Suicide is a leading cause of death for youth and young adults. Youth who have a history of poor or inappropriate coping skills may be at increased risk.
During the COVID-19 pandemic, rates of suicide rose in summer to autumn 2020, possibly reflecting stress associated with returning to school after being away from it for several months. However, rates of suicide returned to pre-pandemic levels by December 2020.
Risk Factors
Risk factors are things that increase a young person’s chance of suicide. They can include mental health problems like major psychiatric disorders such as schizophrenia, anorexia nervosa and depression. They can also include the presence of certain life events, such as experiencing a traumatic event or being bullied. They can also include having access to lethal means of suicide, such as a firearm or pills.
Adolescents who talk about suicidal thoughts or make threats of suicide are at a much higher risk of actually trying to kill themselves. Having a family member who has committed suicide or a previous attempt is also risky. So is being in a rural community, where the rates of suicide are higher. Finally, being a victim of bullying increases the risk as does using drugs and alcohol. Trauma centers and healthcare providers should screen all youths for depression and suicidal ideation and develop a strategy for referrals to mental health services.
Prevention
Youth often give warning signs that their mental and emotional health is deteriorating. It is important that parents, teachers and friends know how to recognize these warning signs and get help right away.
These warning signs include current talk about suicide or making a plan, strong wish to die, preoccupation with death, giving away prized possessions, serious depression, moodiness and expressing hopelessness, withdrawing from friends and social activities, and alcohol or drug use. Anyone who is thinking about suicide should always be taken seriously and seen by a doctor for a medical evaluation.
School communities can prevent youth suicide by instituting prevention, intervention and postvention practices that support all students. This includes developing policies, planning training, and selecting classroom and school-wide activities that promote healthy coping and well being. Creating a community that supports mental health and encourages protective factors like connections with family, peers and teachers can also make a difference. These activities should take into account the specific needs of the youth population, including sex, ethnicity and cultural context.
Treatment
Youth who talk about or threaten suicide need to be taken seriously, especially if they say they are going to kill themselves. It is important to take their behavior and threats seriously, and make sure they are in a safe environment (removing all dangerous means of self-harm).
Treatment options include psychotherapeutic models that reduce suicidal ideation and behaviors as well as medications that treat disorders associated with suicide risk. The goal is to combine these models in a way that addresses the individual youth’s needs and risk factors.
For example, one treatment is SAFETY, a home-based intervention that has been found to be effective in treating youth who have made repeat suicide attempts. This approach integrates psychotherapy, family therapy, and crisis management training to provide an integrated care model for adolescents who are at high risk for repeated suicidal behaviors. It was shown to be superior to routine care in reducing suicide attempt rates, hopelessness and parental depression, and improving youth social adjustment and coping.
Support
It’s important to understand the major risk factors for youth suicide and know local professional resources. This will help you recognize a youth at risk and take action.
Listen to teens and pay attention to their warning signs. Almost all youth who attempt suicide give some kind of warning, whether verbally or behaviorally. They may talk about or try to make arrangements for their death or may be giving away items they treasure. They also may be drinking or taking drugs that can lower their inhibitions and increase their likelihood of attempting suicide.
Be sure to follow up on all suicide threats and attempts and keep a close watch on those at high risk for suicidal behavior. Encourage teens to spend time with supportive friends and family. Protective factors, like connectedness to others and a positive self-esteem, have been shown to reduce stress and promote health among at-risk youth. (4,5)