BILL ANALYSIS Ó
AB 2246
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Date of Hearing: April 6, 2016
ASSEMBLY COMMITTEE ON EDUCATION
Patrick O'Donnell, Chair
AB 2246
(O'Donnell) - As Amended March 16, 2016
SUBJECT: Student suicide prevention policies
SUMMARY: Requires local educational agencies (LEAs) to adopt
policies for the prevention of student suicides, and requires
the California Department of Education (CDE) to develop and
maintain a model suicide prevention policy. Specifically, this
bill:
1)Requires the governing boards of school districts, county
offices of education, the state special schools, and charter
schools which serve students in grades 7 to 12 to adopt,
before the beginning of the 2017-18 school year, a policy on
student suicide prevention for students in those grades.
2)Requires that these policies address, at a minimum, procedures
relating to suicide prevention, intervention, and postvention.
3)Requires the policies to be developed in consultation with
school and community stakeholders, school-employed mental
health professionals, and suicide prevention experts.
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4)Requires that the policies specifically address the needs of
high-risk groups, including:
a) youth bereaved by suicide
b) youth with disabilities, mental illness, or substance
use disorders
c) youth experiencing homelessness or in out-of-home
settings, including foster care
d) lesbian, gay, bisexual, transgender, or questioning
youth
1)Requires that the policy address any training to be provided
to teachers of students in grades 7 to 12, on suicide
awareness and prevention.
2)Requires that materials approved by an LEA for training
include how to identify appropriate mental health services,
both at the schoolsite and also within the larger community,
and when and how to refer youth and their families to those
services.
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3)States that materials approved for training may also include
programs that can be completed through self-review of suitable
suicide prevention materials.
4)Requires the policy to be written to ensure that school
employees act only within the authorization or scope of their
credential or license. States that nothing in act shall be
construed as authorizing or encouraging school employees to
diagnose or treat mental illness unless they are specifically
licensed and employed to do so.
5)Requires the CDE, to assist LEAs in developing policies for
student suicide prevention, to develop and maintain a model
policy to serve as a guide for LEAs.
EXISTING LAW:
1.Requires the Superintendent of Public Instruction (SPI) to
send a notice to each middle school, junior high school, and
high school that encourages each school to provide suicide
prevention training to each school counselor at least one time
while employed as a counselor, provides information on the
availability of the suicide prevention training curriculum
developed by the CDE, and informs schools about the suicide
prevention training provided by the department and describes
how a school might retain those services. This section was
added in 1992.
2.Permits funding for two programs, the Healthy Start Support
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Services for Children and the California School Age Families
Education program, to be used for suicide prevention
counseling. These programs are no longer directly funded by
the state.
FISCAL EFFECT: This bill has been keyed a state-mandated local
program by the Office of Legislative Counsel.
COMMENTS:
Need for the bill. The author states: "According to the
Centers for Disease Control and Prevention, suicide is the
second leading cause of death among young people aged 10-24.
The CDC also reports that 17% of high school students have
seriously considered attempting suicide - and 8% had attempted
suicide - in the prior 12 months.
School personnel who interact with students on a daily basis
are in a prime position to recognize warning signs of suicide
and make appropriate referrals for help. A national study
conducted by the Jason Foundation found that the number one
person a student would contact to help a friend who might be
suicidal was a teacher. When a young person comes to a teacher
for help, it is vital that she has the knowledge, skills, and
resources to respond appropriately.
AB 2246 addresses youth suicide prevention by requiring school
districts to adopt suicide prevention policies. These policies
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would be developed in consultation with school and community
stakeholders and experts in the field of suicide prevention,
and address the needs of high-risk groups of students. The
policies would address any training the district chooses to
provide to teachers on suicide prevention. AB 2246 also
requires the California Department of Education to develop and
maintain a model policy as a guide for school districts."
Youth suicide in California. According to the Lucile Packard
Foundation for Children's Health, which compiles and reports
data from state agency sources:
In 2011-13, nearly 20% of California public school
students in grades 9, 11, and nontraditional classes
reported seriously considering attempting suicide in the
past year.
Reported suicidal ideation is higher among female
students and among students from multiracial and Native
Hawaiian/Pacific Islander backgrounds.
In 2013, 481 California youth ages 5-24 were known to
have committed suicide.
The state's youth suicide rate in 2011-13 was 7.7 per
100,000 youth ages 15-24, slightly higher than previous
years, but substantially lower than the rate in 1995-97
(9.4 per 100,000).
In 2013, males accounted for almost 80% of youth
suicides in California (354 of 452). Statewide and
nationally, many more male youth (ages 15-24) than female
youth commit suicide.
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In 2013, there were 3,322 hospitalizations for non-fatal
self-inflicted injuries among children and youth ages 5-20
in California.
In 2013, 62% of hospitalizations for self-inflicted
injuries in California involved youth ages 16-20.
High risk groups. This bill requires that the suicide policies
required by the bill address the needs of specific groups of
students who are at higher risk of suicide. Research cited in
materials provided by the sponsor indicate the following about
risk factors for the specific groups named in this bill:
Youth bereaved by suicide: Young people appear to be
particularly affected by others' suicides. Research has
found that the relative risk of suicide following exposure
to another individual's suicide was 2 to 4 times higher
among 15- to 19-year-olds than among other age groups, and
that between 1 percent and 5 percent of teen suicides occur
in "suicide clusters." A phenomenon known as "suicide
contagion" refers to the increased risk of suicide for
individuals bereaved by the suicide of others.
Youth with disabilities: Research shows that
adolescents with particular disabilities, such as chronic
pain, loss of mobility, disfigurement, multiple sclerosis,
and spinal cord injuries are at higher risk of suicide.
People with multiple sclerosis, for example, are more than
twice as likely as the general population to attempt
suicide and almost twice as likely to actually complete
suicide.
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Youth with mental illness and substance abuse disorders:
Nearly 90% of all suicides are associated with a
diagnosable mental health or substance-abuse disorder.
People experiencing depression, manic-depressive disorder,
anxiety disorders, borderline personality disorder,
schizophrenia, and conduct disorders are at elevated risk
for suicide.
Youth experiencing homelessness: Limited research
suggests that more than half of homeless and runaway youth
have attempted suicide.
Youth in foster care: Limited research suggests that
youth in foster care are more than twice as likely to
commit suicide and nearly four times as likely to attempt
suicide as their peers.
Youth in juvenile detention: Youth involved with the
juvenile justice system are four times more likely to
commit suicide than their peers.
Lesbian, gay and bisexual youth: LGBTQ youth are four
times more likely to attempt suicide than their straight
peers. Nearly half of young transgender people have
seriously considered suicide, and one-quarter report having
made a suicide attempt.
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Research identifies several other factors associated with
elevated risk of suicide:
Research indicates that a past history of suicide
attempts is the best predictor of future attempts. Youth
who have engaged in self harm are also at elevated risk.
Analysis from the RAND Corporation also shows
significant regional differences in suicide rates in
California, with the highest rates - roughly double those
of the regions with the lowest rates - in the rural
northern counties of the state.
In California, Native Hawaiian and Pacific Islander
(Samoan, Guamanian, Chamorro only) are at elevated risk,
and according to an analysis of data from the California
Department of Public Health, between 2005 and 2010 the rate
of suicide among this group doubled, while increasing 17%
in the white population. While national data indicates
that Native Americans and Alaska Natives are at the highest
risk among ethnic groups, in California this group is not
at elevated risk.
Federal and state recommendations that school districts adopt
suicide prevention policies. SPI Tom Torlakson has convened a
Student Mental Health Policy Workgroup, with funding from the
California Mental Health Services Authority (CalMHSA), with the
goals of assessing the current mental health needs of California
students and gathering evidence to support its policy
recommendations to the SPI and to the California Legislature.
The Workgroup has issued several recommendations. Among them,
the Workgroup recommends that:
School district governing boards should direct district
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superintendents to plan and evaluate the districts'
policies and strategies for suicide prevention,
intervention, and postvention procedures. The evaluation
process should involve school health professionals, school
counselors, school social workers, and other school staff,
as well as parents/guardians/caregivers, students, local
health agencies and professionals, and community
organizations. The board policies and administrative
regulations for youth suicide prevention should align with
each school's Comprehensive School Safety Plan.
In 2015 the federal Substance Abuse and Mental Health Services
Authority (SAMHSA) issued a resource for schools on suicide
prevention titled "Preventing Suicide: A Toolkit for High
Schools." In this toolkit SAMHSA provides information and
guidance on creating a school-based suicide prevention program,
and states, "The two essential components that every school
should have in place are protocols for helping students at
possible risk of suicide, and protocols for responding to a
suicide death (and thus preventing additional suicides)."
The state's "Strategic Plan for Suicide Prevention," published
by the Department of Mental Health in 2008, notes the importance
role schools play in suicide prevention. The plan states:
"Because school is where many youth spend a large part of their
days, school staff are in the position to detect the early
stages of mental health problems and potential suicide
risk?Mental health and suicide prevention programs that are
school-based can be successful in encouraging students at risk
to seek help, and to follow through on referrals to mental
health services. The programs can also be successful in
developing protocols to handle a suicide crisis that minimizes
the chances of a contagion effect."
Suicide policies legislation in other states. Six other states
(Pennsylvania, Georgia, Maine, Connecticut, Utah, and
Washington) have enacted legislation requiring school districts
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to adopt suicide prevention policies. Many other states
provide model suicide prevention policies for their school
districts, as this bill requires.
What works at schools to prevent suicide? This bill does not
mandate specific programs or practices to prevent student
suicides, but leaves these decisions up to LEAs to determine in
the development of their policies. Research points to several
practices shown to reduce suicide risk, including creating a
safe and supportive school climate with a focus on
social-emotional learning; promoting school-based programs which
foster connections to caring adults; and training school
personnel to recognize warning signs and make appropriate
referrals for suicide and self-injury.
Suicide content in health standards. The state health content
standards adopted in 2008 for grades 9-12 include mental,
emotional and social health concepts such as:
analyzing signs of depression, potential suicide, and
other self-destructive behaviors
explaining how witnesses and bystanders can help prevent
violence by reporting dangerous situations
identifying warning signs for suicide
analyzing the internal and external issues related to
seeking mental health assistance; and other related
concepts
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Similarly, for grades 7-8, the mental, emotional, and social
health standards include describing signs of depression,
potential suicide and other self-destructive behaviors,
describing common mental health conditions and why seeking
professional help for these conditions is important, and
applying decision-making processes to a variety of situations
that impact mental, emotional and social health. However, the
existing standards lack focus on instruction relative to how the
school community can assist in preventing suicides and the
importance of making students feel comfortable reporting any
risk behaviors.
The current health framework is out of date and not aligned to
the 2008 health content standards. The CDE had been preparing a
revision of the framework, with expected adoption by the State
Board of Education in 2013, when in 2009 all work on framework
revisions was suspended due to state budget shortfalls. Last
year the CDE submitted a budget change proposal for the
continuous funding of the work of the Instructional Quality
Commission (which develops curriculum frameworks) but this
appropriation was not included in the 2016-17 Governor's Budget.
The CDE has resubmitted this proposal.
Prior legislation. AB 739 (Lowenthal) of the 2011-12 Session
would have required the State Board of Education (SBE) and the
Curriculum Development and Supplemental Materials Commission to
include suicide prevention instruction and mental illness
awareness instruction in the health education framework for
pupils in grades 7 to 12 during the next revision of the
framework. The bill would have authorized a school district,
commencing with the 2012-13 school year, to provide suicide
prevention instruction and mental illness awareness instruction
to pupils in grades 7 to 12. This bill was held in the Assembly
Appropriations Committee.
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REGISTERED SUPPORT / OPPOSITION:
Support
Equality California (sponsor)
The Trevor Project (sponsor)
American Academy of Pediatrics, California
California Federation of Teachers
California Psychological Association
California School Employees Association
California State PTA
Child Abuse Prevention Center
California Council of Community Mental Health Agencies
Disability Rights California
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Los Angeles LGBT Center
Mental Health America of California
National Alliance on Mental Illness, California
National Association of Social Workers, California Chapter
Opposition
California Right to Life Committee, Inc.
Analysis Prepared by:Tanya Lieberman / ED. / (916) 319-2087