Youth Suicide Legislation in the 2019 Session of the North Carolina General Assembly

House Select Committee on School Safety

On February 20, 2018, the North Carolina House of Representatives created the House Select Committee on School Safety. The committee and its subcommittees met several times in Raleigh and other locations throughout the state. In its final report to the General Assembly, the committee made two recommendations related to youth suicide. The first recommendation was to conduct a study to develop a “state-wide system for mental health screening” meant to identify students who were at “risk of harming themselves or others” [1]. The second recommendation was that school safety grants for “services for students in crisis” be expanded in the 2019-20 fiscal year [1]. These two recommendations were accompanied by draft legislation that was introduced in the 2019 Session of the General Assembly as House Bill 75 and House Bill 74, respectively [1].

Legislation Introduced by the House Select Committee

As originally introduced, House Bill 75 would have required the Department of Health and Human Services and the Department of Public Instruction to undertake a study to recommend parameters for a mental health screening process for school-age children [2]. The ultimate goal of the screening process would have been to identify children at risk of harming themselves or others [2]. The study was to examine whether such a screening process should be required, and, if so, which medical professionals should conduct the screen; what behaviors or mental health diagnoses should be targeted in the screening process; the optimal age to implement the screen; and what interventions to take with children identified as being at risk as a result of the screen [2]. House Bill 75 was approved unanimously on the floor of the House of Representatives, but it stalled in the Senate [3]. The mental health screen study portion of the bill was removed by the Senate Appropriations Committee and replaced with the contents of what had been House Bill 74, a discussion of which follows [3]. It is unlikely that the mental health screen study will be taken up again in the 2020 Session of the General Assembly.

As originally introduced, House Bill 74 would have, in part, directed the Superintendent of Public Instruction, in consultation with the Department of Health and Human Services, to award $4,580,000 in grants to community partners who would provide assistance to students in crisis and $4,570,000 in grants to provide training to increase school safety [4]. Funds available under the students-in-crisis grant could be awarded to provide “evidence-based therapy services aligned with targeted training for students and their parents or guardians” [4], including dialectical behavior therapy, an intervention that is “uniquely effective in reducing suicide attempts” [5]. The funds earmarked for school safety training could be used to provide Counseling on Access to Lethal Means (CALM) training for school mental health support personnel and teachers [4]. This training was intended to help prevent youth suicide by “reducing access by students to lethal means” of suicide [4]. Safety grants could also be used to provide training for students and school employees to “improve understanding and responses to trauma and significant stress,” training for school mental health support personnel on Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems, and dialectical behavior therapy [4].

House Bill 74 eventually became law, but the path was not straightforward. The contents of the bill were eventually inserted into House Bill 75, and the grant amounts were reduced to $4,500,000 for each program. House Bill 75 became law on September 17, 2019 [6, 7].

Other Introduced Legislation

In addition to the legislation generated by the House Select Committee, the 2019 Regular Session of the General Assembly considered two other bills that addressed youth suicide. Senate Bill 601 and House Bill 434 both required public schools to implement a mental health training program and suicide risk referral protocol [8, 9]. The mental health training program would be provided to children in kindergarten through 12th grade and address youth mental health and suicide prevention, among other topics [8, 9]. The risk referral protocol would apply to sixth-through 12th-graders and would implement guidelines to identify students at risk of suicide and procedures and referral sources to ameliorate that risk [8, 9]. House Bill 434 passed the House by a vote of 105 to 1 [10]. The Senate did not hear Senate Bill 601 or House Bill 434 when it crossed over to the Senate [10, 11]. On July 7, 2019, the contents of House Bill 434 were inserted into Senate Bill 476 [12]. It is possible this bill will be considered when the General Assembly reconvenes in 2020.