1. Suicide Prevention in School Settings:
Sources of Strength and Creating Suicide Safety in Schools
Evaluating the Impact of the CSSS Workshop on School Preparedness for Suicide Prevention
Dana E. Boccio, Ph.D.
Adelphi University
Garden City, NY
NYS Suicide Prevention Conference September 12-13, Albany, NY

2. Anticipated Direct and Indirect Effects
Participation in CSSS workshop
Changes in attitudes, knowledge, perceptions of administrative support, and feelings of empowerment
Improvements in school suicide safety practices
Pre-test
Post-test
6-Month Follow-Up

3. Participant/School Demographics
93 participants (87 from New York, 6 from Arkansas); % Female, 13.5% Male; 64.4% School Counselors
School Level %
Elementary School
21.1
Middle School
16.7
High School
36.7
Multiple Levels
22.2
District Admin/Central Offices
2.2
Community
1.1
Community Type
Urban
85.4
Suburban
3.4
Rural
7.9
Combination
3.3
Socioeconomic Status %
Low
48.3
Medium
10.1
High
2.2
Mixed
39.3
School Affected by Suicide
25.3
Had Previous Training
63.3
# in Attendance 1
64.1 2
20.5 3
11.5 4
3.8

4. Impact on Attitudes Pre Post Item M (SD) df t p
Pre
Post
Item
M (SD) df t p
Youth suicide is a significant public health problem.
4.56 (0.71)
4.77 (0.59) 79
3.19
.002*
Schools should play an important role in youth suicide prevention.
4.58 (0.75)
4.81 (0.55)
3.46
.001*
Pre
Post
Composite
M (SD) df t p
Attitudesa
9.13 (1.33)
9.58 (1.08) 79
4.11
.000*
Items were rated on a 5-point scale (1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly Agree).
*p < .05
aAttitude Composite – possible scores range from 2 to 10.

5. Impact on Knowledge Item M (SD) df t p Pre Post 3.52 (0.95)
Pre
Post
Item
M (SD) df t p
I have the knowledge I need to help a student at risk for suicide.
3.52 (0.95)
4.12 (0.58) 77
6.70
.000*
I have the knowledge I need to respond after a suicide death or attempt affects my school.
3.30 (0.89)
3.94 (0.75)
5.49
I know of some specific evidence-based suicide prevention programs for schools.
2.93 (1.04)
4.17 (0.66) 76
9.37
I know how to judge school-based suicide prevention/intervention programs against best practice standards.
2.78 (0.88)
3. 82 (0.83)
9.42
I am familiar with some free or low-cost resources that could be used to enhance suicide safety at my school.
2.90 (1.10)
3.98 (0.73) 75
8.55
Pre
Post
Composite
M (SD) df t p
Knowledgea
15.30 (3.64)
20.01 (2.78) 70
10.98
.000*
Items were rated on a 5-point scale (1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly Agree).
*p < .05
aKnowledge Composite – possible scores range from 5 to 25.

6. Impact on Perceptions of Support
Pre
Post
Item
M (SD) df t p
My school has made suicide prevention a priority.
3.44 (1.00)
3.75 (0.88) 74
3.04
.003*
My school values efforts at suicide prevention.
3.93 (0.79)
4.03 (0.76)
0.82
.418
I am part of a team that is working to improve suicide safety at my school.
3.83 (0.95)
4.01 (0.81) 72
1.99
.050*
Our team has the support of our administration to work on improving suicide safety at our school.
3.99 (0.86)
4.08 (0.83) 73
1.56
.124
I have the support I need to help a student at risk for suicide.
3.79 (0.81)
4.01 (0.61)
2.97
.004*
I have the support I need to respond after a suicide death or attempt affects my school.
3.64 (0.84)
3.94 (0.68) 75
3.49
.001*
Pre
Post
Composite
M (SD) df t p
Supporta
22.61 (3.93)
23.76 (3.65) 71
4.07
.000*
Items were rated on a 5-point scale (1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly Agree).
*p < .05
aSupport Composite – possible scores range from 6 to 30.

7. Impact of Feelings of Empowerment
Pre
Post
Item
M (SD) df t p
I feel empowered to work collaboratively with my colleagues on implementing our next steps for improving our school’s suicide safety.
3.90 (0.87)
4.20 (0.68) 74
3.45
.001*
Items were rated on a 5-point scale (1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly Agree).
*p < .05

8. Participants’ Satisfaction Ratings of CSSS Workshop % (n)
Item
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The content of this workshop was relevant to my job.
0.0 (0)
18.8 (15)
81. 3(65)
I learned a lot from this workshop.
2.5 (2)
31.3 (25)
66.3 (53)
I found this workshop useful.
32.5 (26)
67.5 (54)
I would recommend this workshop to others.
68.8 (55)
A follow-up consultation would help in furthering suicide prevention efforts in my school.
15.2 (12)
26.6 (21)
58.2 (46)

9. Practice/Procedures Currently in Place in Participants’ Schools % (n)
Yes
Some Aspects are in Place, but More is Needed No
Don’t Know
Curricula or programs related to building resilience and protective factors (e.g., healthy problem-solving) in students
21.6 (16)
67.6 (50)
5.4 (4)
A school-wide screening procedure to identify students at risk for suicidal behavior
13.5 (10)
39.2 (29)
41.9 (31)
Training for teachers/staff in how to recognize suicidal warning signs and how to respond
19.2 (14)
49.3 (36)
24.7 (18)
6.8 (5)
Training for students in how to recognize suicidal warning signs
9.5 (7)
40.5 (30)
8.1 (6)
Clear referral procedures for school personnel (i.e., teachers and staff know how and to whom they should refer students)
45.9 (34)
33.8 (25)
Clear risk assessment procedures
32.4 (24)
44.6 (33)
A standard protocol or assessment instrument for assessing risk (e.g., semi-structured interview)
28.8 (21)
15.1 (11)
Clear procedures for collaborative safety planning
31.1 (23)
50.0 (37)
Clear procedures for parental notification and involvement
47.9 (35)
38.4 (28)
4.1 (3)
Clear procedures for referring at-risk students and their families to community agencies/resources
41.7 (30)
40.3 (29)
6.9 (5)
11.1 (8)
A collaborative relationship (involving adequate communication) with nearby hospitals/community agencies
12.2 (9)
A clear plan for assisting students with re-entry into school after discharge from a hospital/inpatient setting
29.7 (22)
14.9 (11)
A crisis plan for responding to suicide deaths and suicide attempts
28.4 (21)
47.3 (35)
Procedures for coordinating school and community support services in the aftermath of a suicide or attempt
18.9 (14)
52.7 (39)

10. Summary of Results so far…
Pre-test to post-test improvements in:
Attitudes toward the importance of suicide prevention
Knowledge of best practices and available resources
Perceptions of school-based support to improve suicide safety
Feelings of empowerment to move forward with suicide safety measures
Attendees with and without prior training were similarly likely to benefit from workshop
Individual and group attendance both resulted in benefits
High satisfaction with workshop/attendees likely to recommend to others

11. Next Steps… 6-month follow-up assessment:
Are schools enacting improvements to their suicide safety procedures subsequent to completion of the workshop?
What barriers to implementation of suicide safety practices are being encountered?