Poland

Report
School Crisis: Ethical and Legal
Issues for Best Practices
Dr. Scott Poland
Co-Director of the Suicide and
Violence Prevention Office
Nova Southeastern University
NASP Principles for Professional
Ethics: Revised 2010
• Respect dignity and rights of all persons
• Honesty and integrity in professional
relationships
• Responsibility to schools, families,
community, the profession and society
• Professional competence and responsibility
NASP Principles: Key Concepts
• School psychologists consider children to
be their primary responsibility and act as
advocates for their welfare.
• We also understand the public policy
process to assist us in our efforts to
advocate for children.
• At the very least we do no harm.
Legal Cases Review
• There are many legal cases that have
implications for crisis intervention and
school psychologists
• School psychology literature about legal
and ethical issues in school crisis is lacking
• The following cases highlighted in a lessons
learned format are all cases that I was
personally involved in
Civil Lawsuits Against School
Personnel: Common Questions
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Did an injury occur?
Did the school owe a duty to the student?
Was there a breach of duty?
Is there a causal relationship between the
injury and a breach of duty?
Choquette vs. Onstedt Schools
Elementary age students on school bus viewed a
suicide victim
• Parents were called immediately and a group
activity provided next day for all bus riders
(grades 1 to 6) by psychologist and counselor
• One family did not want their 1st grade daughter to
be told truth and later pulled her out of school and
sued
• The suit for 10$ million claimed she had PTSD as
a result of intervention provided
Activity
• What do you think of the merits of the Choquette
lawsuit?
• How would you defend the school psychologist
and counselor?
• Was is it appropriate to conduct one intervention
for bus riders grades 1 to 6?
• Should parent permission have been obtained prior
to the intervention for students?
Landmark Cases
• Wyke v Polk County School Board in
Florida 11th Federal Circuit Court found the
district liable for not offering a suicide
prevention program, providing inadequate
supervision of a suicidal student and failing
to notify parents when their child was
suicidal
Landmark Cases
• Szostek v Fowler and the CypressFairbanks School District 189th District
Court found the school had not negligently
disciplined the student who died by suicide
and were entitled to sovereign immunity.
This case does highlight school discipline
has been a common precipitating event for
suicide.
Hope Witsell Tragedy
• Middle school teen endured months of
taunting after she sent a topless photo to a
fellow student
• The day before her suicide, she met with a
social worker who had her sign a no
suicide contract
• No other school staff nor the parents were
notified and parents found the contract
after she hanged herself
• Do you see a defense in the lawsuit and
how do we prevent tragedies like this?
Parent Notification Issue: Suicidal
Student
• Maryland school psychologist believed a
student to be suicidal and notified parents.
Student was allowed to walk home per
parent request. Student died by suicide that
night and the parents filed a lawsuit against
the school and the psychologist.
Parent Notification Case:
White Pass, WA.
• Sixteen year old male student
• Referred to school counselor after he wrote a
suicide note and gave it to a friend and there were
rumors about a suicide pact
• Student denied suicidal ideation or plans when
interviewed by counselor
• Please consider whether or not you would call
parents after you review the following pieces of
information that he shared with the counselor
Shared with Counselor
• New to school had been there 5 weeks
• Sad as his best friend at new school who he was
rumored to be in a pact with attempted suicide
today
• Under stress as facing felony charges
• Gets along well with grandmother (who he now
lives with) but not his mother as she hates him
• His mother tried to kill herself last year
• He reports his mother thinks he will probably kill
himself
• He reported he used to drink but has been sober
for two weeks
U.S. Eastern District Court
Lance v Lewisville ISD
• 9 year old boy M. hung himself in the school
nurses bathroom in 2010
• Special education student with Speech, Learning
Disabilities and ADHD
• In 2008 his parents referred him for psychological
evaluation due to their concerns that he was
suicidal
• ARD in 2008 identified him with Emotionally
Disturbed
• The district does not have the psych
evaluation that qualified M with ED
• They have BASC raw data only that
documents suicide/depression
• He received special education counseling
but there is no documentation that service
provider ever talked with him about
suicidal ideation
• From the start of the school year 2009-2010
and his death on 1/21/10 there were 30
behavioral incidents that resulted in him
seeing the AP
• The AP viewed each incident as conflict not
bullying as that would have required the incidents
to be written up and sent to the Superintendent
• No evidence that the AP reviewed his IEP or his
BIP
• M saw the nurse on 16 occasions that year and on
7 of those occasions had physical injuries suffered
at school
• On 12/18/09 five students assaulted M in and he
pulled a pocket knife from his pocket but did not
open it
• M was sent to the DAEP for 10 days and no MDR
was held
• His parents appealed the DAEP in writing
first to the Principal and then to the
Assistant Superintendent stating that he had
been bullied
• The appeals were denied
• The DAEP was not notified that M was a
special education student
• M was suicidal at the DAEP and a high
school counselor interviewed him and
called his father but failed to fill out
paperwork as per district protocol and did
not notify his home elementary school of
his suicidal ideation
• M was in trouble on his second day back at
his home campus and he hung himself in
the nurse clinic bathroom
• The nurse had known for two years that she
did not have a key to unlock the bathroom
door and M and other students had been
known to lock themselves in the bathroom
and she had to call custodian for help
• No one ever told the nurse that M was
known to be suicidal
• The day after he died a new lock was
installed and the nurse was provided a key
to the bathroom
Legal Term: Special Relationship
• “In loco parentis doctrine” raises the
question of whether a special relationship
exists between school officials and students
as students are released by parents for
control and supervision by school officials
• Critical issues are the age and existence of
disabilities for a student and whether or not
the district placed the student in harms way
Lance Case: Outcome
• Court dismissed the case and placed
emphasis on the 2012 Doe v Covington case
decided by the Fifth Circuit Court
• No Special Relationship existed as he was
not incarcerated, involuntarily committed,
nor in foster care
• He was not discriminated against as the AP
failed to implement the bullying prevention
policy for all students
Bullying and Suicide
• Children who have been bullied have reported a
variety of behavioral, emotional and social problems.
• Suicide is the third largest cause of mortality in
children and adolescents.
• Studies reported positive associations between all
bullying types and suicidal risks.
What does the research say?
• Kaminsky (2009) victimization by peers is associated
with greater reporting of suicidal ideation and behavior.
• Klomek, Sourander & Gould (2010) found that bullies
also have been reported to have an increased prevalence
of suicidal ideation and suicide attempts.
• Kim & Leventhal (2008) discussed that any
participation in bullying increases the risk of suicidal
ideation and behaviors, with the strongest risk for
suicide was in Victim-Perpetrators.
• Klomek, Sourander & Gould (2010) reported
that the associations between bullying
behaviors and suicidality have been found in
children of all ages.
• D’Augelli and colleagues (2005) found that
increased sexual orientation-based verbal
victimization, as well as psychological abuse
from parents predicted suicide attempts
described as ‘‘gay related.’’
• Traditional bullying and cyberbullying have
been found to be related to suicidal ideation in
similar ways (Klomek et al., 2008; Hinduja &
Patchin, 2010).
SPRC Brief: Suicide and
Bullying
• Both victims and perpetrators are at higher
risk than peers
• Personal characteristics such as
internalizing problems; low self-esteem;
and low assertiveness increase the risk of
being bullied and these factors are also
associated with risk for suicide
• Children most at risk for suicide are also at
risk for being bullied and it is difficult to
control all the risk factors to determine if
being bullied was a proximal cause to a
youth suicide
SPRC Continued
• Personal risk factors alone do not cause a
child to be suicidal as other key components
are family, mistreatment, domestic violence,
parental depression and a school
environment that lacks adequate support
and supervision along with inconsistent
discipline
• Relationship between bullying and suicide
is the strongest for LGBTQ youth
• Promotion of social support, mental health
services and connectedness at school is
recommended
Bullying and Suicide
Prevention: Common Strategies
• Promote a positive school environment
• Educate parents about warning signs and
increase their involvement
• Key is to build relationships with all
students
• Identify students and families in need of
services and obtain services for them
Suicide Postvention
• Mares v Shawnee Mission Schools Kansas
the school system settled out of court after
being sued following the suicides of two
brothers. The district failed to implement
suicide postvention procedures after the first
death.
State of Montana v Justine Winter
20/20 Season 31 Episode #50
• Nighttime car accident resulted in two deaths
• Justine survived but has extensive medical injuries
including brain damage and has no memory of the accident
• Justine was 16 years, one month at the time of the accident
and had texted her boy friend about crashing her car 6
minutes before the accident
• She was tried in adult court on two counts of deliberate
homicide
• How might you defend her and does this case fit the
pattern of youth suicide?
• What do you want to know about Justine?
Joiner’s Model of Suicide Risk, 2006
Lawsuit over Self Injury Notification
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Coulter Vs. Washington Township, N.J.
Issues
Student deposition/insight into factors
Parent deposition
Counselor deposition
Snohomish, WA Case
• 9th grade female student M (late April) told
her friend K who was angry at her
boyfriend that she would stab K’s boyfriend
for her
• Her friend reported threat to the school
counselor
• School emergency expelled her and told M
and her mother that M would need to get
psychiatric care before she would be
readmitted
School Records and Knowledge
• M seen as quiet, good student but grades
declined 2nd semester 9th grade year and no
history of any discipline incidents
• 8th grade counselor’s notes say M talked
about cutting, sexting and wanting to be
raped
• 9th grade counselor heard M might be
cutting in Dec. that year and met with her
• Checked with her mom in Jan. and found
out M was in private counseling
Continued
• School counselor on date of threat in April
without a release called the private
psychologist to share M had thoughts of
suicide and killing family members
• M was evaluated by a psychiatrist for
homicidal and suicidal thoughts and
hospitalized for 5 days in a partial program
• Diagnosis was Major Depression and
Generalized Anxiety, M was already on an
anti-depressant that was working but was
guarded in treatment, not homicidal or
suicidal at discharge
Continued
• Psychiatrist stated in writing that M was
safe to return to school and was continuing
in out patient treatment (only records
school received)
• School held re-entry meeting on 5/5 with
school staff, M and her mother and
alternative school was mentioned but
declined by M and mom
• Focus was largely academic and how to
support M and behaviors to watch for
• No behavioral concerns reported before end
of school except PE teacher noted cuts legs
Continued Fall Next Year
• Meeting 9/22 with counselor, teachers, M
and her mom
• Mom reported M still in therapy and using
skills learned and had a future orientation
• Teachers shared largely academic concerns
but M had talked of drugs, made at least one
student uncomfortable and patted one
student too hard, had done a paper on a
serial killer and one on managing stress
Stabbing Incident
• Oct. 25th M who still continued in twice a
month counseling and medication, hid in the
restroom listening to violent music, with
knives she had taken from her step-father
• She waited for RR to clear then stabbed the
last two girls in the RR, one of which nearly
died, M did not know either girl
• Plaintiff’s sued the treatment clinic that
provided outpatient treatment , the hospital
and the school
Plaintiff’s Criticism of School
• M should have been placed in alternative
school or not allowed to return, should have
been evaluated for Special education, there
was no wraparound program on return from
hospital, school should have insisted on
more information from the hospital and
clinic
• School threat assessment in April was
inadequate, M should have been searched
every morning or escorted everywhere
including to the RR or M should have been
seen by school counselor every morning,
More Questions
• What else do you want to know about the
treatment that M received at the clinic and
hospital?
• Is the law suit warranted against the school,
clinic and hospital?
• When a psychiatrist does a safety
assessment what does that really mean?
• Did the psychiatrist miss psychotic features
to M’s illness?
• Can schools force records to be released to
them?
Case Discussion Questions
• What do you think of the case against the
school? Can schools force the release of
records?
• Are school personnel in a position to
question a safety letter from a psychiatrist?
• What constitutes a thorough threat
assessment and how good are we at
predicting violence?
How often do female adolescents attempt
homicide and what is the relationship
between homicide and suicide?
Structured Assessment of Violent
Risk Youth (SAVRY)
• Risk viewed as “dynamic” subject to
change not just as “static”
• Improvement noted in clinicians’ ability to
distinguish violent individuals, now better
than chance accuracy
• Previous assessment has been unstructured
purely “clinical”
SAVRY
• Systematic risk assessment with checklist of
risk factors related to violence for 12 to 18
year olds
• Systematic risk assessments perform better
than unstructured ones
• Dynamic risk factors especially significant
for adolescents
• SAVRY has 4 domains and 30 items all
items rated low medium or high
SAVRY Domains
• Historical risk factors such as history of
violence, early initiation of violence, past
supervision failure, history of NSSI or
suicide attempts, exposure to violence in
home, childhood maltreatment, parental
criminality, early caregiver disruption, and
poor school achievement
SAVRY Domains
• Social/Contextual risk factors such as peer
delinquency, peer rejection, stress and poor
coping, poor parental management, lack of
personal/social support and community
disorganization
SAVRY Domains
• Individual/Clinical Risk factors such as
negative attitudes, risk taking/impulsivity,
substance abuse, anger problems, low
empathy/remorse, ADHD, poor compliance
and low interest/commitment to school
SAVRY Domains
• Protective factors such as pro-social
involvement, strong social support, strong
attachment bonds, positive attitude towards
intervention and authority, strong
commitment to school and resilient
personality traits
• Available from Psychological Assessment
Resources www.parinc.com
How Can School Personnel
Protect Themselves from
Liability?
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Maintain Liability Insurance
Seek supervision and consultation
Keep good records
Document training on crisis intervention
Provide Best Practices responses
How Can School Psychologists
Make A Difference?
• Advocate for prevention programs in
schools and communities
• Collaborate with school administrators and
relevant agencies
• Increase the circle of care when students
are known to be at risk
• Keep up with best practices in crisis
intervention
More Information
• [email protected]
• www.nova.edu/suicideprevention
• New book, Suicide in schools by Erbacher,
Singer and Poland, Routledge Dec. 2014

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