Youth suicide is a complex issue. The literature has made significant advances in areas including epidemiology and (potential) etiological mechanisms, but it remains a challenging area of research.
A teen who shows warning signs of suicide should be taken very seriously. These include talking about or making threats of suicide, acting erratically or being grossly agitated.
Risk Factors
The risk factors for youth suicide are complex and varied. They may include mental health problems such as depression or bipolar disorder, previous suicide attempts, personality characteristics, genetic loading and family processes in combination with triggering psychosocial stressors. They can also include access to lethal means, such as a gun.
Often, the most important risk factor for suicide is the feeling that life is hopeless and meaningless, a sense of emptiness or hopelessness. This can be caused by a number of things, including major life events such as marriage dissolution or remarriage, the death of a loved one, relationship conflict and academic or work difficulties.
Other significant risks for suicide in youth are having a family member who has committed suicide, being a male or lesbian or gay (LGBT) teen and having a history of substance abuse. In addition, conflict with a parent or other authority figure has been found to precede about 40% of suicide cases.
Suicide Attempts
If a youth makes a threat to kill themselves, this should be taken very seriously and they should get mental health treatment right away. This will often be done at an inpatient facility to keep them safe and give their family a break while they recover.
It’s important to know that most teens who attempt suicide don’t want to die but are in so much pain they can’t cope any longer. Symptoms of suicidal thoughts or behavior can include a sudden change in their mood, a preoccupation with death (whether they talk about it or not), changes in eating and sleeping patterns, and being withdrawn from friends and family. They may also exhibit behaviors like cutting or self-injury, including non-suicidal self-injury such as a preoccupation with “skinny-cutting” and “scratching.”
Adolescents who are presenting with injuries that might be related to suicide should be assessed in the emergency department and receive mental health care as soon as possible. This can be difficult, and research is exploring ways to better identify these youth and develop a screening and treatment protocol.
Treatment
Many trauma centers are struggling to identify and provide a safe environment for at-risk adolescent patients. Pittenger, who also co-directs YSM’s Center for Brain and Mind Health, says that it is imperative that trauma centers and healthcare providers recognize risk factors, warning signs, and suicide prediction and referral strategies to better meet the mental health needs of their patient populations.
Often, these adolescents may have to be hospitalized for evaluation and treatment. During this time, they should be screened for life-threatening conditions and given a thorough physical examination. They should be given a psychiatric evaluation and appropriate medication as needed.
Several psychosocial interventions that focus on the family have been shown to improve adolescent resilience and reduce suicide risk. For example, adolescent-focused dialectical behavior therapy (DBT) has been shown to be effective in reducing suicidal thoughts and behaviors.
Prevention
During adolescence, young people face major life changes that can lead to strong feelings of stress and confusion. They may feel trapped by these emotions and unable to resolve their problems. They may also feel pressure to succeed. These factors can contribute to depression and other mental health disorders, which are often linked with suicide.
All suicide threats should be taken seriously. Even if a teen says they don’t mean it, they should be evaluated by a professional. They should also be removed from any potentially dangerous materials. A teen who has made a suicide attempt needs a thorough medical evaluation and may need to stay in a hospital psychiatric unit for safety reasons.
In addition to ensuring that all teens have access to professional help, it is important for schools to have well-trained staff who are familiar with risk factors and warning signs of suicide. This will enable students to talk freely about their concerns and seek help if needed.