Each day an average of 12 young people commit suicide in the United States, leaving behind devastated family and friends. Most youth show clear signs of their intention to attempt suicide, but too often those signs go unnoticed, or loved ones don’t know how to respond.
“It’s easy to miss the signs if you’re not completely plugged in because kids don’t usually come out and say, ‘I feel like I’m going to kill myself.’ It’s much more subtle,” says Lisa Boesky, Ph.D., child/adolescent psychologist and author of “When to Worry: How to Tell if Your Teen Needs Help—and What to Do About It.” “You’ve got to be plugged into your child’s life, so that you can see the change in behavior and notice when things are not going well.”
Suicide is the third leading cause of death among 15 to 24 year olds, claiming the lives of 4,600 annually, according to the U.S. Centers for Disease Control and Prevention (CDC).
Adolescence is a period of dramatic physiological and social changes, often accompanied by family conflict, romantic breakups and school issues. The extreme pressure to compete in the classroom and on the field can add to the overwhelming stress of being a teenager. But these factors alone rarely cause adolescents to take their own lives.
“About 90 percent of those who die by suicide have a mental or substance abuse disorder,” says Richard McKeon, Ph.D., chief of the Suicide Prevention Branch at Substance Abuse and Mental Health Services Administration (SAMHSA). More aggressive diagnosis and treatment of mental illness and substance abuse could potentially save thousands of lives annually.
Untreated Depression Ups Suicide Risk
One of the most common mental disorders is depression. In some studies, up to 40 percent of people who have a major depressive episode have thoughts about suicide, says McKeon.
Because suicidal thoughts are often a part of depression, if it is not treated properly, the risk of suicide increases. While depression is typically described as sadness, loss of energy and hopelessness, it can also manifest itself as irritability, aggression and acting out. If kids suddenly lose interest in sports or activities they previously enjoyed, parents should also pay attention.
“Once someone moves from having thoughts about suicide to behavior and has made a suicide attempt, then their risk becomes higher over time,” says McKeon.
No Population Is Immune from Suicide
Another major risk factor is having a friend or family member who has committed suicide. Experts have long known that people exposed to suicides have a greater risk themselves. However, a new study published in the Canadian Medical Association Journal shows that suicidal thoughts and behavior are especially contagious among younger teens whose peers have taken their own lives, even if they don’t personally know them.
Twelve-to-13 year olds who were exposed to a peer’s suicide had a five times greater risk of thinking about suicide themselves or to report that they had attempted suicide. Research shows that the suicidal influence declines as teens age. Sixteen-to-17-year olds were only two times as likely to contemplate suicide as those who did not have any exposure.
Students of Henry M. Gunn High School experienced the copycat effect first-hand when a cluster of suicides took place in Palo Alto, an affluent California town. In 2009, five students killed themselves by jumping in front of a commuter train, all within an eight month period.
“(Henry Gunn) is one of the highest performing high schools, ranked in the top 100 in the country – very high I.Q., Silicon Valley, two-parent families, high achieving youths,” says Boesky. “Suicide is an issue for youth of every race, age, and socio-economic background, whether they’re struggling in school or they’re an honors student, whether they’re smoking in the back alley or they’re getting top honors. Suicide does not discriminate.”
Alcohol and Drugs Magnify Suicide Risk
Parents often ignore teen drinking, dismissing it as a rite of passage, but drinking alcohol puts people of all ages at greater risk for suicide.
“As many as 30 percent of those who die by suicide have blood alcohol levels approaching intoxication at the time of their death, so it’s a huge issue,” says McKeon.
Combining alcohol and drugs with depression can be a deadly mix. They can lower your inhibitions and cloud your judgment, especially if you’re already feeling hopeless and having suicidal thoughts.
“If a young person is thinking about taking their life, and they have access to guns or pills, or other lethal methods, that raises their risk significantly,” says Boesky. She advises parents to lock up all alcohol and prescription drugs and to remove weapons from their home. About half of all suicides involve the use of firearms, with males more likely to use them than females.
Throughout their lifespan, males commit suicide four times more frequently than females. However, women of all ages are more likely to attempt suicide.
Parent Monitoring and Support Keep Kids Safer
When kids are singled out and bullied, it sets the stage for social isolation and feelings of worthlessness. With the digital age, bullying is no longer limited to the school halls and playground. Through social media sites, users can share humiliating posts, pictures or videos with their entire school with the click of a button.
“We’ve seen story after story of young people who have taken their own lives after being relentlessly bullied,” says Boesky. “In person, bullying is brutal enough, but with cyberbullying, it’s kind of 24/7.” Boesky recommends periodically monitoring your children’s social networking sites to keep them safe on-line.
Lesbian, gay, bisexual and transgender (LGBT) youth are prime targets for harassment and bullying, according to Victoria Wagner, executive director of Youth Suicide Prevention Program in Washington state. Rejection from their peers, family and faith community put them at higher risk of depression and suicide than their straight peers. A number of studies have shown that high school students who are lesbian, gay or unsure of their sexual orientation are two to three times more likely to attempt suicide than their heterosexual peers.
One of the biggest protective factors for LGBT is being accepted and supported by family and friends. Those who experienced severe rejection from their family are more than eight times more likely to report attempting suicide, compared with peers who experienced little or no rejection.
Another population at increased risk for suicide is Alaskan natives and American Indians ages 15 to 24. Their suicide rate is 2.5 times higher than the national average for young adults. Wagner says substance abuse, isolation on the reservation and limited resources all contribute to the higher risk.
Be Direct: “Do you want to kill yourself?”
One in seven high schoolers reported seriously considering suicide in the last 12 months, according to the 2011 Youth Risk Behavior Survey. Parents need to engage in frequent meaningful conversations with their children, so they know what’s going on in their lives, no matter how much their teens roll their eyes or lock themselves up in their bedrooms.
“It’s really important for a parent, or anyone that suspects somebody is thinking of suicide, to ask them about it directly,” says Wagner. “If somebody is, they will normally give you a truthful answer.” Asking the question in a direct, non-judgmental way opens up the lines of communication and also helps differentiate between self-injury and attempted suicide.
“Some people worry that if they ask the question, they may put ideas in the person’s head. That’s a myth,” says McKeon. “There’s no evidence that you’ll be putting ideas into someone’s head who hasn’t been thinking about them already.”
Parents should look for warning signs that their child is contemplating suicide, including:
- A dramatic change in personality
- Giving away prized possessions
- Withdrawal from friends
- Uncontrolled anger
- Engaging in risky behavior
- Major changes in sleeping or eating habits
- Increased alcohol or drug use
- Talking or writing about death or suicide more than usual
Delaying Action Costs Lives
If a child says he or she is seriously considering suicide or has just made a suicide attempt, immediate treatment at an emergency room may be necessary.
“It’s important to not panic because one of the most important things is to get more information and get the fullest picture possible of what’s going on,” says McKeon. He advises anyone worried about suicide – including family members, friends and teachers – to call the National Suicide Prevention Lifeline (1-800-273-TALK) and get an assessment from a trained professional 24/7.
Because teens are more likely to communicate online than make a phone call, Lifeline recently added a chat function to their website. Lifeline can evaluate a person’s risk of suicide and identify mental health providers in your area who are specifically trained to handle suicide risk.
“The care, concern and support of friends and family can often be life-saving to someone who is in psychological pain and thinking of suicide,” says Boesky.
As a parent, you can stay better connected with your kids by getting to know their friends and being aware of the pressures they’re under. Don’t be afraid to ask questions, and most importantly, be supportive, no matter what they’re going through. If you suspect a mental disorder, substance abuse problem or suicidal risk, take action immediately. The biggest mistake is doing nothing.