HELPLINE: 650-638-0802 / CRISIS LINE: 650-579-0350 / TEXT 988 LIFELINE

About Mental Health

Mariah was the new kid in eighth grade. Just a few months after her first day, the teacher took notice when she stormed out of class after her assigned partner kept rolling her eyes and talking with other friends. The teacher didn’t know what happened, so he consulted a school official and decided to talk to the girls separately. He started with Mariah. “What happened yesterday?” he said. “You looked upset. You left pretty suddenly.” Mariah reluctantly confided to her teacher that her classmate criticized her looks and behavior. The teacher paused. Such an interaction is all too common for middle school students, but Mariah’s dilemma wasn’t real. It was part of a computer simulation exercise for schoolteachers and administrators. The moment after the teacher paused, the screen gave participants options on what he should say next to Mariah.

A health simulation company called Kognito developed the program as training for teachers in middle schools to recognize at-risk behavior, and it’s one of several new tools being used by Bay Area schools to combat teen suicide since the passage of AB2246.

A computer simulation training program developed by Kognito helps teachers in San Mateo County’s elementary and middle schools recognize warning signs in youths at risk of suicide.

The bill, which has been implemented over the past school year, requires school districts to adopt suicide prevention plans and policies for grades seven through 12. The policies must address numerous students groups, including children with disabilities and those have experienced homelessness or foster care, or are LGBTQ.

Few places in the state acted more aggressively in taking up this option than San Mateo County, which created a prevention plan for its 24 school districts in part because of its proximity to Palo Alto, which has a well-documented history of teen suicide.

“We all were so close to Palo Alto … so we’ve been very, very committed to working together to try to build this more systemic approach,” said Mindy Hill, the wellness director for San Carlos Unified School District.

An astonishing number of youth suicides in Palo Alto occurred in 2014 and 2015, when four people died by stepping in front of trains near Gunn High School. The deaths shocked a community already on edge after the city’s school district dealt with a cluster of suicides nearly five years earlier in 2009 and 2010, when six young people took their lives.

In San Mateo County, 19 people ages 10 to 19 killed themselves from 2010 to 2015, according to data provided by the county. In 2013, the county had the highest rate of children and teens who were hospitalized for self-injury compared with neighboring counties and a rate higher than the state average: 54 per 100,000 people ages 5 to 20.

That number soared to 71.2 per 100,000 people in 2014, said Molly Henricks, the crisis services coordinator for San Mateo County.

After the implementation of AB2246, health officials and school administrators rallied together to develop a plan to address the needs of the students within the county, she added.

“We pulled everybody together and spent about six months going through resources in other counties and school districts and created one that worked specifically for San Mateo County,” Henricks said.

In the first year of the bill’s passing, schools were required to have a policy in place that promoted training to better prepare staff to recognize suicidal thoughts and behavior.

For San Mateo County, that meant tapping into a network of administrators, law enforcement officials, teachers, family members of students who had experienced mental health issues, and current and former students who suffered from depression. Altogether, the county created a tool kit for its two dozen schools — which is part of the guidelines set by AB2246.

At the San Carlos Unified School District, suicide prevention has always been a priority, Hill said, but AB2246 allowed staff to participate in an interactive webinar, which served as extra training to identify at-risk youth.

“It’s kind of coaching the staff member on how to listen to students effectively and then how to direct them to help in a supportive way,” Hill said.

The district wants educators to be on guard for any students exhibiting signs of despair or isolation. Then, a school counselor, the principal or a nurse will be called in to conduct a suicide risk assessment. If the assessment determines the student shows a high risk for suicide, he or she will be placed on an involuntary psychiatric hold, also known as a code 5150. This process is another guideline that AB2246 required from schools.

It’s still too early to determine how effective AB2246 and San Mateo County’s strategies have been in changing the total number of students impacted, Hen-ricks said, but county officials believe the innovative approach will save lives in the future.

Plans are also in place to implement a mobile mental health clinic for students, so that any young person experiencing suicidal thoughts can be treated immediately on campus, Hill said.

Sarah Ravani is a San Francisco Chronicle staff writer. Email: Twitter: @SarRavani

“It’s kind of coaching the staff member on how to listen to students effectively and then how to direct them to help in a supportive way.”
Mindy Hill, wellness director, San Carlos Unified School District