The teen years are an extremely challenging time filled with major emotional, cognitive, and social change. These challenges can contribute to depression, and other mental health issues that may increase risk for suicide.
Threats of suicide should always be taken seriously. If a young person indicates they are considering suicide, it is important to encourage them to seek help.
Identifying Risk Factors
Those that have higher rates of suicide include young men, American Indians, and adolescents who identify as lesbian, gay, bisexual, or transgender (LGBT). Stress related to bullying and rejection by peers and family members is also a risk factor. Many adolescent suicides are impulsive and happen without warning.
The adolescent years are an important time of transition, with new life challenges in education, work, relationships and living circumstances. Adolescents also face challenges in establishing self identity, coping with mood swings and dealing with conflicting feelings like anger or sadness.
During this time, it is important for parents to pay attention to their child’s behavior and be alert for signs of depression or suicide. Red flags may include a change in sleeping or eating habits and the loss of interest in activities that used to be fun. Protective factors are characteristics and behaviors that reduce the risk of mental health problems, including suicide. These are defined by Healthy People 2030 as individual-, family-, school- and community-level health-promoting behaviors and experiences that mitigate the negative effects of risk factors (4).
Identifying Suicide Risks
Suicide is one of the leading causes of death in youth. It has been increasing in boys and girls of all ages. It is important to be aware of the warning signs and never ignore them.
A child or adolescent may talk about suicide or make threats (indirectly in comments or texts, or on social media). They may start planning, which includes saying goodbye to loved ones and disposing of personal items they treasure. They may also be experimenting with alcohol or drugs, which can lower inhibitions and increase the risk of making a suicide attempt.
Mental disorders, previous suicide attempts, specific personality characteristics, genetic loading and family processes in combination with triggering psychosocial stressors, access to means of suicide and lack of protective factors are major risk factors for suicide in youth. Prevention efforts must focus on reducing these risks and strengthening protective factors. This will require integrated and multisector interventions that include education, promotion of health services and the establishment of support networks.
Developing a Plan for Intervention
Educators and school staff are well-positioned to observe and respond to students who may be at risk for suicide. They have daily contact with youth and are often the first to notice a sudden change in mood or behavior. They also have the opportunity to connect them with local resources, including crisis and stabilization services (CCORS) and mental health professionals.
A youth may present with a variety of warning signs, such as a loss of appetite, diminished interest in previously pleasurable activities or a clingy or possessive disposition. Some of these symptoms may be accompanied by hallucinations or delusions, which could be a symptom of a serious psychiatric illness.
CCORS and community mental health and suicide prevention/postvention services can provide referrals to a clinically appropriate treatment for adolescents who are at risk of self-harm. These include the evidence-based CAMS intervention and SPI+ with follow-up, as well as other programs that have promising but insufficient effectiveness data.
Developing a Plan for Recovery
A youth who is at risk for suicide needs to have a plan. The plan can include things like a check-in point with significant adults, time spent with others and/or plans for the future. It is important to understand that any suicidal thoughts or attempts should be treated as a serious issue and not trivialized.
Developing a recovery plan is essential for long term success in overcoming mental health challenges. People can develop their recovery plan with the help of treatment providers, therapists or peer support specialists. It should include a list of personal goals that are important to the person. It is also helpful to make a list of people who are supportive of the individual’s recovery.
It is important for school districts to have policies in place that address prevention, intervention and postvention after a suicide. These can include a protocol for responding to a student who presents as suicidal or has attempted suicide; creating a crisis response team; and choosing classroom and school-wide curriculum and programs.