On the cutting edge
teachers are in a unique position to spot suicidal tendencies among teenagers and should be actively working to prevent pupils hurting themselves, research claims.
In a presentation given to the British Psychological Society this month, Sue Morris, an educational psychologist at Birmingham university, highlighted teachers' roles in identifying vulnerable pupils and encouraging them to discuss any problems they might have.
She estimates that in an average, co-educational secondary of 800 to 1,000 pupils, 10 per cent of pupils will have significant mental health needs.
Between 69 and 86 pupils are likely to harm themselves as a way of coping with stress. And between 120 and 150 will seriously contemplate suicide.
"There are as many pupils with mental health needs as there are with special needs," Ms Morris said. "Schools need to have the presumption of stress, rather than the presumption that everything's OK."
Three times as many boys as girls commit suicide. By contrast, more than twice as many girls as boys report harming themselves or contemplating suicide.
The most common form of self-harm is cutting, followed by drug or toxin overdose. Young people also report burning their skin, pulling out their hair and hitting themselves.
Ms Morris is working on a resource pack, to be published in the spring, which will help teachers address these issues.
"Schools should know about out-of-school arrangements that affect pupils,"
she says. "Often, data protection issues mean that form teachers are the last to know. But they're the best-equipped to notice problems and speak to pupils."
The pack emphasises the importance of personal, social and health education in developing pupils' self-confidence and encouraging them to talk about their problems.
"There should be strategies in school that encourage pupils to be open about any distress," Ms Morris says. "You need a support system in place that kids will use."
When discussing suicide or self-harm in the classroom, teachers are advised to lay down firm ground rules to prevent embarrassment and ensure mutual respect.
When discussing self-harm, they should carefully explain the many complex factors behind it; a single cause is rare.
Ms Morris also suggests careful use of language, to avoid glamorising suicide. Teachers should speak of "a suicide", rather than "a successful suicide attempt", and refer to "dying by suicide", rather than "committing suicide".
Teenagers are particularly susceptible to glamorisation of suicide, seeking to emulate celebrities such as Kurt Cobain. For example, when a character in Casualty committed suicide by taking a paracetamol overdose, there was a sevenfold increase in real-life cases.
Ms Morris says: "Suicides in the media have a visible impact, transforming them into martyrs and making people feel sorry for them."
Teachers should also avoid giving detailed information about suicide methods. For example, while they could tell pupils that a person died by self-inflicted carbon-monoxide poisoning, they should not describe how that person connected a hose to the car exhaust pipe.
All discussion of suicide and self-harm should be accompanied by information about the support available for those experiencing distress.
And teachers themselves should be aware of this support.
"Most teachers have no training whatsoever in dealing with self-harm," Ms Morris said. "They're often very wary of doing the wrong thing. That can stop them taking action or referring something on. It becomes an awful burden that teachers bear alone."
Out of harm's way
Work under the presumption that pupils are dealing with unmanageable stress, rather than the assumption that everything is all right.
Be aware of any changes in pupils' circumstances that are likely to cause them stress.
Actively ask pupils about sources of stress in their lives.
Watch for changes in behaviour. For example, a keen participant in class may become withdrawn, a previously popular pupil may fall out with friends.
Treat form tutors and other staff as responsible professionals, who can be trusted with confidential information about pupils'
Do not write off self-harm as attention-seeking. It can lead to suicide.
Rather than trying to eliminate self-harming behaviour, tackle the causes of stress that lie behind it.
Seek expert help.