Policies and protocols

What exactly do we mean by developing policies and protocols for youth suicide? A protocol establishes the roles of community partners and the step-by-step response that should be enacted in crises related to suicidal behaviour. Policies, often embedded elements of protocols themselves, are key principles that community partners should follow in any event related to youth suicide. Policy and protocol development are opportunities for your community to think proactively and in concrete terms about risk management and postvention, and ultimately suicide prevention.

Policies and protocols are useful for several reasons:

  • They allow community partners to develop a common approach for responding to youth at risk and a death by suicide.
  • They provide opportunities for community partners to collaborate, work together and coordinate efforts.
  • They enhance community capacity to reduce the frequency of youth suicide.

 

Intra-organizational vs Community-based protocols

Communities are home to several different youth-serving organizations, resources and contexts. All can play different roles in youth suicide prevention. For example, schools are in a position to provide ongoing monitoring and day-to-day support to youth however, they may not be as well-equipped to deliver crisis intervention as a mental health agency or a mobile-crisis team. This is where clarity becomes important – your community’s protocols need to capture context and role differences, but also set the stage for a series of coordinated efforts to take place. This is why both intra-organizational and community-based protocols are so valuable:

  • Intra-organizational protocols establish the procedure your organization will follow in crises related to suicidal behaviour. This type of protocol should be tailored to your organization’s expertise, resources and mandate.
  • Community-based protocols include the steps your entire community will take in crises related to suicidal behaviour, regardless of where they may originate. These types of protocols build on the communication pathways between community partners and across your entire network. They’ll most likely require you to align your intra-organizational policies and protocols with the ones of other organizations to ensure all community members agree on what needs to be done, and ensure whole-community responses aren’t disjointed. You’ll also most likely need to create joint policies and protocols, which you can create together and formalize with agreements. For example, what does your community’s referral process look like? Who should notify whom in the case of an emergency? Who is best positioned to deliver what response?

 

Where do you start?

First, it’s important to know that policies and protocols aren’t stand-alone strategies in youth suicide prevention. Simply having a protocol doesn’t help to structure an effective response to suicidal behaviour unless the right resources are in place and everyone is on the same page. To ensure that your policies and protocols fit into your broader community response, you can incorporate them into your strategic plan using the strategic planning worksheet.

Keeping this in mind, remember that many factors can make a difference in the quality and effectiveness of your policies and protocols. Before you dive into developing a policy or protocol, consider these key success factors:

  • All relevant community partners should be involved in the development of policies and protocols – especially for community-based protocols. Most commonly, community partners include:1
    • hospital emergency departments and other services
    • community-based mental health agencies
    • schools
    • police
    • crisis-response programs
    • child protection offices
    • youth, families, elders or other relevant grassroots partners
  • In order to be successfully implemented, protocols need clear communication pathways between community partners. Develop a common vocabulary, establish ongoing dialogues across your network and designate a lead contact for each organization/community partner.
  • Once developed, your protocols should be approved by more than just one expert. Here again, teamwork is crucial.
  • Community resources need to be in place to support the standards set out by your policies and protocols. Proper training and education on safety and interventions for suicidal behaviour should be delivered to all youth-serving staff in your community. The scope of these trainings may differ based on your role or your organization’s mandate.
  • Once developed, your protocols are by no means complete. Develop a plan for reviewing, evaluating and updating your protocols after they’ve been implemented.
  • Monitoring the implementation of a protocol is also important. Think about ways to track how well your procedures are working once they’ve actually been put into action. For example, you could have a feedback component built into the protocols themselves where people could write down thoughts, issues they ran into, things that worked for them and things that didn’t. This could also be used as an opportunity for the various caregivers involved in using the protocol to debrief, and if needed, get support. For more information on how to provide this type of support, refer to to the care-for-caregivers page.

 

What should be included in your protocols?

Here are some resources to help your protocol development process.

  • After a Suicide: A Toolkit for Schools provides a detailed postvention protocol that your community can use for guidance. It’s focused on schools, which are key postvention settings after a death by suicide. However, it’s consistent with a whole-community approach, as you’ll find the roles of other community partners highlighted throughout the toolkit.

     

    Additional resources

    A Resource Aid: Responding to Crisis at a School, developed by the UCLA School Mental Health Project, provides guidelines for responding to crises in a school setting.

    Framework for Developing Institutional Protocols for the Acutely Distressed or Suicidal College Student, developed by the JED Foundation, discusses issues to consider when developing a safety protocol, developing an emergency contact notification protocol and developing a leave of absence and re-entry protocol for colleges and universities.

    Policies and protocols addressing the needs of youth who have attempted or are considering suicide, developed by the Suicide Prevention Resource Centre (SPRC), provides recommendations for developing protocols designed to meet the immediate needs of adolescents and young adults who have expressed suicidal plans or have attempted suicide. The document also guides youth-serving organizations in the development and implementation of a suicide prevention or postvention protocol.

    Principles for developing organizational policies and protocols for responding to clients at risk of suicide and self-harm, developed by the Queensland Governmental Department of Communities, suggests a process and key considerations for the development of organizational policies and protocols in suicide prevention, risk management and postvention.