From Screening to Support: Inside Bellevue's Suicide Prevention Model

Suicide prevention in schools cannot begin only after a student reaches a crisis. It requires a system that can recognize distress early, respond consistently, provide evidence-based support, and connect students to care that continues beyond the school day. Bellevue School District 405 has built that kind of layered approach through its Mental Health Assistance Team (MHAT), universal education and screening, districtwide procedures, and a partnership with Care Solace.

The result is not a single program or referral pathway. It is a coordinated model designed to identify students who might otherwise go unnoticed, give them timely school-based support, and create a reliable bridge to specialized or longer-term services when their needs extend beyond what a school team can provide.

For this case study, we sat down with Kerince Bowen, Director of Student Support Services; Piper Sangston, M.S.W., Mental Health Assistance Team Counselor; and Layne Barker, MHAT Counselor & Signs of Suicide Coordinator, to learn how Bellevue’s model works day to day.

Bellevue School District at a Glance

Kerince Bowen, the district’s Director of Student Support Services, gave us a districtwide view of Bellevue's students, demographics, and access challenges. Bowen described Bellevue as a culturally and socioeconomically diverse Washington district serving just over 19,000 students across elementary, middle, high school, choice, online, and transition programs. She emphasized that needs and barriers vary widely from school to school and family to family, including insurance limitations, long waitlists, language and cultural considerations, and difficulty finding specialized treatment.

Bellevue’s high-achieving culture creates another, less visible challenge. Academic pressure may heighten stress, while some students hesitate to miss class or postpone a test for counseling. That reluctance can make asking for help feel more visible or stigmatizing. Bellevue's experience shows why even a well-resourced district needs multiple ways to identify students, flexible school-based intervention, and a dependable pathway beyond the school walls.

“Our students are very high achieving and very worried about their academics,” Bowen explained. “Oftentimes, those are the students experiencing mental health challenges but unwilling to access support at school because they don’t want to miss class.”

The Challenge: Finding Students Before a Crisis

One of the hardest problems in youth mental health is not only providing care; it is identifying who needs it. Students may struggle quietly for months or years without making a direct request for help. Others may not be noticed until symptoms begin affecting attendance, behavior, relationships, or academic performance.

“Many students are never identified. Kids can go years and years suffering and never get support. We have a process here for doing our best to identify students who need support.”
—Layne Barker, MHAT Counselor and Signs of Suicide Coordinator

Bowen also noted that student mental health needs have not receded since the pandemic. While the overall number of students seeking support may fluctuate, the district is seeing students present with more acute and severe needs, sometimes only after they have reached a serious crisis.

Bellevue’s approach is built to close that identification gap while reducing barriers to the next step. Barker summarized the team’s core pillars as “identify, increase access, and evidence-based care.”

The Model: Prevention, Identification, Intervention, and Continuity

1. Proactive Education and Screening

The district pairs suicide prevention education with mental health screening so students receive both knowledge and a clear opportunity to ask for help. Under the current model, all seventh graders receive a Signs of Suicide lesson in science, and the district reaches approximately one high school grade, primarily through tenth-grade chemistry classes. Lessons are co-taught by a teacher and mental health professional, followed by the BIMAS-2 self-report screener.

The 34-question BIMAS-2 looks across areas including negative affect, conduct, attention, social functioning, academic functioning, and self-harm. A student who reports thoughts of self-harm receives a secondary suicide risk screening under district procedures. Students can also use an exit ticket to ask to speak with a counselor about themselves or a friend. When safety concerns surface, the team aims to follow up promptly, often the same day.

The screening process gives Bellevue more than one doorway to care. Students may be identified through the screener or exit ticket, but they also reach MHAT through parents, teachers, school counselors, siblings, and peers. Barker said peer referrals are especially meaningful: “A friend will bring their buddy down and say, ‘I think my friend needs your help.’” That trust reflects a culture in which asking for mental health support is becoming more familiar and less stigmatized.

2. Dedicated MHAT Counselors

MHAT stands for Mental Health Assistance Team. Sangston and Barker explained that Bellevue’s five MHAT counselors are specially trained, certificated school-based professionals whose work is devoted to suicide prevention, crisis intervention, and short-term mental health treatment. As Educational Staff Associates employed by the district, they bring deep experience with Bellevue’s schools and systems. Unlike traditional school counseling roles, they are not responsible for course scheduling, college planning, lunch duty, testing, or the other administrative demands that can compete with direct mental health care.

That focus gives MHAT counselors the time and flexibility to provide short-term, evidence-based care, including cognitive behavioral therapy for anxiety, depression, and trauma. Students may receive individual or group counseling, brief crisis support, check-ins, or a fuller course of treatment. MHAT counselors are also not bound by a fixed session length. Sangston described staying on the phone with a clinic for as long as needed to secure an appointment, including helping families navigate language barriers.

“The district funding this specific program allows us not to function under the constraints of other roles,” Barker explained. “It frees us up to actually implement evidence-based counseling with kids.”

Because MHAT counselors are embedded in schools, they can connect treatment to a student’s daily environment and respond flexibly when academic demands become a barrier to care. Sangston recalled a student saying, “Shoot, I have a math test right now. I can’t come.” Because she is in the building, she can move the appointment to another period or day, coordinate with the teacher, and help the student receive support without feeling that seeking care means falling behind. MHAT counselors also collaborate with teachers on classroom accommodations and exposure work and coordinate with nurses and school counselors. “It’s such a union of sorts with all of us,” Sangston said. “We just really work together.”

3. Clear Procedures That Help Staff Act Consistently

Bellevue’s model is reinforced by detailed procedures for suicide prevention, intervention, documentation, safety planning, and follow-up. The district provides required online training, annual refreshers for educational staff associates, and more in-depth training for new school counselors, psychologists, nurses, and other providers. The MHAT team also works to extend training to community partners and other adults who interact with students.

The value of that consistency is practical. Sangston and Barker described a recent case in which a teacher noticed that a student’s writing assignment touched on self-harm and alerted the school counselor and MHAT counselor. Because everyone understood the procedure and knew which staff members were already involved, the team confirmed the student’s history and next steps within minutes rather than starting from scratch.

Postvention as Prevention: A Memorial Procedure Built Around Safety

Bellevue’s prevention model also addresses what happens after a death. Its memorial procedure applies to any student or staff death, regardless of the manner of death, and rests on two principles: prioritize student and staff safety, and never treat one human life as more or less important than another.

In the case of a suicide, those decisions become part of postvention. Memorial activities can support grieving students, but they can also unintentionally romanticize the death, heighten distress, or increase contagion risk. Bellevue’s procedure therefore calls for memorials that are optional, closely supervised, culturally responsive, short-term, and focused on hope, healing, recovery, and positive action.

This approach does not minimize grief. It gives schools a compassionate structure for honoring loss without creating additional risk. It also prompts staff to watch for students who need immediate support and connect them to the right level of care.

You can view the detailed procedure here.

Care Solace: The Bridge Beyond School-Based Support

Even a strong school-based mental health program has limits. Some students need specialized, longer-term, or higher-acuity care, while others prefer support outside school - particularly high-achieving students who worry that counseling appointments will take them away from class. Care Solace gives Bellevue a pathway for those situations, whether a student needs immediate placement, ongoing treatment after short-term MHAT counseling, or continued care through summer, graduation, or college.

Before Care Solace, counselors could refer families to community agencies but often had limited visibility into what happened next. With already-full caseloads, staff did not always have time to repeatedly contact providers and families for updates. Care Solace’s warm handoff process creates greater continuity and allows staff to follow a family’s progress toward care.

“With Care Solace, they can do the warm handoff, and then they can track it,” Bowen explained. “They can see where everything is in the process, and I think that’s truly helpful.”

The partnership allows MHAT counselors to remain a trusted source of school-based support while giving families help navigating care beyond the school’s scope, schedule, and walls. As Barker shared, “We love to lean on our outside providers and Care Solace to help us make connections for kids who need that continuity of care.”

Discover more about how Care Solace integrates with school districts to provide seamless mental health support for students and staff.

Lessons for Other School Districts

Bellevue’s experience offers several practical takeaways for districts strengthening suicide prevention and response:

• Build identification into the school day. Prevention lessons, screening, and self-referral options help reach students before concerns become visible through crisis or discipline.
• Protect time for direct mental health care. Dedicated clinicians can provide depth and continuity that staff with broader caseloads may not have the capacity to offer.
• Create more than one doorway to support. Students may enter through a screener, a teacher, a parent, a friend, a school counselor, or their own request.
• Turn policy into practice. Forms, documentation standards, annual refreshers, and role-specific training make it easier for staff to act consistently.
• Treat postvention as part of prevention. Memorial decisions should support grief while reducing contagion risk and directing impacted students toward care.
• Plan the handoff beyond school. A reliable care-coordination partner is essential when needs are specialized, long-term, higher-acuity, or outside the school calendar.

A Connected Pathway, Not a One-Size-Fits-All Program

Bellevue School District’s model demonstrates what suicide prevention can look like when identification, intervention, postvention, and external care coordination are designed as one continuum. MHAT counselors give students skilled support inside the school environment. District procedures give staff a shared roadmap. Care Solace helps ensure that when a student needs something more, the path does not end at a referral.

The work continues to evolve, but the team remains committed to sharing what it learns. As Barker put it, “If we’re doing something that works, we’re happy to share.” For other districts, Bellevue’s example is a reminder that the strongest suicide prevention systems are not built around a single person, lesson, or program. They are built around connection, clarity, and continuity.