Are you thinking of killing yourself?
That's the first question suicide screeners ask students in the Hillsboro School District.
The next is whether the student has any means to carry out a plan. Do they have rope? A gun? Have they made any previous attempts? Are they using alcohol or drugs? What resources and support systems do they have in place?
These are just some of the questions asked during a suicide screening. They're abrupt, and somewhat uncomfortable. Yet research shows these questions are the most effective way to intervene if a person is thinking of suicide.
"There's this notion that if we ask someone if they're thinking about suicide, that it's going to tip them. If we ask them in a responsible way, research suggests that it won't tip someone over the edge," said Hillsboro School District care coordinator Andrew Chipps.
Conducted by principals, administrators and counselors, suicide screening determines whether a student is experiencing suicidal thoughts and helps evaluate their level of risk.
Just 10 years ago, the district didn't have any suicide protocols in place. Now, every elementary, middle and high school in the district has suicide screeners on campus. The screenings are just one of the ways Hillsboro's district is opening up the conversation about mental health.
The change has not happened overnight. According to Chipps, in 2009, HSD became one of the first school districts in Washington County to create its own suicide prevention protocol. Over the course of nine years, the district has added suicide screenings, suicide awareness teacher trainings, and has incorporated mental health into the curriculum.
The district recorded 101 suicide screenings in the 2013-14 school year, according to Chipps. In 2016-17, it recorded 225. In 2017-18, it had 352.The drastic increase in screenings could be for a variety of reasons, Chipps said. One is that the protocol helped teachers develop a greater awareness of their students' mental health. Also, as teachers became more familiar with the protocol, they may have felt more comfortable addressing students.
As a care coordinator, Chipps not only works with at-risk individuals, but also facilitates yearly suicide-awareness trainings. What he wants to do with the trainings is plant the thought that talking responsibly about suicide does not increase the likelihood of it. "We don't have to be a mental health expert to help someone who is at risk for suicide," he said.
Yet according to Jacqueline Nguyen, a 2019 Century High School graduate, students are largely unaware of the mental health resources her school offers. "Most students don't know we have a school health center," she said. And it was only last year that Nguyen learned that her school had suicide screeners on campus through her School Health Advisory Club adviser.
"I don't think the school has ever talked about suicide specifically," Nguyen said. To further address it, Nguyen proposed her school take a day during Unity Week to discuss it. The week is dedicated to unifying students, and Nguyen said students need to be educated about the mental health resources available to them.
Nguyen's comments are "reflective of the challenge that students and school staff face when working together on important topics such as mental health," Chipps said.
Still, all HSD high schools work to make sure students have the best mental health resources on hand, he said.
At Forest Grove High School, mental health and suicide are being talked about. But according to three members active in SHAC last school year, the conversation is being led not by the school but by the students themselves.
Hanneke Hunter said she has helped friends on the brink of suicide. She's had friends help her when she's been struggling. Yet talk of suicide or mental health is confined within friend groups, she said.
"Suicide is dealt by peer-to-peer," Hunter said. Instead of reaching out to counselors, students rely on the support of their friends.
Hunter wants the school to engage with students about their mental health. "We need kids to feel close to their counselors. They need to feel that connection with their counselor to trust them," she said.
Jairo Vega-Garibay agrees with Hunter about the school's lack of information on mental health. "It's general knowledge that the school has counselors and that students could go there for help," he said. "But the school doesn't really talk about mental health or suicide."
Besides the events that SHAC puts together and the occasional health class, Hunter and Vega-Garibay thought their school neglects talking about mental health. To raise awareness of suicide, Vega-Garibay said the school should have mental health professionals visit each class and have a conversation about the signs of someone experiencing suicidal thoughts, and what resources they have available to them.
FGHS counselor Megan VanZanten had a different perspective. "It's an ongoing effort to communicate to all students what is available to them," she said. Students are educated about suicide through health and advisory classes, both of which are required for all students, she said.
Additionally, along with having mental health professionals on site, FGHS conducts schoolwide mental health surveys to collect information on which students need support. VanZanten felt confident that students would know how to contact a counselor, administrator or teacher if they or a friend needed help.
Two years ago, the FGHS group Student Voices for Equity surveyed students about which issues were the most important for the school to address. The issue that received the most responses was racism, which was expected. The second issue was mental health awareness, which came as a surprise.
In response, students in the FGHS poetry club wrote a group poem describing their own different kinds of struggles with mental health. It described the anxiety of walking into a crowded room, the panic attacks that can happen at any moment, the pain of having no one to turn to. It embraced those feeling alone, defeated and lost.
Ending with words of comfort and hope, the poem offered solace: "Our hearts go out to those like us. Take them. So you won't be alone."
Hannah Kendall is a student at Pacific University in Forest Grove. She reported this story this spring as part of her Advanced Reporting class.
Screening for Suicide
In the Hillsboro School District, anything a student writes, says or even posts that indicates suicidal thoughts is cause for a suicide screening. Whether it be a bus driver overhearing a student talk about suicide or a teacher finding evidence of it in their schoolwork, the student is screened.
How students answer the questions determine whether they need to be evaluated by a mental health professional. Student risk is categorized as either level 1 or level 2. Students at level 1 aren't a danger to themselves and are at low to moderate risk. However, students rated at level 2 are at high risk and are taken to a hospital, their therapist, or the Hawthorne Walk-In Center, a Washington County clinic that provides free, immediate care for mental health emergencies.