A number of things can lead to suicide. These include mental disorders (like depression), drug use, family and social issues, poor coping skills and access to lethal means like guns or medicine.
There are also protective factors that can lessen the risk of self-harm or suicide. These include strong connections to family, friends and the community, good problem-solving abilities, cultural and religious beliefs that discourage suicide and support self-preservation, and easy access to clinical care.
Risk Factors
The “ingredients” of suicide vary from person to person, and adolescence is an especially vulnerable time. But some risk factors are common: past suicide attempts, depression and a family history of depression or other mental health problems. Other risk factors include drugs or alcohol abuse, a lack of social support, relationship conflicts, stress and pressure to perform in school and/or the workplace, and the ready availability of lethal means (e.g., firearms and pills).
It’s also been found that kids who have good problem-solving skills are less likely to commit suicide. And they’re at less risk if they have strong connections to friends and family. They’re also at less risk if they don’t have easy access to lethal means. Finally, they’re at less risk if there is a lack of family violence or direct conflict with parents. Several studies have shown that comorbidity of mood and substance use disorders increases the likelihood of suicide.
Warning Signs
A child or adolescent who is considering suicide typically gives warning signs. They may be withdrawn or sad and seem to have no interest in things that used to make them happy. They may have trouble concentrating or be sleeping more than usual. They may also give away their most prized possessions. They might begin writing about death and dying in journals or pictures.
Threats of suicide should never be taken lightly. If a child or adolescent talks about this, you should take them seriously and get help right away.
Other warning signs include a history of depression, drug or alcohol abuse, bullying, family or social conflicts, a serious school or disciplinary problem, and difficulties with their sexual orientation in an unsupportive environment. A child or adolescent with a suicide attempt in their past may be at especially high risk for a future attempt.
Treatment
Effective medical and mental health care involves ongoing relationships where kids feel like professionals take them seriously and are available to them. Some youths are at greater risk for suicide than others, including those who identify as LGBTQ, American Indian or Alaska Native or those involved in the child welfare or juvenile justice systems and those who have served in the military.
Young people who are considering suicide usually give warning signs, such as acting sad or withdrawn, complaining about stomachaches or headaches, or making a sudden change in behavior. They may also talk about suicide or make threats, and they might begin planning for their death by giving away treasured items or by saying goodbye to loved ones.
If a youth reports SI or tries suicide, health care providers should assess the situation in a safe environment and refer them for an acute evaluation by a mental health specialist as quickly as possible. HCPs should be familiar with the providers in their communities to make referrals easier.
Prevention
Many of the risk factors for suicide are preventable. Family members need to learn the warning signs and be prepared to take them seriously when they occur. They need to make sure there are no means of self-harm in the home and that potentially lethal materials like hangers and ropes are not accessible. They need to talk openly with their youth about emotional difficulties and if necessary seek the help of mental health professionals.
Schools also have a role to play in preventing suicide. They should have trained mental health staff who can assess and treat suicidal students, warn parents and school personnel of a possible threat and refer the student to community services.
Community-based programs that foster peer relationships and social skills development, reduce isolation and build a sense of belonging can also protect against suicide. It is also important for teenagers to have good problem-solving abilities, and a strong support system, especially in the face of difficult personal or relationship problems.