Indiana Connect to Care in Schools Study Research Report

This research project would not have been possible without the support of many individuals and organizations. We are particularly grateful to the school districts at the heart of this study who allowed us the opportunity to learn from their school staff’s experiences so that together, we can identify strategies to improve suicide prevention in schools while also helping make school staff’s work lives better.

We are also deeply grateful to Prof. Bernice Pescosolido. Her tireless advocacy for stronger suicide prevention science for Indiana and beyond and her vision for the Indiana Innovation Think Tank on Suicide made this research study possible. Funding for this study has been provided in part by the Indiana Family and Social Services Administration’s Division of Mental Health and Addiction, the Irsay Institute and the Luther Dana Waterman Professorship of Dr. Mueller.

Similarly, the Irsay Institute provided the intellectual home and resources necessary to complete this project, and the Indiana University Center for Survey Research (IU CSR) provided critical survey design guidance and programming. Specifically, the C2C research team is deeply grateful to Leticia Gonzalez for the (beautiful) graphic design support and Maksymilian Szostalo for the excellent website from the Irsay Institute, and Lilian Yahng from the IU CSR for her thoughtful survey guidance. 

The content is solely the responsibility of the authors and does not necessarily represent the views of any of our funders.

This report presents the findings from the Connect to Care in Schools School Staff Survey (C2C Study), which was administered in the spring of 2025 in Indiana. The purpose of the staff survey was to assess strengths and vulnerabilities in school staff’s approaches to supporting student mental health and preventing student suicides. 

All public-school districts across the state of Indiana were invited to participate in this study in January of 2025. Invitations were sent directly by the research team and through state partners, including the Indiana Department of Education’s weekly publication for school leaders and stakeholders. After the survey was reviewed and approved, 11 districts opted to participate. Participating school districts were a representative mix of smaller rural and larger suburban school systems from across northern, central, and southern Indiana. All school staff – from principals to teachers to school counselors, custodians, librarians, paraprofessionals, and beyond – were invited to participate in the survey.

School administrators were asked to email invitations to complete the C2C survey to their high school staff members. School administrators were also asked to disseminate two follow-up emails to staff, reminding them to complete the survey. Participation was optional, and there were no consequences for schools or school staff for nonparticipation. In addition to sending email invitations to participate, three school districts were selected for additional recruitment efforts, during which we mailed letters to staff inviting them to complete the survey. Ultimately, 772 school staff members responded to the survey. 

To estimate survey response rates, we focus on full-time teachers, as the number of full-time teachers at each school is available in the National Center for Education Statistics Common Core Data (NCES CCD) Files (https://nces.ed.gov/ccd/schoolsearch). When NCES CCD data were unavailable, we obtained the number of teachers from the school website. This approach provides the most accurate denominator for response-rate calculations. Overall, we estimate that the C2C survey achieved a 42.8% response rate among full-time teachers across all districts. There was district-level variation in response rates, ranging from approximately 20% to 71.8%, with a median of 43.2%. Only 2 districts experienced response rates below 38%. In short, generally our response rates were strong, indicating that we can draw meaningful conclusions about staff attitudes towards suicide prevention and mental health promotion in these school districts.

The confidential survey was administered online. Staff were able to complete the survey at their convenience and at a location of their choice. Before beginning the survey, staff reviewed the informed consent document and provided active informed consent for participation. Staff who completed at least 90% of the survey and provided an email address received a $25 e-gift certificate for Amazon.com. 

Staff who completed the survey reported diverse roles in their schools, including classroom teachers, principals and other administrators, school counselors, school psychologists, social workers, secretaries, paraprofessionals, food service staff, bus drivers, and others. We refer to school counselors, school psychologists, school social workers, and school nurses as “mental health staff” to protect their identities. We refer to school principals, assistant principals, deans of students, and athletic directors as “school administrators.”

Table 1. Descriptive Statistics for C2C Indiana Survey (N=722)

Notes: Percentages are reported for all characteristics. “School leaders” include principals, assistant principals, and other administrators. “Mental health staff” include school counselors, school psychologists, school social workers, and school nurses.

Figure 1. Most school staff agree that schools should support student mental health and prevent suicide  

Key Findings

• Over 97% agree that schools should actively support student mental health and prevent suicide.
  • Nearly 99% of school staff AGREE that schools should train staff members to recognize the warning signs of suicide.
  • Over 97% of school staff AGREE that schools should educate students about the warning signs of suicide.
  • About 97% of school staff AGREE that schools should provide access to mental health therapy in the school building.
  • Roughly 98% of school staff AGREE that schools should provide support to suicidal students during the school day.
  • About 98% of school staff AGREE that schools should collaborate with parents to support their children’s mental health.
• Only 30% of school staff AGREE that schools should leave mental health in the hands of parents.

Figure 2. Most school staff report that suicide prevention is part of their job

Key Findings

• Most school staff report youth suicide prevention as part of their job
  • Over 88% of school staff report that knowing the warning signs for suicide is PART OF THEIR JOB.
  • About 61% of school staff report that talking to a student they are concerned about being suicidal is PART OF THEIR JOB.
  • Nearly 98% of school staff report that telling an appropriate staff member about their concerns that a student may be suicidal is PART OF THEIR JOB.
  • About 51% of school staff report that asking a distressed student if they are thinking about suicide is PART OF THEIR JOB.

Figure 3. A sizeable minority of staff report the symptoms of burnout  

Key Findings

• Many school staff report experiencing psychological effects related to their work occasionally, often, or very often.
  • Over 26% of school staff report that reminders of their work with students upset them.
  • Nearly 25% of school staff report noticing gaps in their memory about interactions/experiences with students. 
  • About 15% of school staff report avoiding people, places, or things that reminded them of their work with students.
  • Over 40% of school staff report that things they once enjoyed about their work feel burdensome.
  • About 50% of staff report feeling less motivated and more psychologically worn down because of their work experiences.

Figure 4. Concerns about legal liability are the most prevalent barrier to asking an extremely distressed student if they are thinking about suicide  

Key Findings

• The top barrier to asking an extremely distressed student if they are thinking about suicide was legal liability, with 36% of staff endorsing this barrier.
• Other top endorsed barriers include:
  • “I would be overstepping my role” – 29%
  • Fear that asking a student if they are thinking of suicide would increase the likelihood of them attempting suicide – 29%
    • Please note: Past research has definitively established that it is safe to ask a person, “Are you thinking of suicide?” This does NOT increase their likelihood of attempting suicide (Mueller and Abrutyn 2024; O’Connor 2023).
  • Not having enough knowledge about suicide – 18%
• Roughly 27% of staff report that nothing would stop them from asking an extremely distressed student if they are thinking about suicide.

Figure 5. School leader's preferred responses to an extremely distressed student  

Key Findings

• Most school leaders prefer that teachers inform others when a student is distressed and continue to monitor that student.
  • ALL school leaders would prefer a teacher to tell the student’s counselor if they notice an extremely distressed student.
  • About 86% of school leaders would prefer a teacher to continue to monitor an extremely distressed student.
  • Nearly 64% of school leaders would prefer a teacher to tell the principal if they notice an extremely distressed student.
  • Almost 55% of school leaders would prefer a teacher to talk to an extremely distressed student as soon as possible.

Figure 6. Teacher’s preferred responses to an extremely distressed student  

Key Findings

• Most teachers prefer to inform the school counselor about an extremely distressed student, with roughly 91% of teachers endorsing this response.
  • Nearly 78% of teachers would continue to monitor an extremely distressed student.
  • About 66% of teachers would talk to the extremely distressed student as soon as possible.

Figure 7. Teachers frequently engage in diverse forms of suicide prevention work  

Key Findings

• Teachers are often involved in helping students with their distress, but do not frequently have explicit discussions with students about their suicidal thoughts.
  • About 38% of teachers sent a distressed student to an appropriate staff member, either MONTHLY or WEEKLY.
  • Roughly 32% of teachers told an appropriate staff member they were concerned about a student’s mental health, either MONTHLY or WEEKLY.
  • 28% of teachers spoke individually with a student about their mental health, either WEEKLY or DAILY.
  • Nearly 65% of teachers have NEVER had a student tell them they are thinking about suicide.
  • About 65% of teachers have NEVER asked a student if they are thinking about suicide.

Figure 8. School mental health staff frequently engage in diverse forms of suicide prevention work  

Key Findings

• School mental health staff are frequently and consistently engaged in direct support for addressing students experiencing mental health distress and thoughts of suicide.
  • About 76% of mental health staff had a school staff member send them a distressed student for support, either WEEKLY or DAILY.
  • Over 60% of mental health staff had a student tell them they were thinking about suicide, either MONTHLY or WEEKLY.
  • Roughly 68% of mental health staff had a school staff member tell them they were concerned about a student’s mental health, either WEEKLY or DAILY.
  • Approximately 81% of mental health staff spoke to a student about their mental health DAILY or WEEKLY.
  • Nearly 76% of mental health staff asked a student if they were thinking about suicide either MONTHLY or WEEKLY.
  • About 68% of mental health staff screened a student for their suicide risk, either MONTHLY or WEEKLY.
  • Roughly 51% of mental health staff created a safety plan for a student who had suicidal thoughts either MONTHLY or WEEKLY.
  • Nearly 66% of mental health staff had a student who screened positive for suicidal thoughts, either MONTHLY or WEEKLY.

Figure 9. School leaders frequently engage in diverse forms of suicide prevention work  

Key Findings

• School leaders are regularly informed about distressed students and involved in mental health concerns, but are less engaged in directly assessing suicide risk and intervention.
  • Nearly 57% of school leaders had a staff member send them a distressed student for support, either WEEKLY or DAILY.
  • About 51% of school leaders had a student tell them they were thinking about suicide ONCE A SEMESTER or MONTHLY.
  • Almost 65% of school leaders had a school staff member tell them they were concerned about a student’s mental health, either MONTHLY or WEEKLY.
  • About 41% of school leaders spoke to a student about their mental health, either WEEKLY or DAILY.
  • Nearly 46% of school leaders asked a student if they were thinking about suicide at least ONCE A SEMESTER.
  • Approximately 32% of school leaders have NEVER screened a student for suicide risk.
  • Nearly 32% of school leaders NEVER created a safety plan for a student who had suicidal thoughts.
  • Almost 30% of school leaders have NEVER had a student who screened positive for suicidal thoughts.
  • About 38% of school leaders told an appropriate staff member they are concerned about a student’s mental health, either WEEKLY or DAILY.
  • Roughly 49% of school leaders sent distressed students to an appropriate staff member for support, either WEEKLY or DAILY.

Figure 10. Almost 65% of school staff agree that their school has an effective multi-tiered system of supports (MTSS) for students

Figure 11. Over 80% of school staff agree that multi-tiered system of supports (MTSS) helps support students academically and social-emotionally  

Key Findings

• Among staff whose schools have multi-tiered system of support, 82% report that the system helps get students back on track academically, and 82% report that the system helps students get the social-emotional support that they need.

Figure 12. Among staff who work in a school with a multi-tiered system of supports (MTSS), over 70% referred a student this past school year  

Figure 13. Teachers generally report confidence in their school’s suicide prevention protocols  

Key Findings

• Teachers generally perceive their school as having clear and well-developed protocols with respect to suicide prevention and postvention.
  • Over 80% of teachers AGREE that their school has clear protocols for supporting students at risk of suicide.
  • About 87% of teachers AGREE that school protocols for supporting suicidal students protect them from legal liability.
  • Nearly 74% of teachers DISAGREE that school mental health protocols are more about protecting the district than supporting students.
  • 76% of teachers AGREE that their school had a well-developed suicide postvention plan to support students and staff after a suicide.

Figure 14. School mental health staff generally report confidence in their school’s suicide prevention protocols  

Key Findings

• Mental health staff generally feel confident in their school protocols’ ability to prioritize students’ mental health while providing legal protection. 
  • Over 97% of mental health staff AGREE that safety plans are a useful tool to support students at risk of suicide.
  • Nearly 85% of mental health staff AGREE that they feel confident to screen students for their suicide risk.
  • Almost 97% of mental health staff AGREE that school protocols for supporting suicidal students protect them from legal liability.
  • Roughly 64% of mental health staff AGREE that their school had a well-developed postvention plan to support students and staff after a suicide.
  • About 74% of mental health staff DISAGREE that school mental health protocols are more about protecting the district than supporting students.
  • Nearly 82% of mental health staff AGREE that their school has clear protocols for supporting students at risk of suicide.

Figure 15. Over half of school staff do not endorse myths about suicide  

Key Findings

• School staff generally reject misconceptions about suicide and recognize its seriousness.
  • Almost 92% of school staff DISAGREE that if a teenager wants to kill themselves, there is nothing they can do to stop them.
  • Over 88% of school staff DISAGREE that teenagers who talk about suicide really only want attention.
  • Roughly 90% of school staff DISAGREE that if a teenager survives their suicide attempt, they probably didn’t want to die.

Figure 16. 81% of school leaders believe that all staff should be trained to identify the warning signs of suicide.

Key Findings

• Nearly all school leaders reported that all staff should be trained to recognize the warning signs of suicide.
  • ALL school leaders believe school mental health staff—including school social workers, nurses, psychologists, and counselors—and administrators should be trained to recognize the warning signs of suicide.
  • 95% of school leaders believe that teachers and school staff/school resource officers should be trained to recognize the warning signs of suicide.

Figure 17. Most staff endorsed school counselors as responsible for reviewing students’ risk of suicide, followed by other school mental health staff and administrators

Key Findings

• School staff primarily view counselors as being responsible for assessing students’ suicide risk.
  • Roughly 82% of school staff believe school counselors are responsible for reviewing a student’s risk for suicide.
  • About 53% of school staff believe school social workers are responsible for reviewing a student’s risk for suicide.
  • Almost 53% of school staff believe school psychologists are responsible for reviewing a student’s risk for suicide.
  • Nearly 50% of school staff believe administrators are responsible for reviewing a student’s risk for suicide.

Figure 18. Nearly 60% of school staff have not completed a high-quality suicide prevention training in the past three years  

Figure 19. Nearly 21% of school staff completed QPR in the past three years  

Key Findings

• Nearly 67% of school staff have NOT completed a suicide prevention training in the past three years
• Among staff who completed suicide prevention training in the past three years, QPR (Question, Persuade, Refer) was the most popular, with nearly 21% having taken it.

Figure 20. School mental health staff are rarely required to complete the recommended in-depth suicide prevention training

Figure 21. The majority of school staff experienced no barriers to training their staff in suicide prevention, but inadequate funding and access to trainings were noted by 15-23% of staff  

Key Findings

• A sizeable portion of school staff report that limited funding and other barriers constrain their school’s ability to provide suicide prevention training.
  • Almost 23% of school staff report that inadequate funding limits their school’s ability to train staff in suicide prevention.
  • Over 16% of school staff experienced a barrier not listed that limits their school’s ability to train staff in suicide prevention.
  • Nearly 15% of school staff report inadequate access to people who could provide the training 

Figure 22. School staff face several important barriers to connecting students to community-based mental health services, including long wait times, affordability, and transportation  

Key Findings

• School staff frequently experienced long wait times, financial barriers, and transportation barriers when trying to connect students with community mental health services.
  • About 70% of school leaders and mental health staff experienced long wait times for accessing mental health services.
  • Roughly 67% of school leaders and mental health staff reported students’ families facing financial barriers in staffs’ efforts to connect students to community mental health services.
  • Nearly 57% of school leaders and mental health staff experienced transportation barriers in their efforts to connect students to community mental health services.

Figure 23. Many school staff have lived experience with suicide, including knowing someone who has died by suicide  

Key Findings

• Many school staff members have personal experiences with suicide. 
  • Nearly 70% of school staff know someone who has died by suicide.
  • Almost 60% of school staff have worried that someone they know might be thinking about suicide.
  • About 17% of school staff have seriously considered suicide in their lifetime.

Figure 24. Many school staff members have worried that someone they know, including a student at their school, is thinking about suicide  

Key Findings

• Many school staff members have worried that someone they know is thinking about suicide.
  • Almost 37% of school staff have worried about a family member’s suicide risk.
  • 27% of school staff have worried about a student’s suicide risk.
  • Nearly 23% of school staff have worried about a friend’s suicide risk.
• 40% of staff have not worried about anyone’s suicide risk.

Figure 25. Many school staff have been impacted by suicide, including 20% who have known a student who has died by suicide  

Key Findings

• Many school staff members have been directly affected by suicide.  
  • Almost 32% of school staff know a friend who died by suicide.
  • About 25% of school staff know a family member who died by suicide.
  • Almost 20% of school staff know a student at their school who died by suicide.
  • Fifteen% of school staff have had one of their own students die by suicide.
• Nearly 31% of school staff do not know anyone who died by suicide.

Figure 26. About 36% of school staff in our sample report losing a student in their district to suicide in the past five years  

Figure 27. About 20% of school staff in our sample report losing at least one student in their school to suicide in the past five years  

Figure 28. Most staff are unaware of student suicide attempts  

Figure 29. About 15% of schools in our sample reported a possible suicide cluster, meaning two or more students dying by suicide within a 6-month period  

Insights from Principals Across Indiana

Table 2. Descriptive Statistics for C2C Indiana Principal Survey (N=43)

Notes: Principals who responded to the district-wide version of the survey are not included in this sample.

Figure 30. Most principals agree that schools should support student mental health and prevent suicide  

Key Findings

• Principals strongly support proactive school-based mental health initiatives as well as collaboration with parents. 
  • Nearly 98% of principals STRONGLY AGREE that schools should train staff members to recognize the warning signs of suicide.
  • Over 95% of principals AGREE that schools should educate students about the warning signs of suicide.
  • About 98% of principals AGREE that schools should provide access to mental health therapy in the school building.
  • ALL principals AGREE that schools should provide support to suicidal students during the school day.
  • Nearly 56% of principals DISAGREE that schools should leave mental health in the hands of parents.
  • ALL principals AGREE that schools should collaborate with parents to support their children’s mental health.

Figure 31. The vast majority of principals understand suicide prevention to be a part of their job  

Key Findings

• Principals recognize that identifying and addressing distressed students is an essential part of their role.
  • Nearly 98% of principals report that knowing the warning signs for suicide is PART OF THEIR JOB.
  • About 77% of principals report that talking to a student when they are concerned the student may be suicidal is PART OF THEIR JOB.
  • 100% of principals report that telling an appropriate staff member that they are concerned a student may be suicidal is PART OF THEIR JOB.
  • About 77% of principals report that asking a distressed student if they are thinking about suicide is PART OF THEIR JOB.

Figure 32. Almost 61% of principals report that nothing would stop them from asking an extremely distressed student if they are thinking about suicide  

Key Findings

• Roughly 61% of principals report that nothing would stop them from asking an extremely distressed student if they thought about killing themselves. 
• However, a portion of principals reported that:
  • Concerns about legal liability might stop them from asking an extremely distressed student if they are thinking of suicide—nearly 19%
  • Asking an extremely distressed student if they are thinking of suicide would increase the likelihood of them attempting suicide—about 19%

Figure 33. Principals frequently engage in diverse forms of suicide prevention work  

Key Findings

• Principals are regularly involved in supporting students’ mental health, but may engage less frequently in suicide screening and assessment.
  • About 49% of principals had a staff member send them a distressed student for support at least WEEKLY or DAILY.
  • Almost 54% of principals had a student tell them they were thinking about suicide, either MONTHLY or ONCE A SEMESTER.
  • Nearly 37% of principals had a school staff member tell them they were concerned about a student’s mental health, either WEEKLY or DAILY.
  • 61% of principals spoke to a student about their mental health, either MONTHLY or WEEKLY.
  • Nearly 44% of principals asked a student if they were thinking about suicide, either ONCE A SEMESTER or MONTHLY.
  • Roughly 34% of principals have NEVER screened a student for their suicide risk.
  • Nearly 44% of school leaders created a safety plan for a student who had suicidal thoughts, either ONCE A SEMESTER or MONTHLY.
  • About 51% of principals had had a student who screened positive for suicidal thoughts, either ONCE A SEMESTER or MONTHLY.
  • 61% of principals told an appropriate staff member they are concerned about a student’s mental health, either ONCE A SEMESTER or MONTHLY.
  • 25% of principals sent distressed students to an appropriate staff member for support, either WEEKLY or DAILY.

Figure 34. Principals report confidence in their school's suicide prevention protocols  

Key Findings

• Principals view school protocols as effective tools that help student safety, support staff, and offer guidance for suicide prevention and postvention.
  • About 82% of principals STRONGLY AGREE that safety plans are a useful tool to support students at risk of suicide.
  • Almost 98% of principals AGREE that school protocols for supporting suicidal students protect their staff from legal liability.
  • About 88% of principals STRONGLY AGREE that school protocols for supporting suicidal students help to keep students safe.
  • Roughly 84% of principals DISAGREE that school mental health protocols are more about protecting the district than supporting students.
  • Nearly 92% of principals AGREE that their school had a well-developed suicide postvention plan to support students and staff after a suicide.

Figure 35. Few principals endorse myths about suicide  

Key Findings

• Principals generally reject misconceptions about suicide and recognize that suicidal behavior reflects serious risk
  • Almost 93% of principals DISAGREE that if a teenager wants to kill themselves, there is nothing they can do to stop them.
  • About 87% of school staff DISAGREE that teenagers who talk about suicide really only want attention.
  • Roughly 92% of school staff DISAGREE that if a teenager survives their suicide attempt, they probably didn’t want to die.

Figure 36. Most principals believe all staff should be trained to identify the warning signs of suicide

Key Findings

• Nearly all principals believe all staff should be trained to recognize indicators of suicidal behavior.
  • ALL principals believe mental health workers—including school social workers, nurses, psychologists, and counselors—security staff/school resource officers, and administrators should be trained to recognize the warning signs of suicide.
  • About 97% of principals believe that teachers should be trained to recognize the warning signs of suicide.
  • Roughly 92% of principals believe that other staff should be trained to recognize the warning signs of suicide.

Figure 37. Nearly 67% of principals have completed a high-quality suicide prevention training in the past three years  

Figure 38. Many principals have worried that someone they know, including a student at their school, is thinking about suicide  

Key Findings

• Many principals have worried that someone they know is thinking about suicide.
  • Nearly 54% of principals have worried about a student’s suicide risk.
  • About 39% of principals have worried about a family member’s suicide risk.
  • Roughly 29% of principals have not worried about anyone’s suicide risk.

Figure 39. Many principals in our sample have experienced suicide loss, including the loss of students at their school 

Key Findings

• Many principals have worried that someone they know is thinking about suicide.
  • About 46% of principals reported knowing one of their students who died by suicide.
  • Nearly 36% of principals know a friend who died by suicide.
  • About 31% of principals know a student in their school who died by suicide.
  • Roughly 21% of principals do not know anyone who has died by suicide.

© 2026 Indiana University, Irsay Institute

The work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License 

https://creativecommons.org/licenses/by-nc-sa/4.0/

February 2026

Authors

• Anna S. Mueller, PhD: Department of Sociology, Indiana University Bloomington; Irsay Institute
• Roberto D. Ortiz, MA: Department of Sociology, Indiana University Bloomington 
• Kasia Tuzzolino: Department of Sociology, Indiana University Bloomington
• Delanie B. Marks, MPA: Irsay Institute
• Ann McCranie, PhD: Irsay Institute
• Natasha Chaku, PhD: Department of Psychological and Brain Sciences, Indiana University Bloomington
• Addy Rogers: Department of Sociology, Indiana University Bloomington
• Jonathan Singer, PhD, LCSW: Loyola University Chicago
• Kate Phillippo, PhD, LCSW: Loyola University Chicago

Suggested Citation

• Mueller, A. S., Ortiz, R. D., Tuzzolino, K., Marks, D. B., McCranie, A., Chaku, N., Rogers, A., Singer, J., & Phillippo, K. (2026, February). Indiana Connect to Care in Schools Study Research Report. Irsay Institute, Indiana University.