September 29, 2020
2019-125
The Governor of California
President pro Tempore of the Senate
Speaker of the Assembly
State Capitol
Sacramento, California 95814
Dear Governor and Legislative Leaders:
As directed by the Joint Legislative Audit Committee, my office conducted an audit of suicide prevention efforts at a selection of school districts and charter schools, and we examined the role of state agencies in youth suicide prevention. The following report details the audit's findings and conclusions. From 2009 through 2018, the annual number of suicides of youth ages 12 through 19 increased 15 percent and incidents of self-harm increased 50 percent. Because students spend a significant amount of time in school, school personnel are well positioned to recognize the warning signs of suicide risk and to make appropriate referrals for help. To ensure that schools take the actions necessary to prevent youth suicides, we determined that they can more effectively assist students if they do the following:
- Implement appropriate suicide prevention policies.
- Train their faculty and staff to recognize and respond to youth who are at risk of suicide or self-harm.
- Employ an adequate number of professionals, such as school counselors, who can provide mental health services.
In addition to establishing requirements for suicide prevention training, the Legislature passed a law in 2016 requiring local educational agencies (LEAs) to include certain information in suicide prevention policies. However, the six LEAs we reviewed—three school districts and three charter schools—failed to adopt policies and provide training that meet those requirements. When policies and trainings do not meet statutory requirements, teachers and staff may not have the knowledge or confidence necessary to respond appropriately to students who are at risk. Further, the California Department of Education (Education) has recommended staffing ratios for the number of school counselors, school nurses, school social workers, and school psychologists, whom we refer to as mental health professionals, that LEAs should employ. However, of the 1,034 LEAs that submitted personnel information to Education for the 2018–19 academic year, none employed the number of mental health professionals that Education recommends. In the absence of adequate mental health professional staffing, the State’s rates of youth suicide and self-harm have continued to climb.
One best practice for increasing students’ access to mental health professionals is the establishment of school‑based health centers. In 2007 the Legislature required the California Department of Public Health (Public Health) to establish a program to support the development of school-based health centers. However, as of July 2020, Public Health had not established the support program or requested funding to do so. A robust support program could assist LEAs in creating additional school-based health centers and enable them to better leverage available funding to improve student access to mental health services.
Respectfully submitted,
ELAINE M. HOWLE, CPA
California State Auditor