(Editor's note: This is the sixth and final in a long-term series of stories)
Now that school is out for summer, staff at Newberg High School are breathing a sigh of relief.
Sure, everyone is excited that classes have concluded and that, as of this week, even administrators can proclaim that their school year is over and they can take some much needed time off, but the emotional release has been much greater than normal.
The main reason is that there was more to worry about as the leadership at NHS came to realize this spring that it had an acute problem with suicide that required immediate and comprehensive action in order to effectively address it.
The district not only had to scramble to come up with and implement a solution to such a complex and difficult problem, but had less than two months to do it. After all, teen mental health in general and suicide prevention in particular are not the kind of issues that can simply be dropped when the school bell rings for the final time in June, only to be picked up again three months later in the fall.
That made the final six to seven weeks of the school year feel like a race against time, but thanks to community partners like Providence Newberg Medical Center, school officials said they feel like they actually crossed the finished line in time.
That's because not only did they make a wide-reaching effort to identify students in need of mental health treatment, but they were connected with the support they needed before the end of the school year.
"That is a huge victory," NHS principal Kyle Laier said. "I didn't know we would be that well off at the end of the school year. That gives me a lot of hope for where we're going in the future and we don't walk into the anxiety of the summer. The worst thing would have been to identify students who have needs and not have things in place for them. Nobody would have felt good about that."
The suicide problem itself and the sense of a summer deadline were especially acute because of recent history at Newberg High School and the Catalyst alternative high school program.
The district's four secondary principals alerted parents in an email sent April 24 that it had received reports that as many as six teens had made suicide attempts in the preceding weeks. The district had already lost three high school students to suicide since the end of the 2015-2016 school year and all three occurred when school was out of session, including two over the summer.
Following the third student suicide over Thanksgiving break, numerous community stakeholders, including Providence, Yamhill County, the city of Newberg, Chehalem Park and Recreation District and faith-based organizations, partnered with the district to help keep students connected and engaged over winter break.
After the secondary principals sent out their letter, which also included a call to parents to discuss the controversial Netflix television show about teen suicide "13 Reasons Why," the medical and mental health partners in the coalition sprung into action to help the school district get through the rest of the school year without another suicide.
The No. 1 priority was to keep students safe but, at the same time, they also made sure to keep an eye on establishing more permanent systems so as to provide students with more mental health support.
A working group was formed to lead the work and featured psychologist Dr. Jeri Turgesen and behavior health clinic manager Elise Yarnell from Providence Newberg, representatives from Yamhill County Mental Health, George Fox University, the high school counseling staff, several district mental health professionals, and administrators, including dropout prevention coordinator Mikaela Schamp, who served as the liaison between the district and the outside clinical partners.
The first step was to determine which students were at high risk for suicidal ideation.
The district had already trained much of its staff in the QPR (Question, Persuade, Refer) and offered some Mental Health First Aid seminars that were open to parents and students, but in the wake of the suicide attempts, many teachers still didn't feel prepared or quite understood what their role was.
Turgesen helped address this by leading a full-staff seminar about suicide warning signs and secondary staff were instructed to keep their eyes peeled and alert the school counselors when they spotted them.
"My impression was that staff really started to not only see the necessity, because I think everybody was already very much there, but see how they could have a part in it and give ownership to them," Schamp said. "If I know a kid, I don't have to be afraid of what's going on. There's resources to help. This staff has been very active since that time in trying to make sure kids get supports."
That resulted in a surge of referrals to the counseling department, who were already trained to do base level assessment or "soft screens" for suicidal ideation. Enough students were identified during that first stage that Turgesen and other staff from Providence and George Fox began coming to the high school on a daily basis in mid-May to perform more in depth assessments on site.
"We got to the point where we had cleared them, they had their own badges coming in," Schamp said. "They had their own office. We really tried to help them be self-sufficient."
Over the course of 75 appointments, more than 50 students received the second-level assessments and about 30 percent of those were identified as high risk, Tergesen said.
Providence also streamlined its referral process so that students in need could immediately be connected with treatment, most of which was provided off site by the medical center staff and a few other providers.
"My favorite part about those 75 appointments was that every kid who had been seen walked out the door of school with either a recommendation or mental health plan," Schamp said. "Some of what Providence has been doing has been direct service, but a lot of it has been bridging to the person who is currently providing mental health treatment or giving a referral for a new client."
Laier noted that directly connecting students with treatment is the biggest change that he's seen from how schools normally handle things when a counselor has concerns about a student. The new way takes a lot of pressure off parents because they don't suddenly have to figure out how to help their child because that process has already started.
Laier added that in his experience, parents often felt the only immediately accessible option they had was to take their child to the emergency room, which can be a scary experience and less-than-ideal solution.
"You don't expect your kid to be in this situation, so when you get hit with that information, initially it's really hard for any parent to engage with that," Laier said. "So hearing from the school side and the medical side of things, I think that's really helpful for parents and being able to see that there is a lot of people there wanting to help and giving me clear information."
The school also worked out a system that enabled parents to authorize the release of medical information to the school so that both parties were on the same page, which also removed a burden — serving as go-between — that usually falls on parents. Moving forward, the school hopes to have those forms submitted from the beginning to make the process even smoother.
"We're making that easy so that a parent can be a parent while we're doing that work to team around the student," Laier said.
Schamp noted that while Providence did take the lead on the effort and did much of the heavy lifting in terms of assessment and direct service to students, other partners like Yamhill County and George Fox were also playing important roles in the process and will so moving forward.
"We have had an enormous amount of people reach out and ask how they can help," Schamp said. "That includes providers in the area. (Yamhill County) Youth and Family Services is going to have a person here physically throughout the summer to see kids."
Laier said the school had to focus on training staff to spot warning signs first and did not announce broadly to students how it was addressing the situation (in terms of screenings and assessments), but that it will begin to approach what role students can play next school year, including through new health curriculum.
"Those are the kinds of things that, hopefully, as we move forward in the next year or two that we're really going to be able to start looking at," Schamp said. "This is by no means at a stopping point. We really have just started skimming the surface."