Thoughts or Statements of Harm to Self / Cutting
Thoughts or Statements of Harm to Others
Campus Crisis Response Team Responsibilities
School personnel must report all verbal and written statements about suicide, harm to others and cutting seriously. All reports must be reported to campus administration, nurse or counselor, or BISD Police Officer immediately to ensure student and campus safety.
When a student is considered to be at risk for suicide, harm to others or is cutting, a parent or guardian must be contacted and involved from the onset. A trained Campus Crisis Response Team (CCRT), composed of an Administrator, Counselor, Nurse and BISD Police Officer must manage the situation. All assessments of threats, attempts or other risk factors of suicide must be left to an appropriate outside qualified clinical professional. The Campus Crisis Response Team will do the following:
- Escort student to a member of the Campus Crisis Response Team – All CCRT Members should be involved in the management of the student crisis.
- Counselor will maintain a confidential record of all actions taken, Student Safety Plan, Notification of Emergency Conference, and follow-up conference.
- Place the student under the security/watch of an adult who will maintain constant supervision.
- Campus Administrator and BISD Police Officer will conference with student.
- Counselor and Nurse will meet with the student.
- Parents/Guardians are called to school and are informed of the presenting crisis.
- Parents and all CCRT members will sign the Notification of Emergency Conference form.
- Campus Crisis Response Team (CCRT) will work with the parents/guardians to ensure that they are provided with community referral information for mental health /medical assistance for their child. Counselor will provide referral information from the Counseling and Community Resources handout.
- The Counselor will provide a copy of the Notification of Emergency Conference form, Safety Plan and Counseling & Community Resources handout to parents/ guardians with all CCRT signatures.
- Student must return to campus with a mental health /medical clearance before being allowed to return to classes. Campus Administration and Counselor will determine if the clearance form is complete and the student may return to class. A member of the CCRT will make direct contact with parents/guardians and the student if there is a delay with the return of the student to campus.
- Campus may consider sending an email to the student’s teachers to alert them that the student may not reenter the classroom without presenting a clearance pass. Sample email: “Student (ID# and Last Name of student) must present a pass to reenter your classroom. If the student attempts to reenter your class without a clearance pass from campus Administration, Counselor or Nurse, please call the front office for an Administrator or security officer to escort the student to campus administration. You will also receive an email when the student is cleared to return to class.”
- If the parent or family members listed on BISD records cannot be reached, call BISD Police at 956-982-3085 to assist in locating the parents/guardian
- If a parent/guardian is uncooperative, then the Department of Family and Protective Services (DFPS) should be contacted at 1-800-252-5400 and a report should be made under medical neglect.
- If the student is a Ward-Of the-State, ensure that the DFPS caseworker is notified.
- Each outcry is to be treated as a separate incident. Protocols will be initiated for each independent outcry.
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TEACHER AND STAFF RESPONSIBILITIES:
SUICIDE/SELF-HARM INTERVENTION PROCEDURES
All talk about suicide/self-harm should be taken seriously and prompt attention should be given.
If the student approaches you to discuss suicide/self-harm follow the procedures outlined below.
If a student verbalizes, writes or discusses thoughts of suicide or harming him/her self, immediately accompany or escort the student to a counselor or administrator.
- Do NOT leave the student alone.
- Escort the student to the counselor/administrator or call for security.
- If counselor is not available, escort the student to the nurse.
- Do NOT leave messages with the assumption that the situation will be dealt with.
- Do NOT allow the student to leave the area or go to the restroom alone or to attend classes.
- Never leave another student in charge of a student who is experiencing a crisis. The student in crisis must always be supervised by a school employee as designated for that purpose.
- The student may only be released to the informed Parent / Guardian.
After school hours: If a teacher or staff becomes aware of a suicidal/self-harm threat or action by a student, notify the on-site administrator.
If no one is available, call Brownsville Independent School District Police at
956 698-3115 or 956 698-3116
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Brownsville Independent School District
Name of School: ______
Student Safety Plan
Name of Student:______ID#:______
I agree not to harm myself or others in any way. I understand that if I am having suicidal thoughts,
thoughts of self-harm,or thoughts of harm to others, I agree to call the following adult person / people:
______at______.
Family member’s name Phone
______at______.
Family member’s name Phone
I know I can also call:
Emergency 911
Family Outreach - (956) 541-5566
Crisis Hotline – 1-877-289-7199
Tropical Texas Behavioral Health (956) 546-2230
Battered Women Shelter/Friendship of Women – (956) 544-7412
National Runaway Hotline 1-800-621-4000
National Suicide Prevention Lifeline 1-800-273-8255
Student Signature: ______
Parent Signature: ______
Counselor Signature: ______
Date: ______
Important: Students will need to provide clearance to campus administrator within 48 hours from mental health provider/physician in order to return to school.
*The school district is not financially responsible for any suggested services.
BISD does not discriminate on the basis of race, color, national origin, sex, religion, age or disability employment or provision of services, programs, or activities
Updated 2/9/18
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Brownsville IndependentSchoolDistrict
Nombre de Escuela: ______
Plan de Seguridad para el Estudiante
Nombre del Estudiante:______ID#:______
Yo estoy de acuerdo en que de ninguna manera me haré ningún dañoó daño a otra persona. Entiendo que si tengo pensamientos de cometer suicidio o hacerme algún daño, también convengo en llamar a la siguiente persona(s) adulta(s)
______al ______
Nombre del familiar Teléfono
______al ______
Nombre del familiar Teléfono
Yo sé que también puedo llamar a:
Emergency 911
Family Outreach - (956) 541-5566
Crisis Hotline – 1-877-289-7199
Tropical Texas Behavioral Health (956) 546-2230
Battered Women Shelter/Friendship of Women – (956) 544-7412
National Runaway Hotline 1-800-621-4000
National Suicide Prevention Lifeline 1-800-273-8255
Firma del Estudiante: ______
Firma de Padre: ______
Firma de Consejero: ______
Fecha: ______
IMPORTANTE: Se les requiere a los estudiantes que presenten al director/a de la escuela en un periodo de 48 horas documentación de un proveedor de salud mental/medico indicando que pueden regresar a la escuela.
*El distrito escolar no es responsable financieramente por servicios recomendados.
BISD no discrimina a base de raza, color, origen nacional, sexo, religión, edad o discapacidad en el empleo en la provisión de servicios o actividades.
Updated 2/9/18
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Brownsville Independent School District
Notification of Emergency Conference
Name of Student:______ID#______
We have been advised that our child has made statements concerning the following:
______self-harm / cutting
______thoughtsor statements (written or verbal) of suicide
______thoughts or statements (written or verbal) of harm to others
We have been further advised that we should seek mental health provider/physician consultation immediately and have been provided with a list of agencies and emergency numbers. We understand that if no help is sought for my child, the Department of Family and Protective Services may be contacted by school personnel.
______
Printed Name of Parent/Guardian Signature of Parent/Guardian Date
______
Printed Name of Parent/Guardian Signature of Parent/Guardian Date
______
Principal Counselor BISD Police
To Be Completed By School Nurse: Medical Observations ______
Nurse
Observation form other Campus Crisis Response Team Members: ______
______
______
______
FOLLOW UP WITH MENTAL HEALTH PROVIDER/PHYSICIAN
______
Physician / Mental Health Provider Printed Name Business/Position/Phone #
(Must Practice in the US)Action taken for the above named student: ______
______is cleared to return to school as of date ______
Mental Health Provider/Physician Signature: ______Date: ______
Important: Students will need to provide clearance to campus administrator within 48 hours from mental health provider/physician in order to return to school.
The school district is not financially responsible for any suggested services.\
BISD does not discriminate on the basis of race, color, national origin, sex, religion, age or disability employment or provision of services, programs, or activities.
Updated 2/2018
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Brownsville IndependentSchoolDistrict
Aviso de Conferencia de Emergencia
Nombre del Estudiante:______ID#:______
Se nos ha informado que nuestro hijo/hija ha hecho comentarios sobre
______daño a si mismo/a
______pensamientos ó declaraciones de cometer suicidio
______pensamientos ó declaraciones de dañar otra persona(s)
Además, se nos ha indicado que debemosbuscar ayuda de el proveedor de salud mental/Medico inmediatamente. Se nos ha proporcionado una listade agencias y números de emergencia. Entiendo/entendemos que si no se busca ayuda para mi hijo/hija, lasleyes federales y estatales
requieren que el personal de la escuela notifíque a la Agencia de proteccióna menores (Dept. of Family and Protective Services).
______
Nombre de Padre ó TutorFirma del Padre ó Tutor Fecha
______
Nombre de Padre ó TutorFirma del Padre ó Tutor Fecha
______
Director Consejero Policía de BISD
Debe ser completo por la enfermera de la escuela: Observaciones y asesoramiento
______
______
______
Enfermera
Observaciones y asesoramiento de otros miembros del (Campus Crisis Response Team):______
______
______
______
SEGUIMIENTO CON PROVEEDOR DE SALUD MENTAL/MEDICO:
______
Nombre del Proveedor Mental/MedicoNegocio/Posición/Teléfono
(debe de ejercer en los Estados Unidos)
Medidas tomadas para el estudiante: ______
______
______
______puede regresar a la escuela en esta fecha_______.
Firma de proveedor mental/Medico ______Fecha: ______
IMPORTANTE: Se les requiere a los estudiantes que presenten documentación al director/a de la escuela en un periodo de 48 horas de el proveedor de salud mental/Medico indicando que pueden regresar a la escuela.
*El distrito escolar no es responsable financieramente por servicios recomendado
BISD no discrimina a base de raza, color, origen nacional, sexo, religión, edad o discapacidad en el empleo en la provisión de servicios o actividades.
Updated 2/2018
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