CRISIS Response and recovery Miami-Dade County Public Schools Crisis Management Program Division of Student Services Martha Z. Harris, Administrative Director Alina Gallego & Frank Zenere, Crisis Team Members

CRISIS RESPONSE DATA: 2016-2017 Incident Number Student Accidental Deaths 15 Student Deaths by Illness 20 Student Homicides 13 Student Suicides 7 Student Non-Fatal Incidents Staff Fatalities 25 Total Crisis Responses 87

Student Fatality Data: Five Year Review   2012-13 2013-14 2014-15 2015-16 2016-2017 Student Fatalities 45 38 36 41 55 Student Fatality Data by Cause of Death 2012-13 2013-14 2014-15 2015-16 2016-2017 Accidental 13 8 9 6 15 Homicide 14 19 Illness 16 12 20 Suicide 7 3 1 Total 45 38 36 41 55

Miami-Dade County Public Schools Student Fatality Data by Cause of Death Five Year Review: 2012/13- 2016/17

Crisis Helpline Report: Five Year Review Risk Behavior 2012-13 2013-14 2014-15 2015-16 2016-17 Suicides 7 3 1 Suicide Attempts 67 69 32 33 Suicidal Gestures 26 31 47 Suicidal Threats 207 183 231 211 321 Suicidal Ideations 310 349 219 282 268 Self- Injury 242 260 221 190 227 Homicide Attempt Homicidal Threats 103 82 98 122 91 Homicidal Ideations 27 23 19 13 Homicidal Gestures 2 5 Misc. Risk Behaviors 255 300 188 204 Total 1,268 1,300 1,143 1,109 1,214

Miami-Dade County Public Schools Student Suicidal and Self-Injurious Behaviors Five Year Review : 2012/13-2016/17

Crisis helpline report: additional data Incident 2014-2015 2015-2016 2016-2017 Baker Acts 221 224 226 Baker Acts Initiated at School 164 157 168 Baker Acts Initiated at School by School Police or Clinician 127 122 142 Baker Acts Initiated at School by Local Police 37 35 26 Baker Acts Initiated at Home 57 67 58

DISTRICT CRISIS MANAGEMENT TEAM: ROLES AND RESPONSIBILITIES Lead and coordinate the assessment of students’ and staff’s emotional and behavioral needs following a critical incident or disaster. Coordinate and provide crisis counseling services at school sites in the aftermath of a student or staff death, or other traumatic incident impacting M-DCPS students or staff members.

DISTRICT CRISIS MANAGEMENT TEAM: ROLES AND RESPONSIBILITIES Provide: consultation for school administrators, school mental health professionals, teachers and parents resource materials prevention oriented presentations for school staff, parents and students training for school-based critical incident response teams

SCHOOL CRITICAL INCIDENT RESPONSE TEAM Administrator Counselor, Social Worker, Psychologist, TRUST specialist Teacher Office Manager Cafeteria Manager School Nurse, Health Aide Parent P.E. Teacher Custodian Security/School Resource Officer

GUIDELINES FOR IDENTIFYING STUDENTS WHO MAY BE IMPACTED BY A DEATH witnessed the incident; were close friends; shared a class; shared extracurricular activities; shared a similar characteristic; had a troubled or strained relationship with deceased; and have a history of loss or emotional difficulties.

CIRCLES OF VULNERABILITY ASSESSMENT OF IMPACT/ POTENTIAL TRAUMA CIRCLES OF VULNERABILITY MAPPING BY THREE DIMENTIONS GEOGRAPHICAL PROXIMITY PSYCHOSOCIAL PROXIMITY POPULATION AT RISK Lahad, M., Crisis Prevention Center, Israel

RESPONSE ACTIONS: SUPPORTING STUDENTS Designate a private and quiet space for counseling services (separate areas for students and staff). Equip room with boxes of tissues. Supply water and snacks. Provide rolls of paper (light colors) and markers. Follow the class schedule of the deceased student or teacher.

RESPONSE ACTIONS: SCHOOL MENTAL HEALTH PROFESSIONALS Goals : Help students understand and deal with difficult feelings. Help students with coping behaviors to enhance emotional functioning, maintain attendance, and support classroom learning.

SCHOOL MENTAL HEALTH PROFESSIONALS RESPONSE ACTIONS: SCHOOL MENTAL HEALTH PROFESSIONALS Psychological First Aid An evidence based approach for assisting individuals in the immediate aftermath of a critical incident or disaster. Designed to reduce initial distress connected to traumatic events, and enhance short-and-long-term adaptive functioning.

Psychological First Aid: Core Actions Contact and engagement Safety and comfort Stabilization Information gathering Practical Assistance/ Self Empowerment Connections with social supports Information on coping Linkages with collaborative services

Psychological First Aid: Making Contact Introduce yourself and ask permission to talk to the individual; explain purpose of meeting. If you do not know an answer, find someone who does and be sure to follow up with the individual later. If your help is declined, respect that decision and provide information where help can be found later. Accept people where they are emotionally at the time of contact. Do more listening than talking. Conduct yourself in a calm, respectful and competent manner.

Providing Psychological First Aid: Promote Safety and Comfort Evaluate the area for physical safety risks and make necessary alterations. Evaluate the area for emotional safety and make necessary alterations such as protecting individuals from the media or removing reminders of the event. Provide assistance in an area with little noise or distraction. Meet basic needs. Dispel rumors; clarify misunderstandings.

Psychological First Aid: Stabilization Remove students in need of individualized support. Help put words to feelings and concerns; help them to understand their feelings and attempt to reduce their stress. Use breathing/ relaxation techniques to bring distress under control. Validate reactions and feelings being experienced.

Psychological First Aid: Information Gathering Listen to people talk about their concerns as it relates to their current needs. Don’t push for detailed information about the traumatic event. At this point ask questions that encourage yes or no responses in order to limit too much discussion. Maintain focus on the task at hand.

Psychological First Aid: Practical Assistance/Self-Empowerment Problem solve and address practical needs. Provide information about what to expect, without making unrealistic promises. Support the following of a daily routine that includes normal/familiar life. activities.

Psychological First Aid: Connections with Social Supports Ask students what they need. Help family members reunite. Help connect with friends, teachers. Discuss ways that students can help each other. Inform students of activities and recovery efforts for which they may volunteer. Urge students to alert an adult if they or peer are in need of assistance.

Psychological First Aid: Information on Coping Provide education about range of reactions one may experience. Describe coping strategies that other students have found helpful. Encourage self-care practices and routines. Address potential problems (sleep, mood, functioning). Reestablish the learning environment.

Psychological First Aid: What Not to Say You’ll feel better soon You are lucky you survived I understand Don’t feel bad You’re strong You’ll get through this Don’t cry It’s God’s will It could be worse At least you still have… Everything will be OK

Psychological First Aid: Linkages with Collaborative Services Let students know how they can obtain individual services. Connect students with appropriate support persons and agencies. Discuss constructive or pro-social activities that can promote recovery. Encourage school officials to monitor student reactions and make necessary referrals.

SCHOOL MENTAL HEALTH PROFESSIONALS RESPONSE ACTIONS: SCHOOL MENTAL HEALTH PROFESSIONALS Psycho-education Crisis facts are understood and rumors are dispelled. Potential crisis reactions are identified and normalized. Stress management strategies are identified and/or taught. Psychopathological crisis reactions and coping strategies are discussed and referral procedures identified.

Coping with CRISIS: WHAT HELPS Talking to another person for support. Engaging in positive distracting activities (sports, hobbies, reading). Getting adequate rest and eating healthy meals. Trying to maintain a normal schedule. Scheduling pleasant activities. Taking breaks.

Coping with CRISIS: WHAT HELPS Spending time with others. Using relaxation methods (breathing exercises, meditation, calming self-talk. Participating in a support group. Exercising in moderation. Keeping a journal. Seeking counseling.

RESPONDING TO A SUICIDAL CRISIS Keep student under adult supervision at all times. Conduct a risk assessment (school mental health professional). Contact Miami-Dade Schools Police (305-995-COPS) if a Baker Act is being considered. If a Baker Act is to be performed, the student’s parent/guardian should be contacted AFTER the student has left the school-site and is in route to the appropriate crisis center.

RESPONDING TO A SUICIDAL CRISIS In all other cases of suicidal crises or self-injurious behaviors, the student’s parent/ guardian should be contacted and asked to come to the school and receive their child. Parent/ guardian should be provided a list of appropriate community-based counseling resources and strongly encouraged to immediately transport their child for a mental health assessment. Contact the District Crisis Helpline( 305-995-CARE) for consultation and reporting of incident. Enter appropriate risk codes into ISIS.

Post-Hospitalization procedures Hold emergency SST/ RT meeting to address the following: The nature of the crisis Current diagnosis or diagnoses Risk behavior, behaviors of concern Discharge summary/ impressions/ recommendations Community-based services

Post-Hospitalization procedures Hold emergency SST/ RT meeting to address the following: Safety concerns Data review (attendance, academic performance, behavior, disciplinary actions, medical reports) Develop a Behavior Intervention Plan (BIP) Need for onsite support services (counseling, modification of schedule, increased supervision) Need for additional evaluation

Supporting Student reentry to school Conduct immediate counseling session. Schedule daily check-in sessions (first week). Provide weekly counseling sessions (first month). Support the development of coping strategies. Maintain parental contact.

Crisis Helpline Reporting The crisis helpline is used to report select student risk behaviors that have come to the attention of a school staff member, whether the behavior occurred on campus or in the community. The school mental health professional that is working with the student is responsible for reporting the risk behavior, after the crisis situation has been stabilized. The student should be supervised by a staff member in another location, while you make the report.

How and What to Report? Contact the Crisis Helpline at 305-995-CARE (2273) Identify if you are calling to complete a report or if you require immediate consultation Send an email if you fail to establish telephone contact and require immediate assistance Report knowledge of the following behaviors: Suicidal ideation, threat or gesture Suicide attempt Homicidal ideation, threat or gesture Self-injurious behavior

What we do with the information Create data base for future reference. Analyze data to determine trends. Identify schools and children with high incidence of risk behavior. Provide intervention services for schools in the form of training, consultation and linkage to appropriate community support services.

CONTACT INFORMATION Crisis Management Program Frank Zenere, School Psychologist Chairperson, Crisis Team Member fzenere@dadeschools.net 305-995-2273 Alina Gallego, Licensed Clinical Social Worker Crisis Team Member agallego@dadeschools.net