Columbia SA Initial Assessment
Safety Plan
Follow-Up
100
Who should report to the social worker/counselor/admin when a student is in crisis?

EVERYONE! All faculty and staff shall immediately and confidentially report to the appropriate counselor/social worker or administrator when a student mentions wanting to end his/her life or write about suicide. They shall immediately refer reports from other students about a student’s suicide wish or any signs of serious depression. 

100

At what severity level should a safety plan be created?

Moderate and High, but you can create one at Low as an added intervention.

100

How soon should you follow-up with a student to complete side B of the Columbia?

The next school day at the first bell.

200

What are the 3 severity levels for the Columbia-Suicide Severity Rating Scale Response Protocol?

Low, Medium and  High

200

At what step of the process should the safety plan be created?

During the emergency conference.

200

True or False: Upon return, you should walk the student to their first class. 

True. The counselor/social worker shall accompany the student to his/her homeroom teacher (or other teacher as appropriate). Every effort should be made to do this with sensitivity and confidentiality. 

300
When is it safe to leave a student who has made an outcry alone?

Never. ****DO NOT LEAVE THE STUDENT ALONE is the first sentence of the referral and intervention protocol.

300

How many agency resources are listed on the suicide plan? Bonus if you can name them.

Three. 

National Suicide Prevention Lifeline

Center for Healthcare Services Crisis Line 

Crisis Line Serving Bexar County

300

True or False: Form F-31D: Release to Return to School is always required for the student to return to school.

False, although such documentation cannot be required, the principal shall inform the parent/guardian that the staff needs such information in order to continue to support the student. Also refer to (FORM F31- F Notice for Release/Consent to Request Confidential Information). 

400

If a student is at High Risk and needs immediate assessment, who should take the student?

Parents should be notified and recommended to take the student immediately. If parents/guardians are unwilling to transport student, immediately contact SAISD Police Department for support at (210) 354-9050. 

400

The last question on the safety plan is...

The one thing that is most important to me and worth living for is:

400

Staff that should receive copies of Form F31-C Student Safety Plan and Form F31-A Columbia-Suicide Severity Rating Scale (Side B) are....

School admin and the nurse. The counselor/social worker shall provide copies of these forms along with any medical documentation to the administrator and school nurse. Documentation shall be placed in the student’s health file. 
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