Guest Blog: Suicide Training in Elementary Schools and Transgender Health Care

As a part of PRMS’ ongoing commitment to behavioral health we invited Anna Weaver-Hayes, Executive Director of the Colorado Psychiatric Society, to be featured as our guest blogger this month.

The Colorado Child and Adolescent Psychiatric Society (CCAPS) is tackling big topics in its spring meetings. In 2016, our Spring Meeting focused on school-based suicide prevention, which was followed by elementary school trainings through a partnership with Denver Public Schools. For the 2017 Spring Meeting, the focus is transgender health care and what EVERY health professional should know.

Some readers may find it shocking that suicide training is needed in elementary school. I know I did when the topic was suggested by Ellen Kelty, Denver Public Schools’ program manager for the Department of Social Work and Psychological Services in the Office of Social and Emotional Learning. But I quickly learned 3 facts that reshaped my thinking:

  1. It happens. At the end of 2015, two 11-year-olds completed suicide in one week in Colorado.[i] As AACAP President Gregory Fritz, MD, noted in a CBS interview, “Adults need to realize that school-age children as young as 5 kill themselves.”[ii]
  2. Although completion is rare in very young children, behaviors and attempts are not as rare as previously thought. It is difficult to determine the number of attempted suicides in general. This is especially true with children, where attempts and even completions may be classified as accidental. While young children often lack the cognitive skills and ability to complete suicide, research suggests that about 1 in 10 children as young as age 3 years may have suicidal thoughts or suggestive behaviors.[iii]
  3. Starting prevention efforts in middle and high school is too late. By the time a child reaches middle school, where suicide prevention efforts often start, it may be too late. According to a University of Washington study, 40 percent of youths attempting suicide make the first attempt before reaching high school.[iv]


In 2014 alone, suicide deaths for Colorado youth aged 10-18 surpassed drowning, poisoning, homicide, cancer, and motor vehicle fatalities among the same age group.[v] With the limited number of CAPs, we need help from community partners who are engaged with students on a daily basis—such as teachers, school counselors and staff and coaches—to identify children in need of support and assist parents in getting them to the appropriate level of care. In 2016, with the guidance of then CCAPS President Kristie Ladegard, CCAPS set out to educate teachers and staff about what to do if they are concerned an elementary school student is suicidal. We also wanted to provide a list of Colorado resources that teachers could share with parents as well as educational references and resources for clinicians. You can read more about the ongoing trainings here.

Transgender and Gender Diverse Youth

Suicide prevention is of heightened importance for the population focus of the 2017 Spring Meeting, co-sponsored by CCAPS and the American Academy of Pediatrics, Colorado Chapter, titled “Transgender Health: What EVERY Health Professional should know.” With almost 28,000 respondents, the National Transgender Discrimination Survey (NTDS) is the largest survey devoted to the lives and experiences of trans people. It found that 40% of respondents have attempted suicide in their lifetime—nearly nine times the attempted suicide rate in the general U.S. population (4.6%).[vi] It is important to note that protective and risk factors for transgender individuals are similar to other populations—those with immediate family support are less likely to attempt suicide; those who have experienced violence, discrimination, abuse or are people of color are more likely to make an attempt.[vii] The 2017 CCAPS/AAP Spring Meeting will help providers ensure their clinical practices are gender affirming.

What YOU can do:

Adapt our elementary school suicide prevention powerpoint for your state, update our wallet cards for your community and listen to the words and actions of kids.

Learn more about caring for trans and genderfluid patients by attending the CCAPS Spring Meeting on April 8th. Register at

Resources: – Visit our website for the elementary school suicide prevention powerpoint, wallet cards for teachers and staff, a list of Colorado resources and guides for teachers, school staff, parents, families and providers. – The Trevor Project provides crisis intervention and suicide prevention services to LGBTQ individuals.

[iv] James J. Mazza, Richard F. Catalano, Robert D. Abbott, Kevin P. Haggerty. An Examination of the Validity of Retrospective Measures of Suicide Attempts in Youth. Journal of Adolescent Health, 2011; 49 (5): 532 DOI: 10.1016/j.jadohealth.2011.04.009
[v] Colorado Health Information Data Set,  (2014) Retrieved from (3 drowning deaths, 9 unintentional poisoning deaths, 16 homicides, 18 cancer deaths, 35 motor vehicle deaths, and 50 suicides)