We are so grateful to you for being a part of our team. We know that by joining REACH you have experiences with depression, suicidal thoughts, behaviors, or self-harm. We want to make sure we are clear about each of our roles, as REACH YAB members and leaders.
As a reminder, the purpose of this board is not to provide therapy or crisis services for mental health. In our board meetings, you will not be asked to share personal details about your mental health and lived experiences that are not directly relevant to the REACH YAB. Individuals may have different levels of comfort in sharing their own experiences and in hearing about others’ experiences with depression, suicide, and self-harm. We encourage you to seek any support or mental health services that you may need outside of this board, and we have a list of resources available to you (https://www.foxlabdu.com/copy-of-resources).
If you need mental health support right away please contact one of these resources:
● Suicide Prevention Lifeline: 988
● Crisis Text Line: Text HOME to 741-741
● Trevor Project Hotline: 1-866-488-7686
● Trevor Project Text Line: Text START to 678-678
● Find a local Warmline (a warmline is a phone number you can call to talk with someone in mental health recovery who is not a mental health professional) here: https://warmline.org/
● Talk with a trusted adult or parent/guardian to ask for support
● Talk to your own therapist, pediatrician, or another one of your trusted healthcare providers
● Visit your local emergency department or crisis center
It is important that you know that we are clinical psychologists. This means that we must take certain actions if we learn someone is at risk for suicide, or if their safety is at risk.
If we learn that you are currently thinking about acting on suicide urges or thoughts, or have recently acted on these thoughts or urges, we must ask follow-up questions and take steps to help keep you safe. This may include talking with your trusted adult or parent/guardian.
If we find out that an adult is currently or has hurt or abused you in the past (sexually, physically, or emotionally), we have to call the child protection agency in your state to make a report to help keep you and others safe.
These steps are blurry because we do not know your exact location. However, you should think about these steps we must take before you share information with us.
To make sure we can take these steps if we need to, we must collect some contact information from you in the event of an emergency and may have to share private information about your safety. To participate in the REACH YAB, we need your full name, the state you live in, and the name of at least one trusted adult emergency contact that you are comfortable with us reaching out to for your safety, if needed. This should be someone that can help you in an emergency, such as check on you or go with you to the emergency room if needed.
Signing this form indicates that you have read the above information about our safety protocol and understand when we may have to break your confidentiality.
Statement of agreement:
Name (first and last):_________________________________
State of residence:_________________________________
Name of one trusted adult who will be your emergency contact (e.g., a parent or guardian, other adult relative like a grandparent or aunt/uncle, your therapist, a coach or faith leader):_______________________
Contact telephone # for emergency contact: _______________________
Optional: other emergency contact (name and number):_____________________________