assessing and screening students for their risk of dying by suicide; outlining the steps nurses can take when they determine a student is at risk of suicide; and how school nurses can care for themselves, manage burnout, and identify signs of distress in themselves as they continually work through challenging situations with students.
The training and its objectives align with existing New York City schools procedures about responding to tragedies and mental health challenges, Walker said.
“This training kind of just further links the how-to to the policy,” he said.
The training also covers the ways in which the nurses and other mental health professionals in the school can and should work together to provide care. For example, the training outlines the steps a school nurse should take to loop in mental health support if a student comes to their office with self-inflicted wounds, Walker said.
As of Sept. 30, about 700 school nurses had completed the training. At its completion, participants are asked to fill out a survey to gauge its effectiveness. More than 9 in 10 participants reported they felt well prepared to incorporate the training into their daily work, and all participants reported an increase in their confidence in administering a suicide screening and helping students in crisis.
JED and the New York school district officials are discussing whether other groups of staff in the district should undergo the same training, and JED is hopeful it can be replicated for other districts, Walker said.
