factors. Students are taught skills that build their self-esteem, help them identify emotions and stressors in their lives, and increase communication and problem-solving skills while eliminating self-destructive behaviors. This program also helps participants create personal and community goals. The lessons are interactive and use personalized experiences related and relevant to an American Indian’s adolescent life. The program has been adapted to be used by 20 different Native American tribes (LaFromboise, 2014). Expected outcomes from this program are an increased level of suicide-intervention skills and a decrease in feelings of hopelessness. A study was performed in the Zuni Pueblo reservation. Of the group participants, 59 students were assigned to the no- intervention group control group and 69 students were included in the intervention group. Students in the intervention group performed significantly better on measures of hopelessness and on the risk of suicide, including suicidal ideation. However, there were no differences noted between the control and the School-based interventions The University of California, Los Angeles, developed suggestions for intervention strategies when students are in immediate danger of suicide, including how to respond to the student (UCLA, 2016). Their guidelines suggest taking action if a student is: ● Talking about wanting to die or to kill themselves. ● Looking for a way to kill themselves, such as searching online or obtaining a gun. ● Talking about feeling hopeless or having no reason to live. Intervention strategies suggested by UCLA are as follows: ● Talk with the student. ● Listen without judging and show you care. Assess the student for risk of suicide and other forms of self-injury. ● Take away any potential method of harm, such as a knife or pills. ● Do not leave the student alone, not even in a restroom. ● Collaborate with the school administration and any other available behavioral health staff in making decisions about next steps. ● Notify and involve the parents/legal guardians. They must always be notified when there appears to be any risk that a student may harm himself or herself, unless doing so would place the child in a dangerous situation. It is important to be sensitive to the family’s culture, including attitudes toward suicide, mental health, privacy and help-seeking. Many school-based, workplace-based, and community-based interventions and multicomponent primary care interventions can reduce the incidence of suicide and suicidal behavior. It has also been shown that the organization of school-based programs in conjunction with primary interventions can lead to enhanced identification of those at risk, as well as reduce the access to means of suicide through work with parents and families (Perlis et al., 2016). Leads for youth Linking Education and Awareness of Depression and Suicide (LEADS) is a school-based suicide awareness program in which high school youth learn about depression and suicide in an effort to empower help-seeking. Teachers can implement the three- hour program, which has demonstrated outcomes regarding knowledge and attitudes related to depression and suicide and knowledge of resources (Minton & Bruner, 2016). Applied suicide intervention skills training The Applied Suicide Intervention Skills Training (ASIST) is an evidence-based program rated as promising within the most recent NREPP standards. The ASIST intervention is divided into three phases: connecting, understanding, and assisting. The first two phases focus on listening to personal at- risk experiences with a specific concentration on risk factors and motivations. In the final phase, caregivers assist clients in creating a safety plan
intervention groups in the levels of depression. The intervention group showed better problem-solving skills and greater suicide- intervention skills compared to the control group (LaFromboise & Malik, 2016): This curriculum addresses key issues in Native American Indian adolescents’ lives and teaches such life skills as communication, problem solving, depression and stress management, anger regulation, and goal setting. The course is unique in its skills- based approach. After first increasing awareness and knowledge of suicide, it then teaches students specific methods to help a peer turn away from suicidal thinking and seek help from an appropriate helper. The skills-based approach of this curriculum follows well- established teaching methods to develop social skills. Teachers and peers inform students of the rationale and components of a particular skill, model and demonstrate the skill for them, and later provide feedback on individual skill performance. that specifically addresses each issue identified during the first two phases. Training to become an ASIST caregiver takes place over two consecutive days and encourages the recognition of a direct connection between current struggles, suicidal thoughts and potential supports. A randomized control trial focused on the National Suicide Prevention Lifeline revealed that ASIST-trained counselors showed stronger suicide- intervention skills, including a greater likelihood to explore warning signs, reasons for living, ambivalence about dying, and supports; they also had longer calls, and their callers reported more positive change compared to callers who spoke to other counselors. Similarly, school counselors who received ASIST training reported increases in suicide intervention skills, knowledge about suicide, and helpful attitudes related to suicide (Minton & Bruner, 2016). Lifelines Lifelines, a comprehensive prevention program designed for use in middle and high schools, focuses on opening pathways for help-seeking youth and ensuring that both students and staff can respond appropriately to students at risk. The three- hour curriculum has been demonstrated to increase knowledge about suicide and promote positive attitudes related to suicide intervention, seeking adult help, and helping a friend get help (Minton & Bruner, 2016). Kognito: At-risk for high school educators Kognito is a one-hour online program that teaches school staff members how to identify, approach, and refer students at risk of suicide. The program includes role-play interactions that help teachers motivate students to accept support. Participants who complete Kognito have shown greater ability to recognize, approach, and refer students, and they are more likely to do so than control groups (Minton & Bruner, 2016). California youth suicide prevention In 2019, Governor Gavin Newsom signed three suicide- prevention bills. Assembly Bill 1767 expands suicide-prevention programs to all the grades before grade 7 (Yarbrough, 2019). Another bill, AB34, targets bullying, a problem that has been linked to youth suicide. Assembly Bill 984 allows taxpayers to send excess tax payments to a suicide prevention fund (Yarbrough, 2019). The best place to find and identify youth who might be vulnerable to suicide is in schools. Assembly Bill 1808 was passed in 2018, covering education finance. According to Chapter 32 of the bill before passage, this bill requires the State Department of Education (DOE) to identify one or more evidence-based online training programs that a local educational agency, as defined, can use to train school staff and pupils as part of the local educational agency’s policy on pupil suicide prevention. The bill then requires the DOE to provide a grant
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