19 of 33 cases of GDOE referred to behavioral health | Guam News


There were 33 cases of suicide ideation in the current and previous school year, and 19 of these student cases were referred to Guam Behavioral Health and Wellness Center.

“The statistics are based on consultations with school counselors regarding suicidal ideation. We can only follow students identified by school staff and referred to school counselors, ”said Nadine Cepeda, chief district psychologist for the Guam Department of Education.

Cepeda noted that a few students are duplicated in the count due to their involvement in different incidents. She is responsible for the GDOE Student Support Division.

From the figures provided, it appears that up to 14 pupils were not referred for out-of-school support after initial contact with a school guidance counselor.

Currently, school counselors screen students with suicidal thoughts. Using a suicide checklist, the student’s risk level is assessed and the scale goes from high and moderate to low.

“The interventions are actually made to refer to behavioral health in the school setting. However, if you read the chapter, they should go to the licensed mental health service if it’s immediate and get them to Guam Behavioral Health, ”Cepeda said. “This is unfortunately what we are dealing with in our community even before the COVID-19 pandemic. Since last week, three counselors have consulted me on suicides, real serious cases.

She took charge of one of the high risk cases, made home visits and the student was admitted to GBHWC for safety reasons.

While the student in the case was referred, Senator Telena Nelson, who chairs the Legislative Assembly’s committee on education, stressed that standard operating procedure does not require the dismissal of students identified by the risk assessment as low risk.

This delay has been attributed to the process involved in complying with current law and obtaining informed consent from parents within 45 days of mental or psychological assessment or screening of a student with warning signs of suicidal thoughts.

Time is of the essence in responding to a student who is considering suicide. But, GDOE cannot provide immediate support to students, as it should under the American School Counselor Association’s Best Practices, ASCA, 2020 for several reasons.

Recently added to the SOP, Chapter 17 draws directly from ASCA’s position on response, which states: “When they discover that a student is considering suicide, school counselors assert their ethical and legal responsibility to commit suicide. report a suspected suicide risk to parents / guardians and appropriate authorities. . “

While school counselors are required to use assessments, screening, or any other instrument to determine suicide risk, ASCA advocates that they should never be required to deny any level of risk or harm because students can tell school counselors what they think will get them off the exam. , according to the senator.

Chapter 12, however, does not allow this to happen right away; it details the process that school guidance counselors must follow before providing immediate support to a student.

“The kid will always go home and you only have four district psychologists at GDOE, there is now a load of mental health needs due to COVID-19,” Nelson said. “There is going to be a delay in serving the child during the whole process of one, two, three and four (sessions) before they receive the support.”

She asked the GDOE to think about the issue and make a change to the SOP to immediately get the support students need. In the same SOP, Part C states that counselors must provide daily support counseling until the student is stabilized, which means they must continue to support even if there is no reference to GBHWC. It also says school counselors should use the Columbia Suicide Severity Rating Scale to assess a student’s risk of suicide.

“Are we going to fix this problem in the SOP?” Because here it says school counselors shouldn’t assign it, but in the SOP it says counselors to assign those risk levels, ”Nelson said.

But according to Cepeda, school counselors are using a filter, not an assessment.

“Again, in Columbia’s suicide risk assessment filter, he (uses) yes, no, yes, no. The second examiner on the checklist determines high, medium and low. Again, we never deny it, ”Cepeda said.

According to Cepeda, suicide risk assessments are much more comprehensive in determining whether admission is warranted.

“They don’t do that, they determine what the level of risk is and two, in which direction,” Cepeda said.

She said school counselors consult with mental health professionals to determine recommendations, develop a student safety plan and guide management of the response.

“When they consult on the basis of certain questions, we determine what needs to be done. (We) provide internal and external coping skills that they identify for students, and then they also provide resources and numbers that they can access, ”Cepeda said.

Cepeda has been consulted quite often and has said that if a case warrants it is referred to GBHWC.

“We’re not doing anything different and again, if it’s immediate, we’ll send them; they will consult with the nurse and the principal and if it warrants it, we will call 911, ”Cepeda said.

Four district school psychologists

Another aggravating factor is that the GDOE only has four district school psychologists who can administer assessments.

This worried Nelson, who presumed that “there must be a backlog, due to the mental health needs that have been affected by COVID-19.”

Although Cepeda said school counselors have been trained to perform these assessments, district school psychologists cannot see all students.

“We’re down to three or four now. These advisers are the front lines and the guardian and we don’t see them, ”Cepeda said. “Then on the 46th day, they then do evaluations, then it’s too late. So what do we do there? They always consult and if it really warrants it, we make a safety plan, you let the parent know about the safety plan and if it warrants going to GBHWC.

GDOE Superintendent Jon Fernandez took responsibility for contributing to the delay, indicating that when he joined the GDOE, Behavioral Health reported that there had been a “more” dismissal of students.

“I have to take responsibility for it. I made the decision to invest in a strong team of district school psychologists to provide internal support. So I think that’s part of the reason why referrals aren’t sent to Behavioral Health immediately, ”Fernandez said.

The focus on school counselors and student suicide risk assessment was prompted by a grievance filed over the summer by 25 GDOE school counselors regarding their roles in the process and conflicting SOPs.

After meeting 40 school counselors on Monday, Nelson chose to continue the dialogue with the GDOE and address the issues in future working sessions.


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