State Auditor Releases Report on Youth Suicide Prevention Efforts

This week, California State Auditor Elaine Howle released an audit report on youth suicide prevention efforts at a selection of school districts and chart schools, as well as the role of state agencies in youth suicide prevention. As indicated by the state auditor, from 2009 through 2018, the annual number of youth suicides (ages 12-19) increased 15 percent and incidents of self-harm increased 50 percent. The report describes how school personnel are well-positioned to recognize warning signs of suicide and self-harm risks and make appropriate referrals for assistance.

The auditor recommends local education agencies implement appropriate suicide prevention policies, train faculty and staff to recognize and respond to youth who are at risk of suicide or self-harm, and employ an adequate number of professionals, such as school counselors, who can provide mental health services. The auditor determined the schools reviewed in the report failed to adopt policies and provide training that meet requirements of state statute relative to suicide prevention activities. Further, it was determined that none of the 1,034 local education agencies that submitted personnel information to the California Department of Education (CDE) did not employ an adequate number of mental health professionals in schools, failing to meet CDE staffing ratio recommendations.

The report additionally reviews the availability of school-based health centers throughout the state, determining only four percent of California’s kindergarten through 12th grade students attended a school with a school health center. The auditor concludes the state has done little to foster broader implementation of school health centers which could improve access to youth mental health services.

Further, the auditor discusses a 2007 statutory requirement for the California Department of Public Health (CDPH) to establish a program to support the development of school health centers. As of July 2020, however, CDPH had not established the support program, determining that the $1.2 million across two fiscal years (FY 2016-17 and 2017-18) provided to CDPH by the Legislature was insufficient to establish a full program. The auditor determined CDPH has not requested additional funding for the program and that a robust support program could assist local education agencies in creating school health centers and enabling them to better leverage available funding to improve student access to mental health services. In responding to the auditor’s findings, CDPH indicated the department will evaluate resources necessary to establish and implement the support program as required by statute.

The Department of Health Care Services (DHCS) is recommended to work with the California Department of Education to inform local education agencies of their ability to partner with county offices of education to centralize administrative responsibilities necessary to obtain reimbursement through the billing option program for certain mental health services provided by schools. DHCS indicated their intent to implement the auditor’s recommendations.

The full state auditor report is available here.