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					‘Choose Life’ Website: The Development of a Self-Harm and
Suicide Reduction and Prevention Website by Pupils
Bereaved after Suicide During a Critical Incident Involving a
Suicide Cluster

LORRAINE SILVER
Educational Psychology Service


Introduction

Suicide is one of the leading causes of death amongst young people (Debski,

Spadafore, Jacob, Poole & Hixon, 2007). The Office for National Statistics

recorded suicide as being the second most common cause of death after road

accidents amongst 15 to 24 year olds in England and Wales during 2007 and

2008 (Street, 2010). Suicide constitutes a significant public health issue and

given the growing concerns about adolescent and youth suicide an

abundance of literature has been generated identifying potential risk factors. It

is generally recognised that suicide is a complex issue, the cause of which is

likely to be multifaceted. However, common themes in the suicide literature

suggest that suicide ideation and suicide attempts are typically associated

with demographic and personal characteristics, behavioural changes,

previous suicide attempts, family correlates and precipitating events, such as

the break up of a boyfriend / girlfriend (Debski et al., 2007).



One precipitating event which has been the subject of much debate is the

affect of news reports of other youth suicides in the same community, with the

suggestion of a causal relationship between the portrayal of suicide in the

media and actual suicidal behaviour (Pirkis, Blood, Beautrais, Burgess &



                                         1
Skehan, 2006). The effect is amplified when there are similarities in age and

gender, where descriptions of the method are provided and where stories are

of high impact (Pirkis et al., 2006). There is considerable evidence that

heightened community awareness and glorification of the deceased leads to

elevations in suicide, especially among adolescents (Hacker, Collins, Gross-

Young, Almeida & Burke, 2008). Communities affected by outbreaks of

suicide involving young people have been well documented both nationally

and internationally (e.g. Gould, 2003; Hacker et al., 2008). Hence, the term

suicide cluster is commonly used to describe a group of suicides or suicide

attempts, or both, which occur closer in time and space than is considered

usual for the community (CDC, 1988). Previous studies suggest that suicide

clusters may account for approximately 1% to 5% of adolescent suicides

(Hacker et al., 2008). A community-wide coordinated response is vital to

investigate, intervene and prevent suicide clusters (Hacker et al., 2008) and

from the outset it is paramount that multidisciplinary prevention and

postvention plans are put in place.



This paper describes how educational psychologists can work in diverse,

unique and therapeutic ways with vulnerable young people affected by

suicide. Background is provided to the suicide cluster in one LEA and how

pupils became involved in developing a self-harm and suicide reduction and

prevention website. The paper provides an overview of the growing

development of information technology and the advancement of websites.

Pupil participation and relevant ethical issues are discussed. The role of the

educational   psychologist   in   postvention   activities   and   psychological



                                       2
approaches underpinning this work is considered. The engagement in multi

agency working and with other professionals not normally associated with the

role of educational psychologists is highlighted. Future directions will be

considered and implications for the role of the educational psychologist.



Background

During 2008 a number of young people in the County Borough area took their

own lives. The Child and Adolescent Mental Health Service (CAMHS)

reported a statistically significant rise in referrals for depression and suicidal

behaviour in 2008 compared with 2006 and 2007. There was wide media

coverage and sensationalism linking the unexpected deaths. The suicide

cluster affected many pupils attending local comprehensive schools, which

placed tremendous strain on existing resources. In addressing the needs of

groups of vulnerable young people throughout this difficult period, particularly

those who had suffered loss or made a suicide attempt, there was effective

multi-agency working across a range of children’s services, including

professionals working in the community with children and young people, their

families and their carers. Throughout the critical incident educational

psychologists prioritised work with vulnerable groups and became involved in

a range of interventions at individual, group and systemic levels.



It was during this time that three 15 year old pupils attending a local

comprehensive school in an area affected by the spate of suicides became

known to the educational psychologist. Their lives had been changed by the

loss of a young person very close to them and in the days following the event



                                        3
the pupils reported experiences of people telling them how they should feel,

rather than just listening to their feelings and accepting them. The pupils

described the devastating effect that the loss had on them as well as their

friends and family and members of the community and they expressed

feelings of anger and frustration. Believing that there was not enough access

to information about the affects of suicide they proposed the creation of an

internet site which young people could access in order to help themselves.



By listening to the views of three pupils bereaved after suicide, support was

offered to develop a self harm and suicide reduction and prevention website

for the LEA. The ‘Choose Life’ website was designed as a messaging system

to provide information to young people through survivors of their own age

group, with the aim of progressing this to a wider audience via social

networking sites.



The internet is becoming increasingly popular as a means of communicating

information and can offer a valuable source of support. However, currently

little is known about self harm and suicide reduction and prevention websites

as limited research has been conducted into the use of such sites, suggesting

further evaluation is needed in this area.



The growth in information technology and the advancement of self-harm

and suicide reduction and prevention websites

It is widely recognised that the use of technology is a growing 21st century

phenomenon. The recent 2008 annual report of the American Psychological



                                        4
Association Policy and Planning Board entitled ‘How Technology Changes

Everything (and Nothing) in Psychology’, provides an overview of the positive

and negative implications that technology has for the science and practice of

psychology. The report highlights the opportunities for the internet to

potentially harm others due to ease of access, anonymity, disinhibition and

lack of restrictions on what people say on line with few consequences.

Needless to say that perceived risks are greater with unprotected sites where

there is exchange of information, opinions and views. The report also

emphasises the benefits of information technology, in particular the availability

of online therapy, support groups and self–help programmes.           The rapid

growth of the internet means that information is available for anyone seeking

help, advise and support whether they are feeling suicidal or have been

bereaved after suicide. However, presently there is a lack of research and

clear guidelines on precisely how to improve communication to reduce rates

of suicide and suicide attempts. One recommendation is to provide supportive

information on suicide prevention websites (Aldrich and Cerel, 2009).



Internet websites have been dedicated to the issues of self harm and suicide

as sources of information, some provide the facility for people to communicate

to each other via internet chat or message boards and others provide support

and advice. General categories of sites include: support for the bereaved and

support for those with suicidal feelings (Lipczynska, 2009). Despite a lack of

knowledge about such sites and the benefits to users, websites have been

overly criticised as being potentially harmful. More concerning is the

implication that websites encourage self-harming and suicidal behaviours. For



                                       5
this reason Baker and Fortune (2008) interviewed users of self-harm and

suicide websites to gain further understanding of the websites that they use in

order to inform future research. They concluded that the users found them to

be sources of empathy, understanding and friendship, indicating that they

offered a way of coping with social and emotional distress. This would

suggest that for some people self-harm and suicide websites offer an

‘accessible and effective alternative to conventional psychotherapeutic and

pharmacological interventions’ (Baker & Fortune, 2008, p.121). This is

especially the case for those who are reluctant to seek out help through more

traditional methods. Furthermore, as only a minority of bereaved attend group

interventions or therapies (Andriessen, 2009) and drop out rates are known to

be high (Baker & Fortune, 2008), other forms of support such as internet

websites are needed to give people a choice.



Importantly website messages ought to be tailored to meet the needs of this

vulnerable group. Therefore, it seems reasonable that the views of young

people bereaved after suicide be obtained when considering effective

messages for self-harm and suicide reduction and prevention websites.

Particularly if intervention by close others is fundamental to prevention

(Aldrich & Cerel, 2009).



Pupil participation

Increasingly over the past two decades national and international legislation

has aimed to promote the ‘voice’ of the child. The Children Act 1989 in

England and Wales encouraged local authorities to ascertain the wishes and



                                      6
feelings of children before making any decisions relating to them. Article 12

and 13 of the United Nations Convention on the Rights of the Child (1989)

recognised that children should be given the opportunity to seek and receive

information and ideas of all kinds and be allowed to expresses their views

freely on all matters affecting them.



The ‘Every Child Matters’ (ECM) agenda (DfES, 2004b) encourages children

and young people to make a ’positive contribution’, giving them confidence to

become more actively involved in decision making, including reviewing,

evaluating and developing services and policies (Burton, Smith & Woods,

2010). From a service perspective, the report ‘A Review of the Functions and

Contribution of Educational Psychologists in England and Wales in light of

Every Child Matters: Change for Children’ (Farrell, Woods, Lewis, Rooney,

Squires & O’Connor, 2006) reviewed how effective educational psychologists

are in contributing to the five outcomes of ECM, recommending that on a day

to day basis educational psychologists should monitor, record and where

appropriate communicate this contribution. Subsequent examples of good

practice have been documented where educational psychologists have

empowered pupils to participate in research projects to help inform school

improvements (Burton et al., 2010) and children and young people have

contributed to educational psychologists’ understanding of the factors that act

as barriers to effective pupil participation (Aston & Lambert, 2010).



More recently, at a national level, Wales has placed the principles of the

United Nations Convention on the Rights of the Child at the heart of its 5 year



                                        7
rolling plan for children and young people in the Getting it Right (2009)

agenda. Priority 8 aims ‘to increase the opportunities for all children and

young people in Wales to participate in decision making on issues that affect

them’ and Article 12 to ensure that ‘children have the right to say what they

think should happen when adults are making decisions that affect them and to

have their opinions taken into account’.        This concurs with the ECM

framework for change.



Legislation promoting pupil participation is relevant to the practice of

educational psychologists when working with children and young people and it

follows that if pupils are to become more involved in decision making

processes then their views should be elicited on issues that affect them.

However, careful consideration should be made with regard to the age,

maturity and capability of the young person (DfES, 2001) as it can not be

assumed that children and young people have the relevant skills and

knowledge on all issues affecting them. Hence, they should not be

overwhelmed with determining outcomes, nor should the decision-making

process be completely passed over to them. In practice there is a need to

balance the responsibility afforded to pupils in decision making whilst

adhering to ethical guidelines to maintain confidentiality and protect them from

potential risk of harm.



Involving pupils in the development of a self-harm and suicide reduction and

prevention website raises ethical issues because by its very nature the




                                       8
subject of suicide evokes emotions. How to overcome potential ethical issues

needs to be considered carefully and sensitively.



Ethical issues

If someone bereaved after suicide provides a better understanding of suicide

and its prevention (Andriessen et al., 2009) then it is feasible that their

contribution to postvention activities could enhance the lives of others. Whilst

it is recognised that ethics should be considered when involving vulnerable

groups in activities or research on sensitive issues that personally affect them,

there is lack of clarity about the precise nature of the ethical problems and

how to overcome them (Lakeman & FitzGerald, 2009). Historically this has

resulted in many services developing ‘passive’ models of postvention,

whereby people bereaved after suicide are provided with information about

available resources to help them (Campbell, Cataldie, McIntosh & Millet,

2004) with limited interaction taking place, or dialogue, to establish their views

and opinions. Consequently, there is little documented in the suicide literature

about children and young people actively participating in areas of work

involving suicide prevention and postvention.         Intuitively, Lakeman and

FitzGerald (2009, p.15) propose that the process of participants actively

contributing to postvention activities such as suicide research may be

therapeutic providing:



     ‘the opportunity for participants to exercise altruism, by
     conveying hope, by gaining personal insight (into own
     psychology and situation), by gaining a sense of universality
     (they are not alone and others suffer similarly) and by being
     listened to (having the opportunity to talk and be heard)’.



                                        9
This would suggest that contributing to postvention activities may be a

positive experience for participants who have experienced loss.



For practicing educational psychologists the British Psychological Society

(2006) Code of Ethics and Conduct provides ethical guidelines to protect

participants from harm. Ethical issues can be dealt with by obtaining informed

consent, making assessments of risk and providing appropriate support. More

recently Lakeman and FitzGerald (2009) provide general ‘normative

guidelines’ concerning the ethics of involving children and young people in

suicide research. The guidelines were generated from an online survey

completed by members of the Human Research Ethics Committee identified

through web-based lists in the United Kingdom, Ireland, Australia, Canada,

and   New Zealand. Recommendations include             consulting with     other

experienced professionals during the process, establishing procedures to

identify participants who may be at risk, ensuring support is available,

providing information about the consequences of participation, acknowledging

the vulnerability of participants and responding with care. Lakeman and

FitzGerald (2009) also recommend that researchers make use of supervision

with experienced professionals for the purpose of problem solving and

debriefing. These guidelines are helpful and provide greater specificity of the

ethics involved in suicide research which can be generalised to other

postvention activities and projects involving children and young people.



Media guidelines have also been developed by a number of countries to

promote responsible reporting of suicide. The guidelines stress the



                                      10
importance of challenging the myths about suicide and recommend providing

information about help services. However, further evaluation of the

effectiveness of these guidelines is recommended (Pirkis et al., 2006).



Ethical and media guidelines have been adapted and refined over time to help

inform courses of action which may affect the wellbeing of others. The current

guidelines helped inform the educational psychologist’s postvention work with

pupils, families, members of the community, multi agency teams and other

professionals, as part of an ongoing negotiated process during the

development of the Choose Life self-harm and suicide reduction and

prevention website.



The role of the educational psychologist in postvention

According to Andriessen (2009, p. 43) postvention involves ‘activities

developed by, with, or for suicide survivors in order to facilitate recovery after

suicide.’ During critical incidents involving suicide a range of postvention

activities are undertaken by educational psychologists. At a systemic level

educational psychologists are primarily involved in building capacity in schools

through empowering school staff to support vulnerable young people affected

by suicide. Triage work and the process of referring ‘at risk’ pupils to external

agencies such as CAMHS is also an important aspect of crisis intervention

work (Debski et al., 2007), highlighting that collaborative multi agency working

plays an important role. Moreover, with the newly established children’s

services there is increased emphasis placed on educational psychologists

working in a multi–agency context. When working with individuals and groups



                                       11
educational psychologists generally intervene by applying psychological first

aid as well as therapeutic and counselling approaches. Whilst it is recognised

that postvention work is paramount in the aftermath of suicide, due to limited

evaluative research there is insufficient information about treatment,

programmes and appropriate group formats across different subgroups of

survivors (Andriessen, 2009).       This poses a challenge to educational

psychologists as one of the most frequently encountered crisis situations

experienced in the school setting is intervention with potentially suicidal young

people.



Educational psychologists’ distinctive contribution when working with children

and young people is the application of psychological theory to practice, which

is a fundamental principle underpinning all aspects of               educational

psychologists’ work. Of relevance is the theory of Social Constructionism

(Burr, 1995) which maintains that different people hold different constructions

of reality, suggesting that the perspective of young people may differ from

professionals but is equally valid. To effectively work with vulnerable people

bereaved after suicide a number of theoretical perspectives may also be

drawn upon, including theories on loss and bereavement (e.g. Kubler-

Ross,1970) and specific approaches can be employed, such as solution-

focused brief therapy (De Shazer, 1985).



Moreover, as the grief response differs between individuals it makes sense

that importance should be placed on helping the survivor find his/her own,

unique way to deal with the loss (Andriessen, Beautrais, Grad, Brockman, &



                                       12
Simkin, 2007). To support this process West (2008) advocates ‘child-centred

negotiation’ using a person–centred approach with its roots based in

humanistic psychology, which places direct emphasis on the ‘client’.         Its

philosophy is to give the client a voice by eliciting personal thoughts and

feelings about issues in their life.        For this approach to be effective

opportunities need to be developed for children and young people to gain the

skills and knowledge to make informed decisions. A genuine belief should

also be held that children and young people can be involved in collective

decision making processes, whilst at the same time flexibility is required to

modify plans if appropriate (West, 2008).



Intervention: development of the Choose Life website

After reviewing the suicide literature and considering psychological theory,

research and practice as well as relevant policy it is generally understood that

children and young people bereaved after suicide have their unique way of

dealing with grief, which should be respected. Having experienced loss of

significant others they are best placed to contribute to a better understanding

of suicide and its prevention. They have a right to have views on matters that

affect them, have their opinions taken into account and participate in decision

making at different levels. The extent to which is dependent on age, maturity

and capability of the young person, ethical implications of such involvement

should also be taken into account. One psychological perspective

underpinning this philosophy is person-centred psychology, where young

people are made to feel important and their experiences and ideas valued.

When taken together, the above provides a rationale for collaborative work



                                       13
with three Year 11 pupils who have been bereaved after suicide and informed

the process of facilitating the Choose Life self-harm and suicide reduction and

prevention website.



Planning the website

In February 2008, despite experiencing the loss of significant others, three 15

year old pupils from a comprehensive school where many pupils were deeply

affected by the suicides were motivated to produce a self-harm and suicide

reduction and prevention website for young people to access electronically. In

the previous weeks the pupils had experienced the impact of suicide on their

family, friends and the local community. Their intention was to appeal to their

age group to make a difference to young, vulnerable people.



At the start of the project the pupils believed that social networking sites would

be the best place to provide information to support young people affected by

suicide, given that the internet is frequently used by this group as a means of

communication. They proposed that the site should be easy to access and

simple to navigate and that the language should be reduced so that

information could be understood by all young people, even those with special

educational needs. Furthermore, the pupils felt that messages to their peers

should be communicated by young people bereaved after suicide, using the

words of the ‘young’, rather than through the voices of professionals who may

not share the same understanding and experiences. The pupils presented as

mature and resilient, having remarkable insight despite going through difficult




                                       14
times. The website though designed to help others offered a therapeutic

approach to the pupils themselves.



The following week the proposal was put forward to an organised meeting

which had been scheduled to formulate responses to the suicides. A number

of specialist agencies were in attendance, including the Educational

Psychology Service, CAMHS, Child Protection Service, Social Services,

South Wales Police, Counselling Service, senior personnel from the LEA and

secondary school headteachers. Young people were represented by a sixth

former from a neighbouring school elected as Youth Mayor, who during the

development of the project offered support to the pupils to extend their skills

and knowledge through the gathering of appropriate materials from

recognised self-harm and suicide prevention sites (including voluntary support

agencies and registered charities).



The Local Service Board (LSB) had already developed a suicide management

group which established strategic and operational groups (gold, silver and

bronze structure) to fast track, monitor and manage various responses to the

suicides. The bronze tactical group was involved in the coordination of a

multi-agency approach and was attended by the Educational Psychology

Service. As part of the process it was intended that the progression of the site

should be fed back to bronze group and silver (strategic) group.




                                      15
Proposed Content

In subsequent meetings with the educational psychologist the content of the

site was developed by the pupils to include ‘myths and facts’ about suicide

and personal statements about the affects of suicide on those left behind.

Advice would be offered on where young people can get help if they felt

suicidal or if they are bereaved after suicide and it was proposed that a

hyperlink should be created to offer direct access to the help lines and support

agencies’ websites. The pupils also suggested that the Educational

Psychology Service booklets for children and young people                 about

bereavement and loss and for adults about how to help a bereaved child

should be downloadable on the web pages. Believing that their home town

had received ‘bad press’, the three young people suggested that an

ambassador for the LEA area could bring back confidence to the community.

Support was given by a former Wales and British Lions international rugby

legend who spent time with the pupils and was an inspiration to them. His

family represented the local area in both sport and business.



Ethical considerations

Ethical issues were overcome during different stages of the development of

the Choose Life website. Firstly, because of the intense and intrusive media

interest shown in the pupils their identities remained anonymous. The pupils

were offered support by the Educational Psychology Service and their school

throughout the project and there was liaison with their families. Secondly, at

the early stages of the project the pupils anticipated that information could be

placed onto social networking sites to reach out to a wider audience of young



                                      16
people. However, the educational psychologist expressed concerns about

material being located on unprotected sites which could invite unwarranted

feedback, comments and opinions (some of the messages and images posted

on the internet at the time were disturbing and harmful). Consequently,

confirmation was sought about the potential risks of unprotected sites versus

secure sites from the Children’s Commissioner for Wales and the Corporate

Principal Solicitor, the LEA. At the same time a letter was sent by the pupils to

social networking sites about accessing a secure site. Unfortunately the pupils

were unsuccessful in obtaining a secure social networking site, in part due to

difficulty contacting decision makers. At this stage it was the opinion of the

pupils to develop the pages as a website for the LEA which offered a secure

site, with the aim of progressing the pages onto social networking sites at a

later stage. Thirdly, a focus group activity took place with Year 11 pupils to

elicit their views on the content of the website before it was launched. There

were no issues raised by any of the pupils about the website messages or the

language used. Fourthly, for the purpose of problem solving and debriefing

the educational psychologist was offered supervision by senior members of

the Educational Psychology Service. The educational psychologist was also

mindful of how the role of the ‘website facilitator’ and care provider could blur.



Progression of the website and multi agency involvement

In December 2008 the three pupils were invited to present the final version of

Choose Life website to members of the silver group. Following the power

point presentation which conveyed the purpose of the website and its content

there was consensus to launch the Choose Life web pages on the LEA



                                        17
website. During the development of the website the pupils met with Youth

Services, the police and a range of professionals within the County Borough

Council, who supported the progression of the website, assisted with technical

support for its design in conjunction with the pupils and helped organise the

communication links for the website launch.



Launch of the Choose Life website

On the 9th July 2009 the LEA placed the web pages via a hyperlink onto their

home page and the pupils were invited to launch the Choose Life website on

radio. The opportunity to have it broadcast on television was turned down to

maintain anonymity for the pupils. Several local papers reported on the

website, it was adopted by a number of rugby clubs in the area and has since

been placed via a hyperlink onto local comprehensive schools home pages.

The pupils hoped that the website would support young people not only in the

local area but all over Wales and the UK. However, they recognised that

ideally a website link should also be located on internet social networking

sites where it would be more accessible to young people.




                                     18
Preliminary evaluation: Choose Life website hits




                  1200



                  1000
 Number of hits




                  800



                  600                                                                              English
                                                                                                   Welsh
                  400



                  200



                    0
                         July   Aug   Sept   Oct   Nov   Dec    Jan   Feb   Mar   Apr   May June

                                                         Months




Figure 1. Choose Life website hits from July 2009 to June 2010 in

English and Welsh language.



Figure 1 shows that Choose Life website received the most hits in July 2009

due to the publicity given to the launch. The analysis shows a greater number

of hits in English (2023) compared to Welsh (450) with a total of 2473 hits

received over a 12 month period. In the first five months after the launch more

people accessed the website with the number of hits declining during the

following six months.




                                                           19
The CAMHS team reported a statistically significant rise in referrals for

depression and suicidal behaviour in 2008 compared with the previous two

years. Referrals in 2009 fell from the 2008 level but were still 50% higher than

in 2007. CAMHS referral rates for 2010 are not yet available.



The only available data for the Choose Life website is the number of hits the

site received as information is not available about who accessed the site and

for what purpose or how the messages were received. Therefore, it would not

be meaningful to make direct comparisons between CAMHS referral rates for

depression and suicidal behaviour and the Choose Life website hits.



Discussion

Preliminary analysis provides an overview of how frequently the Choose Life

website has been accessed since its launch in July 2009. Given that the web

pages are located on the LEA website relatively high numbers of hits were

received in the months following the launch. It is difficult to speculate the

reason for the demand for the site decreasing over time without having details

about the users and their motivations for going onto the site. Ideally,

interviewing those who have downloaded Choose Life would provide a rich

source of data about the benefits of the website, but this form of data

collection was not possible.



Advances in information technology have provided increasing opportunities to

communicate to others about the impact of suicide on individuals, schools and

communities. Of key importance is reaching the people it is aimed at. If



                                      20
Choose Life is located on a site which is frequently accessed by young people

then the website messages are more likely to reach the target audience.

Given that internet appeals to young people, the pupils believe that presenting

Choose Life on social networking sites will offer help to a wider population of

young people who are feeling suicidal or who have been bereaved after

suicide. However, very few studies have evaluated self-harm and suicide

reduction and prevention websites and there remains scepticism about the

potential risks and benefits of such sites. Further research into this area is

needed.



Of benefit to the pupils during the progression of the Choose Life website was

the therapeutic nature of the work that they were undertaking. The pupils

reported that the website ‘kept them going’, that they were able to talk about

their experiences and felt listened to. Importantly for the pupils it helped build

up their own resilience and gave them the satisfaction of being able to transfer

the knowledge and skills that they had acquired to others who needed it.



The postvention work has implications for the role of the educational

psychologist as it demonstrates how they can work in creative ways with

young people by helping them actively participate in collaborative work on

issues that affect them. It highlights how educational psychologists can

engage with a range of professionals in a multi agency context. It also

emphasises the requirement for further research into prevention and

postvention work, particularly involving cluster suicides in order to inform

practice.



                                       21
Conclusion

The Choose Life website was designed by three pupils attending a

comprehensive school as a messaging system to provide information to

support young people who may be considering self-harm or who are feeling

suicidal. The pupils were bereaved after suicide during the time of a critical

incident involving a suicide cluster and the website though developed by them

was supported by an educational psychologist through regular meetings with

them and other professionals. The pupils highlighted the importance of

listening to the views of young people on matters that affect them and they

offered a different perspective from that of professionals. They emphasised

that the mode of communication and the language used is vital for messages

to be well received by children and young people. By drawing on their own

experiences the pupils wished to make a difference to the lives of vulnerable

young people. The pupils’ views and opinions were valued, considered worthy

and developed in collaboration with the educational psychologist. An

important issue is that the Choose Life website would not have been created

without the pupils’ participating in every respect. Thus, highlighting the need

to avoid ‘tokenism’ where professionals listen to young people’s views but

with little evidence that their suggestions influence outcomes, such as school

developments, service delivery or policy.



Ethical issues can be overcome when young people participate in postvention

activities by following appropriate guidelines.      To instil confidence in

professionals there needs to be more supportive evidence that involving



                                      22
young people in service developments relating to sensitive issues can result

in positive change. To date there is little documented in suicide literature

about postvention activities being undertaken by suicide survivors and it is

considered that Choose Life website is the first self-harm and suicide

prevention and reduction website to be produced by young people bereaved

after suicide.



Future directions

The intention of the pupils is to promote the website via a hyperlink to be

added onto social networking sites in the future. The community has

recognised the pupils’ contribution to suicide prevention and they have since

received the Mayor’s award for their work. Presently discussions are taking

place with a leading registered charitable organisation about progressing the

website via a hyperlink onto their home pages. Furthermore, arising out of a

presentation to ACAMH in June 2010 there is ongoing communication with an

acknowledged expert in the field of self-harm and suicide based at Columbia

University New York about how to evaluate and progress the website.



Acknowledgements

The author would like to thank the three pupils for their dedication to the

development of the Choose Life website and for being an inspiration to other

young people.


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