County of Orange County-Wide Response Plan To Sudden Child/Adolescent Death

Introduction

The tragic phenomenon of sudden child/adolescent death has, in recent years, represented a significant social problem for many school communities throughout the county. Unfortunately, several regional and county area school districts have also experienced child/adolescent suicides and deaths from other causes. Recently, educational leaders throughout the Orange-Ulster BOCES area have recognized the need for an organized approach on a county-wide basis to deal with this potential crisis situation. In deference to such concern, the Orange-Ulster BOCES has organized an alliance of local educational and public mental health professionals for the purpose of developing a County-wide Response Plan to Sudden Child/Adolescent Death.  The result of this “Response Plan” is to offer local school districts the opportunity to receive supplemental support personnel for one or two days and to provide procedural guidelines should the unfortunate case of sudden child/adolescent death occur.

 

The County-wide Response Plan to Sudden Child/Adolescent Death contains the following two provisions.

 

  1. The “Response Plan” establishes a County-wide Crisis Team consisting of professionals from local school districts and from the Orange County Department of Mental Health. These dedicated individuals are offering their experience and expertise with the support of their respective superintendents of schools on a request basis to local school districts during a time of crisis. School districts without sufficient experience in dealing with the delicate issue of child/adolescent death, or in need of additional staffing, required to implement a response plan, may contact the Orange-Ulster BOCES to request expertise and assistance. Support may be in the form of consultant services or direct intervention as determined by a requesting district.
  2. The “Response Plan” presents specific Preparatory and Procedural Response guidelines that school districts may follow in the constructive treatment of a sudden death crisis within their districts.

 

Specific Response to Sudden Child/Adolescent Death

A.  Preparatory (before sudden/adolescent death)

  1. School districts designate which in-district clinical support staff (psychologist, social workers, guidance counselors, etc.) will be assigned, as Crisis Team Members, to each building in the district should a crisis occur.
  2. School Principals designate the potential locations of crisis centers.
  3. School districts should project the extent of their need for support from the county-wide crisis team prior to a crisis situation.
  4. School districts designate a primary spokesperson to deal with the media.
  5. School principals designate, in advance, which building staff member will serve as an assistant organizer/decision maker during the time of crisis.

B.  Procedural (after sudden child/adolescent death)

 

Alert Day

  1. Student found dead of an apparent suicide. This usually occurs after school hours or on weekends.
  2. District representative (school principal, central office administrator, psychologist) contacts Crisis Team members (in-district) as soon as possible.
  3. District representative contacts the District Superintendent or Deputy or Assistant Superintendent of Orange-Ulster BOCES, requesting assistance from COUNTY WIDE Crisis Team.
  4. Local superintendent contacts and confirms the district professional who is the designated primary spokesperson to deal with the media.
  5. Building principal contacts and confirms as assistant organizer/decision maker to facilitate response plan in the school building that has been affected.
  6. Building principal or crisis team member in building where sudden death has occurred contacts crisis team members in other district schools. This is important to provide support for siblings, relatives and close friends in other schools.
  7. Building principal designates an individual who will have primary re- sponsibility for answering parent questions.
  8. Building principal activates telephone chain to announce a faculty meeting prior to the opening of school on the next day.

 

Day One (In School)

Early morning faculty meeting is held with several purposes:

  1. Principal reviews the known facts of the case, in order to establish a common reference base and to dispel rumors.
  2. Principal introduces crisis team members; reviews special schedule for day; and communicates the location of the “crisis centers.”
  3. Crisis team members describe the feelings which students may be experiencing and suggest how the teachers might handle them. Time is allowed for questions and dealing with the feelings of the staff. Some staff may be particularly upset and require additional support.
  4. Guidelines are provided for helping any students who are upset and for having them escorted to one of the “crisis centers” set up in the building (guidance office, etc.). Faculty should identify close friends of the deceased and other high need students for potential follow-up.
  5. Teachers are encouraged to allow students in their classes’ free expression of grief. The guiding principle is to return to normal routine as soon as possible within each class and within the school. School- wide assemblies or memorial activities are discouraged. Students (individually) should be allowed time needed to express grief. Not all students will recover at the same rate, even those who have no close relationship to the individual.
  6. The teachers are asked to dispel rumors wherever possible, and to discourage any “glorification” of the event. For example, if a student is heard to say, “I wouldn’t have the guts to kill myself,” the teacher can respond, “We all care for the individual and his/her family, but suicide is not really a brave act! It is far more courageous to go on living and to face your problems each day as you and I do.
  7. The principal and/or guidance counselors and clinical staff may meet with each grade, either by individual homerooms or by total grade (if possible) in order to:
    • Review the known facts and to dispel rumors.
    • De-mythologize the act. (This is not heroism or a media event. It is a real concern for the family.)
    • Inform students and staff of the location and role of the crisis center.
    • Encourage students to express their reactions in whatever way is appropriate for them. (All responses are acceptable, from severe upset to no reaction whatsoever).
    • Discuss possible feelings of guilt or feelings of responsibility.
    • Discuss possible fears for their own safety and that of their siblings and peers.
    • Ask students to be supportive of one another and to escort any friend who is upset to a teacher or the crisis center.
    • Reassure students that any adult in the building is available to help.
  8. Telephone calls are made to parents of individual students who are particularly upset during the day. The crisis team will collaborate to determine which parents are called. The telephone contact is ideally handled by clinical staff that can explain the student’s reactions to the parents. This person should give appropriate advice as to how the parents should handle their son/daughter. Some parents may be asked to pick up the student at the school.
  9. All building staff are assembled after school to:

Allow for the expression of feeling and mutual support. (After a full day of dealing with their own emotional responses and that of their students, the teachers are generally quite drained).

 

Review the events of the day.

 

Review the characteristics of high-need students (those who seem especially upset or depressed or show other signs of not dealing well) and compile a list, based on staff observations, of individual student reactions during the day.

 

Announce funeral arrangements and encourage staff to attend, in order to provide support to students and their families.

 

 

Follow-Up Activities

The Crisis Team shall suggest follow-up activities to the building principal and superintendent of schools that shall determine the most appropriate course of action. It is further suggested that staff be reminded that there is one media contact person.

  1. Outside consultants may be called upon. At this point, it may be helpful to have “outside” professionals because they are not emotionally involved and can, therefore, provide objective support and direction. Some of the services they can provide are:
    • Recommend to parents private evaluations for “high-risk” students.
    • Speak at a general faculty meeting on the issue of adolescent suicide, identification, prevention, response.
    • Conduct evening informational meetings for all concerned community members.
  2. Guidance and clinical staff continue meeting with individual students and small groups to provide support, and to further identify “high risk” students and faculty.
  3. Contact all parents of students identified as “high risk” to express concern and to suggest possible follow-up evaluation by informing parents of community and Orange and Ulster County resources available.
  4. Outside consultant and school staff may conduct an evening meeting of all concerned parents to answer questions and allay concerns.
  5. Guidance and clinical staff continue crisis intervention, answer phone calls of anxious parents, and meet with concerned staff.
  6. The principal and superintendent of schools will determine whether letters should be sent to parents of “high risk” students reminding them to seek a private or community professional evaluation, in order to insure the health and safety of the child. (Return receipt mail is suggested.)
  7. “School/Community Steering Committee” can be formed and can plan a meeting of the teenagers of the town.
  8. “Front-line” staff that has been dealing directly with the crisis should meet with a consultant for expression of feelings and mutual support. (This is a very necessary ingredient).

 

Closing Comment:

An outside support consultant can help the superintendent, principal and other key coordinators to examine their own view of the situation and, at the same time, validate key responsibilities toward children, teachers, parents and/or the community as a whole.

 

Addendum - Event with Multiple Casualties

 

Introduction

The County-wide Response Plan was developed to provide guidelines for school administrators and clinical personnel in preparing for and reacting to the sudden death of a student, faculty member or staff member. This plan provided strength and guidance during events on a large scale; specifically, the tornado at East Coldenham Elementary School, Valley Central School District, and the Monroe- Woodbury bus accident. Following these events, it was felt that an addendum should be added which would incorporate the knowledge gained by the individuals who dealt with the aftermath of these tragedies. The process of identifying the “what to do” has taken many individuals back to a circumstance they would do anything to prevent. They have given of themselves to develop this addendum in the hope that no one will ever need to use it. However, should a disaster occur again, they hope their experience will serve to guide staff, students and families through the crisis.

 

Large-scale disasters take many forms and each presents unique situations and needs. At the time of the event, immediate emergency procedures must be given priority in order to cover medical and safety concerns. The provision of mental health support personnel to respond to and care for traumatized individuals within the school community is the focus of the Crisis Response Plan. This addendum identifies procedures for obtaining crisis support personnel by temporarily reassigning local school, county and state employees to the site during the crisis period. The goal is to assess needs, provide services and resume normal operation as quickly as possible.  It should be noted, however, that major disasters may require two to five years before school functioning returns to normal.

 

Specific Response to an Event with Multiple Casualties

Pre-Crisis Planning: Schools need to be prepared to respond effectively in the event of a major school disaster.  To this end, the following recommendations are offered:

  1. Each school district should develop, review and annually revise a district-wide Emergency Management Plan and a Crisis Response Plan. Building administrators should annually review with staff the main components of these plans, including personnel assignments.
  2. Key district and building personnel should receive professional in-service training, as identified below:
    • Key administrators and crisis coordinators should be trained in how to prepare for disasters and in procedures for responding to disasters;
    • Key administrators, pupil personnel service staff and other designated responders should be trained in crisis intervention techniques; and
    • Key administrators, pupil personnel service staff and other designated responders should be trained to provide grief counseling and long-term clinical services for Posttraumatic Stress Disorder.
  3. District administrators should plan a communication mechanism to maintain control of the communication process. Methods and time frames should be established to convey information to various audiences: staff, students, parents, board members, State Education Department, physicians, clergy, general public and media.
  4. District administrators should develop lists of resources which may be called upon in the event of a crisis, e.g., volunteer service agencies, physicians, clergy, private security companies, State and County resources, insurance contacts, press contacts.
  5. District administrators and/or pupil service personnel should develop a library of crisis-related materials for parents, teachers, counselors, clinical personnel and community members.

 

 

The Day of the Disaster, the Superintendent of Schools, District Emergency Coordinator and/or designee(s) will need to:

  1. Notify emergency services, e.g., police department, fire department, mutual aid, and ambulance.
  2. Assess the damage and the amount of support needed.
  3. Notify the District Superintendent to activate the county-wide Response Plan. The District Superintendent will need to know:
    • the nature and extent of the disaster (numbers of students involved);
    • the approximate number of Crisis Team members needed (assess high); and
    • the type of Crisis Team members needed, e.g., school psychologists, social workers, nurses.
  4. Organize school personnel to quickly respond to the disaster by assigning staff to committees to provide the services listed below. These committees should meet daily throughout the crisis phase in order to
    • Coordination - Assign personnel to coordinate the intervention effort, establish working committees and advise district administration about needs and status of services.
    • Notification of Parents - Assign personnel to a calling committee to inform parent(s) or Guardians about the disaster and related procedures. (E.g., bussing, pick up of children, school closing and support services that will be provided.)
    • Release of Students - Assign personnel to set up a temporary shelter area, identify procedures for release of students to parents and monitor release of students to parents.
    • Counseling and Direct Intervention - Assign staff and temporary personnel, assigned through the County- wide Response Plan to provide direct intervention to affected individuals. A team leader from the district should coordinate assignments, brief staff and temporary personnel and provide information to the coordinating committee.
    • Media Control - Assign a person(s) to prepare sample press releases, identify a media center, direct media away from the crisis area until the situation is stabilized, help to conduct briefing sessions, act as a liaison between the crisis area and the press room and establish procedures for photography and/or videotaping. Note:  The area may need to be secured for police or insurance purposes.
    • Coordinate Volunteers - Assign personnel to coordinate volunteer services such as food, shelter, transportation, babysitting and donations and to maintain lists of volunteers and services provided.
    • Notification of Other Individuals - Assign personnel to coordinate a telephone committee to identify siblings, neighbors and other related individuals (e.g., club members or non-public students) who may need to be informed of available support services.
  1. Designate an Official spokesperson (usually the Superintendent of Schools) to deal with the press.
  2. Obtain additional crisis intervention support personnel from sources such as County, State and State Police, if needed.
  3. If students or staff are hospitalized, assign Crisis Team members to the hospital(s) to work with families, students, faculty and staff, as needed.
  4. Close school in the affected building or district-wide, if needed. Notify media of closing, following established district procedures.

Note: The integrity of the building may need to be determined by a structural engineer prior to occupying the building again.

  1. Identify counseling support areas. Large areas should be provided for food and general talk; small, more intimate areas should be provided for private discussions.

Note: Traumatic experiences cause people to forget information, retain only pieces of information or confuse facts, therefore, important information will need to be repeated frequently.

  1. To promote continuity and structure, develop and distribute the following materials:
    1. Crisis Team assignment rosters which lists name, organization, home phone, work phone, length of time available and assignment should be distributed to the Crisis Team and Building Administrators;
    2. A Crisis Plan overview which describes the response plan and the role of the support services should be distributed to the Crisis Team;
    3. Building floor plans should be distributed to the volunteer workers and the Crisis Team;
    4. Lists of community resources and phone numbers should be distributed to the Crisis Team and volunteer workers;
    5. Copies of materials describing reactions and how to cope with crisis should be available for faculty members and parents;
    6. Copies of clinical materials about crisis, expected reactions, Post-traumatic Stress Reaction, etc. should be made available to counselors and the Crisis Team; and
    7. Copies of forms to be used to identify “high risk” individuals who appear to be suffering traumatic reaction should be distributed to the Crisis Team.

 

The Day(s) After the Disaster

The Superintendent, District Emergency Coordinator, Building Administrator and/or other individuals designated by the Superintendent may need to coordinate long- term response efforts and identify and respond to long-term crisis needs. Following are suggested activities which will provide this support:

 

  1. Cancel regular classes on the day(s) following a disaster, if needed. The Crisis Team should be available to meet with parents, students and staff at the affected site or another designated site. Provide childcare services. Teachers should be available (in their classrooms, if possible) to provide a sense of “normalcy” and support.
  2. Develop press releases, as needed.
  3. Maintain complete rosters of:
    • Crisis Team members—name, district or agency affiliation, address, home and work phone numbers and the length of time available; and
    • Volunteer Workers—name, home and work phone numbers, service provided and date. These rosters can be used later to generate thank you letters.
  4. Determine the need for attendance at funerals, arrangement of memorial or ecumenical services and provision of counseling services.
  5. If students or staff are hospitalized, daily hospital visits by teachers and administrators are advised.
  6. Determine the need, nature, content, timing and location of public meeting(s) to review the disaster; describe crisis intervention, insurance and other responses; and allow structured community comment. Obtaining an outside expert on disaster or trauma may be advisable; a “neutral” expert may help to diffuse some of the emotion surrounding the incident
  7. Arrange for direct billing to the insurance company or school to avoid billing the families of injured students.
  8. Conduct regular briefing meetings with all administrators, Crisis Coordinating Committee, Crisis Team leaders, Crisis Team members, teachers and staff (this should be continued daily throughout the crisis phase). The focus of these meetings should be to:
    • Provide current information regarding the event such as medical conditions of the injured, funeral arrangements for the deceased, role of the Crisis Team members, role of district staff, daily response plan and overall Crisis Response Plan;
    • Distribute materials (items b, e, f and g, above), as needed;
    • Announce daily Crisis Team assignments;
    • Review organization and communication chain;
    • Provide daily contact with coordinating agencies to define needs and roles of support personnel;
    • Determine a need for teacher substitutes.
    • Share information about perceived student, staff and community needs; and
    • Provide a mechanism for interaction among teachers, support personnel and clinical staff.

Note: It is important that the Principal retain control and authority in the building; students, faculty, parents and the community will look to the Principal for leadership and stability.  Other Administrators and the Crisis Coordinating Committee should support the Principal’s role, providing direction and advice to him/her, as appropriate. If possible, the Principal should make personal daily contact with injured students and families.

 

Also Note: Personnel who have been directly involved in the disaster may be traumatized; additional support and/or temporary relief from decision making processes may be needed.

  1. Provide follow-up counseling sessions for staff, faculty and transportation personnel, emergency workers (e.g., police, rescue squads or hospital staff) and Crisis Team members, as needed.
  2. Obtain a trained trauma counselor to debrief traumatized teachers, students, support personnel and community members.

 

Long-term Response

By the second or third day of the crisis, district personnel should be assigned by the Superintendent and Building Administrator to:

  1. Meet with the Crisis Coordinating Committee to determine long-term needs;
  2. Arrange for replacement counselors, if needed;
  3. Arrange for long-term clinical personnel (District, County, State, Private) to be available for intervention or referrals;
  4. Identify high-risk individuals and arrange for continued support services;
  5. Designate an individual to document and summarize the Crisis Response efforts in a written report;
  6. Review staffing patterns in anticipation of increased mental health needs in the school(s) and community;
  7. Meet with representatives of mental health intervention resources to ensure that the “hand-off from the crisis phase to the long-term phase is organized, defined and efficient; and
  8. Formally acknowledge, in writing, the voluntary contributions of all personnel engaged in the crisis response effort.