“If college had listened to me, it could have prevented my mental health from getting worse. A few months after I took the overdose, I was taking minor overdoses every single night for weeks. It was just normal to me at that point.”

Annie* is 18 years old. Last summer, she attempted suicide. A week later, she was back at college.

“The support was terrible when I got back from hospital. My head of year asked me what work I had coming up. I told him I had a deadline for English coursework in a week’s time. They kept that deadline in place, even though I was still ill,” says Annie.

“Because I’d done stuff in the past that was shocking, they didn’t see it as much of a concern. I think they were just like, ‘OK, this is like her taking an overdose again, but she got into hospital for it this time’. They almost normalised bad mental health.”

Annie’s troubling experience is one that is becoming more commonplace. According to the Samaritans, the suicide rate for female under-25s increased by 93.8 per cent between 2012 and 2019. And across both genders, suicide is the biggest killer of young people: in 2018, 759 young people took their own lives in the UK and Republic of Ireland.

Suicide is a complicated and sensitive issue that many people feel ill equipped to talk about. However, colleges can - and should - play a key role in preventing suicide among young people, says Jo Smith, emeritus professor of early intervention and psychosis at the University of Worcester. She says that it’s not enough to have mental health provision in place - there must be specific support on suicide, too.

“It is a bit like playing rounders and having a backstop,” she explains. “Sometimes colleges are great on mental health, and that’s like having the players on the field and keeping people running, but you also need a backstop because the moment the ball goes behind, it can go a long way and the whole play stops.”

Loss of coping mechanisms

So, what exactly is causing the rise in suicides among young people and what can colleges do?

According to The Interpersonal Theory of Suicide (Joiner, 2005; Van Orden et al, 2010), suicidal ideation emerges when people simultaneously experience thwarted belongingness (feelings of alienation), perceived burdensomeness (the belief that you are a burden to family, friends and society) and feelings of hopelessness - but in reality, the matter can be a lot more complicated. Smith says that while there is no single factor causing the rise in suicide rates, research suggests that perfectionism, feelings of failure and exposure to social media can all contribute.

It’s a complex picture - one that hasn’t been helped by the pandemic and subsequent lockdown. Liz Scowcroft, head of research at the Samaritans, says that while official data on mental health during lockdown hasn’t yet emerged, it’s obvious that young people are feeling incredibly anxious.

“We’ve definitely seen that young people are affected by what’s going on,” she says. “They are experiencing a loss of their usual coping mechanisms that usually centre around their friendship groups. They feel less able to cope than before the pandemic and they’re feeling a lot of frustration. Everybody feels that in lockdown, but it’s felt particularly acutely by young people.

“And there’s this sense of uncertainty about what their future holds at such a crucial time in their lives. It’s causing a lot of anxiety among young people. It’s really important that we recognise all of those concerns and feelings that they have and make sure that we support them, particularly since we know there were rises in suicide and self-harm for this group in the years prior to the pandemic.”

So, there are certainly some factors here that colleges can consider when they think about the support they offer.

For instance, at the Activate Learning college group, the focus is on helping learners to feel connected and understood as a way to combat any feelings of isolation.

“Isolation doesn’t necessarily come from them being on their own; it’s that feeling that nobody will understand and that nobody else can ever feel as bad as they do,” explains Leanne Hicks, group head of student support for Activate. “It’s all about showing them that we do understand, and we are there for them.

“If a student discloses they have feelings of suicide, they are not left alone for one moment. Our support services and my team are alerted, and we will then establish the level of risk. It can be a simple ‘1 to 10’: 1 is you feel OK; 10 is, if you were left alone, you’d do it.”

Based on the level of risk, Hicks will then determine what support the student needs, whether that means a call to the emergency services or working with the college’s nurses and counsellors.

According to Emma Fairhurst, a manager at HopelineUK (a helpline operated by suicide prevention charity Papyrus), it is important to ask students as directly as you can about their current state of mind. Often people are scared of the answer and don’t ask the question, she says, and this needs to change.

“We really encourage anyone to ask about thoughts of suicide clearly and directly,” she says. “Use the term ‘suicide’ or ask, ‘Are you thinking of killing yourself?’ Be that direct. If they say they are thinking of harming themselves, that could be a bit ambiguous. Being clear and direct is crucial so that we can know how best to support them.”

Smith echoes this view. She believes that all college staff should be made aware of the need to talk openly about suicide. “There’s something about looking at who students have conversations with - for example, catering staff - and thinking about how they get involved,” she says. “If it’s a casual conversation, make sure they’ve got the tools, know helpful things to say and know who to alert. It needs to be in your infrastructure.”

For that to happen, colleges will need to provide training. At Activate, Hicks has already done a lot of work with staff to enable them to have those difficult conversations. But more could be done to alert fellow students, too, she points out.

“Sometimes it’s not the staff who might be the first person to hear that [someone is feeling suicidal] - students go to their peers, and we have to give them the confidence to say ‘let’s go get some help’.”

Partnering with local services

Giving both staff and students the confidence to talk about suicide is important, then, but that doesn’t mean colleges should view this as an issue that needs to be solely tackled internally, says Smith. It’s also crucial to foster strong partnerships with local services; this is something that colleges don’t always get right.

“Many institutions act as islands rather than seeing themselves within the context of a broader community,” she says. “In terms of suicide prevention, local authority and public health have the lead on that and there’s value in connecting with them to pick up resources, funding, opportunities and partnerships.”

This is something that the wellbeing team at East Coast College in Great Yarmouth have found to be very useful: they have fostered a close relationship with the local council.

We’ve worked really closely with Great Yarmouth Borough Council to ensure that we’ve got an idea of what the locality triggers might be,” explains Nikki Lane, assistant principal for student wellbeing at the college. “For example, if we know that there’s a high number of Universal Credit applications sitting and waiting, we know there might be a pinch point financially for people. If there’s a rise in homelessness, we might be looking at families that have been displaced in the local area.”

When these situations occur, Lane and her team can then ensure that these topics are covered during tutorial times with repeated messaging to signpost where and how students can speak to someone.

Safety in the moment

Having these general signposts in place is a useful preventative measure. But what should colleges do about individual students who they already know pose a risk to themselves?

In these cases, Fairhurst suggests developing a “safety plan” with the student. To do this, someone needs to first ask the young person about how and when they plan to complete suicide. It may seem that this is the last thing you would want to ask - and the last thing that a student would want to talk about - but if the topic is broached by a trusted member of staff, students will usually be willing to open up, Fairhurst says. And if they don’t, then colleges should call on external support.

“It can be quite difficult when a student does not want to engage with their teacher or make a safety plan - it’s important that a student is comfortable with whoever they are making a safety plan with,” she says. “It may be that they have sources of support externally to their college. Also, there is HopelineUK - they can always call us and work with an adviser to do this plan. If possible, they could call us while in college.”

Once colleges have established how a young person intends to complete suicide, barriers should then be put in place that make that plan harder to carry out - for example, deactivating their student card so they can’t leave the building in a hurry, or planning with them a route around the college so that a certain toilet in which self-harm has occurred before is avoided. Fairhurst says it’s all about keeping that young person safe in the moment. She recommends that, at the very least, colleges should be aware of any safety plans a student might already have.

At East Coast College, the safeguarding team already does this by filling out risk assessments directly with students.

“The students aren’t necessarily aware of it, but as we’re talking to them about that safety plan, we’re just getting an idea of how they think,” Lane says. “With one student, we knew how she wanted to complete suicide and we were able to let the police know where they should look.”

Having plans like these in place will form the backbone of support that colleges are able to offer. Yet, for those plans to be successful in the first place, all college staff must learn to take young people who are struggling seriously, urges Annie.

While mental health services and counselling need to be more accessible, the real key to improving support is for all staff members to be understanding and flexible because, ultimately, a basic level of compassion will go a long way.

“If someone has ended up in hospital from a suicide attempt, or has taken an overdose or self-harmed badly, don’t dismiss them - just give them genuine understanding,” she says. “Open up the question to them and ask: what can we do to support you and help you to stay in college?”

Kate Parker is an FE reporter at Tes

*This name has been changed

This article originally appeared in the 30 October 2020 issue under the headline “‘When I got back from hospital, they kept my deadline in place’”