A Three-Part Study Investigating Suicide Risk Assessment in Schools
Background: As the second leading cause of death in adolescents, suicide is a major concern for youth-serving professionals. With the amount of time students spend in the academic setting, schools are pressured to address youth suicide through prevention and intervention procedures. However, many schools do not assess for suicide risk or engage in suicide prevention with students. As school-based mental health providers, school psychologists are uniquely positioned to address suicidality in adolescents; however, many leave graduate school with a lack of training in this area. Previous studies show a disparity in school psychology trainees and program directors' perceptions of graduate training in this area. This incongruence may reflect a gap in research related to the current state of school psychologists' training in suicide risk assessment and the impact that lack of preparedness may have on crisis responding and knowledge of suicide-specific measures for diverse populations. Moreover, this lack of training may lead to lack of accurate and appropriate assessment of diverse populations, such as individuals with ASD who are at higher risk for suicide attempt. Purpose: Three studies examined school psychologists' role and competency in suicide prevention and examined the factors that may influence comfort and confidence identifying and intervening with students who are suicidal. The first study sought to better understand school psychologists’ graduate preparation and perception of both their role and competency in suicide risk assessment. The second study examined what factors influenced school psychologists’ comfort identifying and intervening with suicidal youth. The aim of the third paper was to conduct a scoping review to examine suicidality in school-age youth with autism spectrum disorder. Methods: Study 1 surveyed school psychologists (N = 92) to examine their perception of their role and competency in suicide risk assessment. Study 2 was a secondary analysis using data from Study 1. This study involved conducting multivariate multiple regression to examine whether receiving graduate training in suicide risk assessment, the level of graduate training, or serving on a crisis team predicted confidence in suicide-specific knowledge, comfort identifying, or comfort intervening with students at risk for suicide. Study 3 was a scoping review examining suicidality in autistic youth. It was conducted using the five steps laid out in Arksey and O'Malley (2005) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: Study 1 participants indicated lacking adequate graduate preparation; however, most participants were confident in their knowledge of suicide and suicide risk assessment and were comfortable identifying and intervening with a student who is suicidal. Study 2 results found that receiving suicide-specific professional development, suicide-specific graduate training, and crisis team membership predicted confidence in knowledge of suicide, comfort identifying students at-risk for suicide, and comfort intervening with students who are suicidal. Study 3 extracted 48 studies focused on suicidality in youth with ASD. This study highlighted suicide risk factors, measures used for suicide risk assessment, and the impact of ASD characteristics on suicide risk assessment processes for autistic youth. Implications for practice and directions for future research are discussed.