TEACHERS FACING THE SUICIDAL BEHAVIOR AMONG ADOLESCENT STUDENTS: PERCEPTIONS AND INTERVENTIONS

ABSTRACT

This research sought to analyze the interventions of integrated high school teachers when they perceived suicidal behavior in students. Therefore, a field research was developed, with a qualitative approach and applied nature, with 12 permanent professors from a federal educational institution. Data were collected using an electronic form (Google Forms) and analyzed through content analysis. The findings revealed that teachers have a superficial view of suicide and difficulties in managing their students’ suicidal behavior; when they do so, they are based on personal values and experiences; hesitation and insecurity mark the conduct of professors. The study highlights the need for the school to become a space for dialogue and teacher training on suicidal behavior.

Keywords:
high school teachers; suicide prevention; students

RESUMO

Esta pesquisa buscou analisar intervenções de professores do Ensino Médio integrado ao perceberem o comportamento suicida em alunos. Para tanto, desenvolveu-se uma pesquisa de campo, de abordagem qualitativa e natureza aplicada com 12 professores efetivos de uma instituição federal de ensino. Os dados foram coletados por formulário eletrônico (Google Forms) e analisados por meio da análise de conteúdo. Os achados revelaram que os docentes têm uma visão superficial acerca do suicídio e dificuldades em manejar o comportamento suicida de seus alunos e, quando o fazem, tomam como base valores e experiências pessoais; hesitação e insegurança marcam as condutas dos docentes. O estudo realça a necessidade de a escola se tornar um espaço de diálogo e formação docente acerca do comportamento suicida.

Palavras-chave:
professores de ensino médio; prevenção do suicídio; estudantes

RESUMEN

En esta investigación se buscó analizar intervenciones de profesores de la enseñanza secundaria integrada al percibir el comportamiento suicida en alumnus. Para tanto, se desarrolló una investigación de cmapo, de abordaje cualitativa y naturaleza aplicada con 12 profesores efectivos de una institución federal de enseñanza. Los datos se recompilaron por formulario electrónico (Google Forms) y analizados através del análisis de contenido. Los hallazgos apuntaron que los docents tienen una visión superficial acerca del suicidio y dificultades en manejar el comportamiento suicida de sus almnos; cuando lo hacen, toman como base valores y experiencias personales; hesitación e inseguridad marcan las condutas de los docents. El studio pone de relieve la necesidad de la escuela volverse espacio de diálogo y formación docente acerca del comportamiento suicida.

Palabras clave:
profesores de enseñanza secundaria; prevención do suicidio; estudiantes

INTRODUCTION

Suicide constitutes a complex and multi-faceted phenomenon. It requires a more comprehensive look that is based on different points of view, such as: the biological, the social, the individual, and the psychological point of view. It is a public health problem and, according to The Atlas of Violence (Institute of Applied Research in Economics, 2018), from 2012 to 2016, the total number of suicides in Brazil rose 10,8%. The study by Cicogna, Hillesheim and Hallal (2019) argues that, between 2000 and 2015, 11.947 deaths by suicide took place among individuals from 10 to 19 years of age. Most of the suicides (85,32%) committed by individuals in the studied ages involved adolescents from 15 to 19 years of age.

According to the Brazilian Psychiatry Association (ABP) (ABP, 2014, p. 9), suicide can be conceived as a “[...] deliberate act that is executed by individuals themselves with the intention to cause themselves death in an intentional, conscious way, by means of an action that is believed to be lethal.” This act is configured as constitutive of suicidal behavior, which involves ideation, planning, attempts, and the accomplished act.

It is important to emphasize that the suicidal behavior also comprehends more specific demeanors involving self-destruction and self-injury, sometimes without lethal intention, though equally susceptible to intervention due to the risks it poses to victims. Such behaviors are more characteristic of the adolescent population. According to the studies by Garreto and Zetterqvist (in accordance with Fonseca, Silva, Araújo, & Botti, 2018), when comparing different age groups, adolescents present a higher prevalence than adults. In this context, it is worth it to recognize the fact that a considerable part of the Brazilian population is made up of young people who, therefore, need attention.

According to the last census by the Brazilian Institute of Geography and Statistics (IBGE) (IBGE, 2010), the young population (from 15 to 29 years of age) is approximately 51 million people. A significant part of this universe is made up of adolescents from 15 to 18 years of age, and they must be fully enrolled at school.

School basically aims at sharing socially valid, scientific knowledge. In order to do so, it offers basic education, which is nationally divided into three levels: Child Education, Elementary School, and High School, which is the level at which most of the teenagers are enrolled.

After Constitutional Amendment no. 59/2009, mandatory basic education extends to the age of 17 years. The referred amendment establishes the mandatory status of this level of education and, consequently, a guarantee that these adolescents will in fact be attending High School.

In this context, considering the high rates of suicide among adolescents and the legal mandatory permanence of these kids at school, it is possible to understand that many young people at high school might develop suicidal behaviors. Most suicide cases, according to the literature (Botega, 2015; Karaim, 2018; Teixeira, 2001), do not happen without previous warnings or signs, and many of these messages are shared via socialization spaces such as school. Besides that, the school space is the one that most often aggregates people of reference (friends, teachers, advisors) for these adolescents. Such people of reference can provide suitable support to solve the conflicts these young people are going through.

School needs to pay attention to social demands as well as to the demands of its students, while establishing itself as an ally in the identification of risky behaviors, as well as in the prevention of these risks in order to decrease the alarming rates of suicide among young people. The Intersectoral Guide for the prevention of suicidal behavior among children and adolescents (2019) advocates the insertion of vigilance, of the promotion of life and of the prevention of suicide in the political pedagogical project of school, with a focus on the protagonism of educational spaces in the lives of adolescents. The referred guide points out that school, “[...] must be a space that awakes the desire for life among students” (p. 20).

In the school environment, discussions on the strategic role played by teachers in the identification and intervention for these behaviors are fundamental because the close contact between educational professionals and students benefits these actions. Thus, researchers proposed the development of this study, whose research problem consists of the following question: What are the interventions by high school teachers and vocational course instructors after recognizing suicidal behaviors among adolescents?

With the intention to respond to the proposed problem, researchers establish the following general objective: assessing interventions by high school teachers and vocational course instructors after recognizing suicidal behaviors among students. As specific objectives, researchers intended to describe the perceptions by teachers concerning suicidal behaviors among adolescents, to characterize the actions of teachers as a response to suicidal behaviors among adolescents, to identify the feelings of teachers who participate in the study concerning suicidal behaviors among adolescent students, and to specify formative processes with an emphasis on the management of suicidal behavior that students have experienced.

It is understood that, due to their proximity to students, teachers are able to observe abrupt changes in habits and behaviors, poor performance, situations where students lose interest in activities they used to enjoy, lack of hope concerning the future, and other warning signs emitted by adolescents who are displaying self-destructive demeanors (Botega, 2015).

In order to do so, it is essential that teachers feel prepared to act on such contingencies and to understand their strategic role in the identification and, especially, in the solutions for these situations. A possible route in this preparation is a continued formation that provides solutions for the instrumentalization of teachers for the identification of signs and for action with students who are suffering and displaying suicidal behaviors. Therefore, the present study justifies itself by promoting a dialogue on suicide and its resonance in the school context.

METHOD

The study connects itself to a qualitative approach because it considers the dynamic relationship between the real world and individuals. The study intended to produce knowledge for later practical application with the planning of teacher formation aligned with the research results, so its nature can be regarded as applied. Such idea justifies the fact that the research was descriptive because the researcher aims at describing facts, without any interference, while merely searching for observations that foment the production of knowledge (Prodanov, 2013).

Thus, the study’s technical procedure is the field research and, after being submitted to the Committee of Ethics and Research (CEP), received approval decision no. 18607319.5.0000.5211 before getting started. It was structured by means of recruiting stages by e-mail and answers provided though Google Forms. The research was realized at a school institution, of federal level, which assists schools of basic, technical, and technological level. The institution is located in a central district of Teresina, capital cityh of Piauí.

The participants of the study were 12 (twelve) teachers in high school in collaboration with vocational course instructors for all areas of knowledge (identified by letter P followed by a number from 1 to 12). Data were organized and assessed in accordance with the content analysis technique.

RESULTS AND DISCUSSION

In this section, data produced during the study, as well as their analysis by means of realized literature review and under the criteria of content analysis.

Preliminary conceptions by teachers on suicidal behaviors

Understanding a phenomenon as complex as the suicidal behavior demands specific knowledge on characteristics, data, risk factors and the impact of the problem on public health. Thus, it is important to pay attention to the fact that this is an issue that is underestimated and that, quite often, it does not receive at school the attention it deserves from the actors that operate in the school context. In this context, the statements by the teachers participating in the research demonstrate their previous knowledge on the problem and reveal important evidence of how the suicidal behavior can be regarded by teachers. In order to describe a student with this behavior, P3 affirms:

Someone who visits creepy websites, with self-destructive stuff [...] I know people who did drugs and killed themselves, but then I also met people who did not display any signs of suicidal personalities and at a certain time took their own lives. There must be a lot of reasons that lead people into suicide and specialists have already managed to draw a profile of the suicidal personality. (P3)

P3 mentions the visits to specific websites and the association between drug abuse and suicidal acts as elements to be identified in the suicidal behavior, but it also indicates an anachronistic idea regarding the problem by labeling individuals as “suicidal” or drawing a “suicidal profile”.

Literature (Karaim, 2018; Moreira & Bastos, 2015; Zappe & Dell’aglio, 2016) demonstrates that the suicidal behavior does not limit itself to one type of individual or only to individual characteristics. There is a profusion of factors that might make any person vulnerable. Fonseca, Silva, Araújo and Botti (2018) outline people’s interpersonal and social dimensions as important evidence of suicidal behavior. Braga and Dell’Aglio (2013, p. 5) list diverse risk factors and warn us that it is important to remember that “these aspects, by themselves, are not predictors of suicide, but their indirect consequences might increase the vulnerability of these individuals.” Thus, it is possible to understand that suicidal behaviors are not defined by a priori individual characteristics, and they also do not sediment on individuals to the point of turning them into “suicide victims”. They are states, and vulnerabilities that, when duly managed, can be drastically reduced.

The following ideas lead to a better understanding of what teachers make of suicidal behaviors:

Any attitude that might come up against a person’s own life (P4).

Thoughts and attitudes that might cause any type of self-injury (P8).

Behavior that might lead people to cause themselves [physical] harm. (P10)

The statements by P4, P8, and P10 hint at the conception that the suicidal behavior manifests itself by means of acts of self-inflicted violence, although teachers pay little attention to the fact that these acts do not necessarily precede suicide attempts and the same acts might take place without the suicidal intention. It is important to take into consideration, in these cases, the intentionality of the self-injury behavior. The study by Fonseca et al. (2018) explains that most of the self-injuries by the adolescents participating in their research serve the purpose of mitigating feelings of emptiness and indifference or bringing bad feelings to a halt, which therefore does not imply the conscious intention to cause death. Santos and Faro (2018) argue that self-injury constitutes a set of behaviors that lead to intentional injury against an individual and highlight, beyond the physical harm that P10 identifies, the psychological damage. In other words, it is necessary to understand the meaning of self-injuries for the adolescents who practice them, because this is a subjective meaning. Self-injury as a manifestation of the suicidal behaviors might, also, have death is the intention. This is the thing that sets apart the intention of the self-injury demeanor, although it is worth it to highlight the fact that all these behaviors deserve attention.

Teachers P9 and P11 affirm regarding suicidal behavior:

In my opinion, suicidal behavior is the one which is stimulated throughout individuals’ life experiences, as the only way to face the frustrations of life. (P9)

Combination of actions and thoughts that demonstrate discomfort regarding one’s own life and convey the intention to “give it all up”. Death thoughts, loss of meaning for life and of the will to live, lack of contentment in the experiences and relationships of everyday life, self-mutilation, and so on. (P11)

It is possible to notice that teachers P9 and P11 are equipped with a more complete vision of the suicidal behavior, and understand the phenomenon as something built upon the singular life experiences of every individual and it does not depend on isolated factors. Rather, it depends on an important context to be taken into consideration.

According to the World Health Organization (WHO) (2000), suicidal thoughts might appear, sometimes, during childhood’s development process into adolescence because that is when individuals have to deal with existential problems and formal thought is being configured. On the other hand, thoughts turn singularly worrisome when adolescents consider them to be the only solution to their problems. Kovácks (2012) points out that the death theme for adolescents takes on a role connected to distance and banalization: or it is something that might never happen to them because they are at the summit of their youth, or something quite commonplace. In order to approach these two positions, the author highlights school as a privileged space for dialogue with teenagers on the theme and its stigmas.

Thus, the preliminary conceptions of teachers lead us to an understanding that although teachers are able to recognize some of the problem’s dimensions, they still have stereotypical views regarding the suicidal behavior. Teachers point out at ideas that are connected to the common sense but prove distortions of what is being discussed in the literature such as outlining a suicidal profile that is too focus on individual cases. The analysis of data, therefore, conveys the need to work on the theme in a more formative, educational way that is consistent with the realities of teachers in the school environment.

Perceptions of teachers regarding adolescents with suicidal behaviors

The suicidal behavior might be divided into three categories: suicidal ideation (thoughts, ideas, planning, and the kill to commit suicide), suicide attempt, and committed suicide. Concerning the way they see adolescents with suicidal behaviors, teachers affirm:

I believe depressed people have a potential to commit suicide. (P3)

They are manifestations that generally precede an illness such as depression. (P4)

I imagine that when someone is deeply sad, they kind of lose the will to live (P6).

They are usually gloomy, very quiet, and interact little with the other students. (P12)

The teachers’ answers convey a more approximate vision but that is still too simple to comprehend the phenomenon, as though it were articulated with only one mental disorder and as though it manifested itself as solely as sadness and depressive moods. The answer by P6, by highlighting deep sadness and the loss of the will to live, also points at depression.

In the survey into the risk factors for suicidal behavior, mental disorders such as depression appear as an element among so many others, such as psychosocial, socio-demographic, and individual ones (Botega, 2015; Braga & Dell’aglio, 2013; Santos & Faro, 2018). There is a connection between the presence of mental disorder and the development of suicidal behaviors, but that cannot be seen as the only factor. In addition, it is important to understand that depression in adolescents cannot manifest itself by means of diverse behaviors and not only evident sadness and isolation. Baggio, Palazzo and Aerts (2009, p. 148) argue that depression can go unnoticed by family members and teachers because, in adolescence, “[...] this disorder quite often manifests itself by means of somatic complaints, sexual malfunctions, poor academic performance, and behavior problems, instead of depressive moods”.

When asked whether they had ever encountered students who manifested any of the types of suicidal behavior, their answers demonstrated that five of the teachers had already been in contact with students who presented some level of suicidal behavior. Moreira and Bastos (2015) point at the fact that the number of suicides among adolescents from 15 to 18 years of age rose 15.3%, which can explain the significant number of teachers who had already had any type of contact with students who manifested suicidal behaviors. On the other hand, it is important to highlight the fact that this number can be still larger because some teachers might have been in contact but failed to notice the behavior in some of their students. The following statements corroborate the idea:

If there was any case in any of my classes, I never knew or never noticed. (P3)

It is not easy to notice something like that in such little classroom time, but

I understand that a sudden change in behavior and acts of extreme

withdrawal can be considered suspicious behavior. (P7)

The teachers report that they had not identified any case of suicidal behavior among their students, whether due to the busy routine of teaching activities, or to the deficit of evidence and information on the theme in the referential framework of teachers. The analyses indicate that the perceptions of the teachers concerning adolescents with suicidal behaviors go through significant interferences by superficial conceptions and limited knowledge of the participants on the problem, which configures a fragile, vulnerable conception of the problem.

Interventions by teachers regarding the identification of suicidal behavior in students

Based on the idea that perception leads to action (Botega, 2015), researchers analyze the actions adopted by teachers when they noticed the suicidal behavior in their students. Such actions can make a difference in the prevention of suicide at school because teachers “take on a large amount of responsibility” (Teixeira, 2001, p. 6) in order to help adolescents at risk and be real agents in the prevention of suicide.

Thus, teachers describe their interventions:

Caution in the way they treat students. (P1)

I have always tried to observe what was going on or refer students to the

psychology service of the campus and any other professional that could

provide assistance. (P4)

I tried to approach the student to try to help somehow, whether with words

or with actions. (P6)

In view of the answers, it is possible to come to the conclusion that teachers are not in accordance when it comes to managing such situations, and each one acts according to their own instincts. Kovács (2012) reveals that the teachers feel discomfort or embarrassment when they have to deal with the death theme with their students. Due to the difficulty to deal with the theme and the feelings it brings out, teachers choose to not start the conversation. It is possible that this is the reason why participants reported shy interventions with their students as caution or careful observation, which denotes the superficiality of such conduct.

One positive aspect to be highlighted is the referral to the psychology service mentioned by P4, which demonstrates that the teacher, by noticing suicidal behaviors, provides students with guidance to search for a service in order to activate the multi-disciplinarian look over students and the phenomenon. Besides that, this referral emphasizes the importance of teachers as agents for the prevention of suicide.

Kovács (2012, p. 75) identifies some difficulties to deal with the death theme such as: “[...] resistance, lack of preparation, need for curricular reform to avoid work overload, establish partnerships with the academic world and personal limits”, which hints at a more ample discussion regarding continued formation and the need for teachers to share experiences, questions, and worries. In addition, it is important to pay attention to the impotence and incompetence that situations like these create in teachers. When they do not know how to act, they might feel unable to help students and society loses an important agent in the prevention of suicide. Teixeira (2001, p. 6) argues that education and health professionals need to deal with suicide as something real so that they will not fall into the “[...] complicity of silence that leads to the negation and minimization of the problem.”.

Thus, it is possible to identify that the interventions by teachers in view of the suicidal behavior of their students do not configure effective actions in the prevention of suicide, since they are concrete attitudes of support in order to mitigate the suffering of students or to strengthen protective factors such as family, personality traits, social relations, and cultural factors. The teachers act in a punctual, disarticulate way that is based on personal values and experiences, which contributes to schools not becoming spaces for dialogue, information, and the prevention of suicide.

Formation of teachers with a focus on the management of suicidal behavior in students: a troublesome blank

The review of literature interlaced in the fabric of this study hinted that the formation of teachers with a focus on the management of suicidal behavior in students is scarce, and it configures as an area that deserves investment by research and formation institutions.

Imbernón (2010) reminds us that historically formative processes aimed at standardized solutions for generic, uniform problems and points out that in this model, instructors choose activities that they suppose will help teachers reach the results they expect. In a contemporaneous perspective, formation needs to approach problem situations that come up in the context itself. Teixeira (2001, p. 2) emphasizes the need for teachers to get ready to deal with the demands created by the occurrence of suicidal behaviors in adolescents and argues that:

The ones that are part of the universe of the adolescents, are inevitably in a key position to the extent that, being so close, teachers can play a fundamental role in the students’ lives by means of prevention actions the success of which will depend not only on their ability to recognize warning signs, but also on their ability to provide a suitable response to the vulnerability of students at this phase where their convictions get shaken and their references get weak.

The route to do that lies on a formation that is articulate with the context, where the teachers feel capable of identifying risky situations, of opening spaces for conversation, and of not becoming an obstacle to free expression by their students.

Concerning formation against suicide, nine of the participating teachers report that they have never gone through any kind of formation with an emphasis on suicidal behavior by adolescents, which is in accordance with the blank in literature regarding such formations and hints at the need to develop formations that will prepare teachers to deal with these themes. Teixeira (2001) defines schools as a space for the promotion of health, from the formation of critical, autonomous citizens to the recognition of the institution as a space for conversation and the promotion of conciliating environments that promote mutual respect.

It is worth it to reflect on the structure of the formation of the three ones who answered ‘yes’ to the question whether they had already participated in these moments:

I only attended a few lectures, not many. (P3)

Some events organized by campus professionals. (P6)

Only lectures on the theme (P12)

The statements by the teachers hint at punctual actions that did not constitute spaces for conversation and sharing of personal experiences. Formation, in order to be effective and cause transformations in the teaching practice, needs to be in alignment with the real demands of teachers, which belong to the context of the teaching practice. When made effective in a theoretical way, ignoring the practical-theoretical dimension, might not consist of praxis, that is, on practice that leads to transformation.

In this direction, the formation of teachers must provide the development of reflexive thought that leads to changes in the teaching practice. The formation of teachers in with an emphasis on the management of suicidal behavior needs to inform, provide specific knowledge and instruments for teachers to act on this contingence, as it is a reality that keeps getting more and more prevalent at school. The answer by P3 points at the need for teachers to get to know more about the theme and signalize at its formative perspectives:

I think it is very important that we discuss the theme because we deal with adolescents, young adults and adults in order to amplify our understanding by means of studies on this theme [...] I would like to take part in some sort of formation on the theme. (P3)

The participants point at the need for schools to become a formative space to open up dialogues on the theme. They can be important partners in the prevention of suicidal behavior. Another relevant data is that six of the respondents manifested interest in participating in a continued formation at the institution that contemplates the focused theme. Three teachers mentioned that they would probably participate and three other teachers argued that they would not do it. This last group, it is important to remember, might demonstrate what Kovács (2012) emphasizes in his study: many teachers, although they believe that students need spaces to work on problem themes, subscribe to the notion that it is not their problem and the whole matter should be handled by specialists. The prevention of suicide, however, must be understood as a social commitment, including teachers.

The guide by the Centro de Valorização à Vida, or Center for the Appreciation of Life (CVV, 2019) for parents and educators brings a series of important guidelines that might be the basis of teacher formation when it comes to the suicide theme. Among such guidelines, understanding schools and teachers as responsible for the promotion of mental health and the prevention of suicide, cease to treat the theme as taboo, or banality, or irony, discuss the glamourization of suicide (which might take place after the death of a famous person), and promote a healthy environment and good relationships in the classrooms, can be valuable strategies in the prevention of suicide. All this, however, hints at formative actions that manage to stimulate relevant teacher practices.

There is still another aspect to be considered regarding teachers that do not make themselves available for formation with an emphasis on the management of suicidal behavior: the taboo theme. Suicide is a difficult topic due to the Werther effect and its concept that the occurrence of a suicide, when emphasized, might lead other attempts and other suicide cases. Nevertheless, it is important to highlight the fact that suitable dialogue on the theme, followed by pertinent guidelines, and advertising of the support network (institutions that act on the prevention of suicide) can make a huge difference when it comes to minimize the taboo status of the theme, and to prevent new cases.

Formation might also promote discussions according to which we need to develop students and, in addition, full-fledged citizens. Thus, it is up to teachers to recognize their important role in providing support for the emotions of students and in the prevention of suicide behavior among adolescents at school.

FINAL CONSIDERATIONS

The discoveries of the research hint at the reality of the teachers of the surveyed institution are in accordance with the data found in the literature, no matter the significant rate of suicidal behavior at school, the teachers’ difficulty to handle the theme, due to personal issues as well as to the absence of formation on the theme.

When it comes to the perceptions of teachers concerning the suicidal behavior by adolescents displaying suicidal behavior, it was verified that the participants in the study make an important association between depression and the suicidal behavior, which denotes the need for amplifying the understanding by teachers on other risk factors and the need to work, with urgency, and demystifying the phenomenon while promoting spaces for debate and continued formation.

Concerning the actions by teachers regarding the suicidal behavior among students, it was possible to observe their difficulty to manage such behavior. The teachers did not point at effective actions. Rather, their actions were based on their own personal conceptions and beliefs, which are not always the best procedures, and denotes the need for formation that harmonizes actions and provides tools for teachers to become relevant actors in the identification and prevention of suicidal behavior. It is possible to understand, by means of the teachers answers, feeling of insecurity, hesitation, and uncertainty regarding students with suicidal behavior because, in fact, they did not learn how to deal with the matter.

In view of the number of respondents who did not go through any formation with emphasis on the management of suicidal behavior and the ones who had access to punctual lectures, formation proves a necessary route, although unexplored, towards the preparation of teachers when it comes to their actions for the prevention of suicide.

It is possible to conclude that many of these behaviors are not even noticed by teachers and the ones who do notice adopt poor interventions that do not configure the foundation for the real prevention of suicidal behavior at school. It is important to highlight the fact that the study does not end here. Rather, it reveals the urgent need to develop new studies on the approach to suicide at school, in order to promote formation practices in order to generate fully developed individuals, who are the product of wholesome, effectively human formation.

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• 3
  This paper was translated from Portuguese by Régis Lima.

Publication Dates

• Publication in this collection
  06 Oct 2023
• Date of issue
  2023

History

• Received
  04 Aug 2020
• Accepted
  04 Mar 2021