Suicide Clusters in Schools and Communities

摘要 这一拟议项目的目标是确定学校和社区的社会环境 产生--或改善--青少年自杀和自杀群组的脆弱性(S/SC)， 组织路径、社会生态路径。在青年S/SC比率上升和下降的背景下 学校资源，理解学校既是脆弱性的可能来源，也是 自杀前和自杀后预防(SPP)越来越重要。研究表明，社会环境 青年问题S/SC；然而，迄今为止的研究忽略了考察学校文化的差异 系统和精神健康安全系统及其更广泛的社会--生态背景--包括 获得资源以及学校和医疗保健之间的桥梁--解释S/SC在学校之间的差异。 此外，研究没有考虑到作为正式组织的学校是如何在日常工作中防止 往往在资源匮乏的情况下，在履行相互竞争的责任时自杀。理解 S/SC的根本环境原因及学校SPP的有效和可持续策略 需要弥补这些差距。指导拟议项目的具体目标是(目标1)确定 促进青年福祉的学校文化系统的特点；(目标2)确定 组织要素，使学校能够创建心理健康安全系统，有效地识别、 分类，并支持弱势青年；以及(目标3)评估更广泛的社会--生态的组成部分 作为学校战略的障碍或推动者的制度，以支持青年福祉和防止S/SC。 为了实现我们的目标，我们采用了混合方法，比较研究设计，并依赖于一个既定的 与科罗拉多州两个公立学区及其10所异质高中(其中3所拥有 严重、持久的青年S/SC问题)。我们有前所未有的机会来观察学校是如何在 每天预防自杀和支持MH。此外，我们将观察数据与访谈和 对学校成员的调查--特别是青少年、家长、校本警察和其他 学校工作人员-以及更广泛的社区-特别是医护人员、治疗师、危机应对人员和 宗教领袖-确定学校SPP战略的挑战和推动者。这个项目是由一位 在青年研究方面有良好记录的新调查员S/SC，由一个老牌的 具有广泛的方法和主题专业知识的跨学科团队。初步的田野调查产生了 与地区、学校和社区领导人以及成员建立牢固的协作关系 青年、社区和学术咨询委员会--成功完成 项目的目标，并推进科学框架，以开发和部署可持续、公平、 并在学校和社区建立有效的SPP，以减少青少年自杀，改善人口健康。

SUMMARY The goal of this proposed project is to determine how social environments in schools and communities generate – or ameliorate – vulnerability to youth suicide and suicide clusters (S/SC) through cultural, organizational, and social-ecological pathways. In the context of rising rates of youth S/SC and diminishing school resources, understanding schools as both a possible source of vulnerability and as a key place for suicide pre- and postvention (SPP) is increasingly critical. Research suggests that the social environment matters to youth S/SC; yet to date studies have neglected to examine how variation in schools’ cultural systems and mental health safety systems, as well as their broader social-ecological contexts – including access to resources and bridges between schools and healthcare – explain variation in S/SC between schools. Further, research fails to consider how schools, as formal organizations, work on a daily basis to prevent suicide while navigating competing responsibilities often under conditions of resource scarcity. Understanding the root environmental causes of S/SC and identifying effective and sustainable strategies for schools SPP requires addressing these gaps. The specific aims guiding the proposed project are (Aim 1) to identify characteristics of schools’ cultural systems that facilitate youth well-being; (Aim 2) to determine the organizational elements that enable schools to create mental health safety systems that effectively identify, triage, and support vulnerable youth; and (Aim 3) to assess the components of broader social-ecological systems that serve as barriers or enablers of schools’ strategies to support youth well-being and prevent S/SC. To accomplish our aims, we employ a mixed-method, comparative research design and rely on an established partnership with two Colorado public school districts and their 10 heterogeneous high schools (3 of which have serious, enduring youth S/SC problems). We have unprecedented access to observe how schools work on a daily basis to prevent suicide and support MH. Further, we integrate observational data with interviews and surveys with members of the school – specifically, youth, parents, school-based police officers, and other school staff – and broader communities – especially, healthcare workers, therapists, crisis responders, and religious leaders – to identify challenges to and enablers of schools’ SPP strategies. This project is led by a new investigator with a strong record of research on youth S/SC who is supported by an established interdisciplinary team with extensive methodological and topic expertise. Preliminary fieldwork produced the strong collaborative relationships – with the districts, schools, and community leaders as well as the members of the youth, community, and academic advisory boards – necessary for the successful completion of the project’s aims and for advancing scientific frameworks for developing and deploying sustainable, equitable, and effective SPP in schools and communities to reduce youth suicide and improve population health.