Youth suicide can seem like an epidemic that’s out of control. Many people have a picture in their mind of the typical youth at risk: a depressed young person with a history of self-harm who is often impulsive and struggles to cope.
But there are also factors that can protect kids from suicide, including having access to good health care and feeling loved and supported.
Risk Factors
The profile of a youth who commits suicide is a complex one. They are usually a person who has significant psychological or psychiatric symptoms (such as depression, bipolar disorder, schizophrenia) and has a history of past or current suicidal behaviors. They are often impulsive and may use drugs or alcohol to cope. They are often socially isolated, with few close friends. They may have a relative or friend who committed suicide in the past. They may also have access to lethal means like guns and pills.
Adolescence is a time of transition and movement in all domains of life, including school, living situation, peer group, relationship status and family. These changes can cause stress and conflict that raises suicide risk. Studies indicate that strained relationships with parents, siblings and boyfriends or girlfriends can be risk factors. Kids who have good problem-solving skills and a strong connection to their families and friends are less likely to harm themselves.
Suicide Ideation
The CDC defines suicidal ideation as “having thoughts of suicide” and suggests that people who think about suicide can often be helped with therapy and treatment. When a loved one expresses suicidal thoughts, it is important to take them seriously and find ways to connect with them and help them stay safe. In some cases, it may mean making a safety plan, helping them access treatment or ensuring that they don’t have access to dangerous objects.
It is also important to understand that the transition from ideation to suicide attempt can be difficult. Research has shown that the way a person is able to regulate their emotions can impact how quickly they go from having ideas to trying to commit suicide. Studies that report only on a composite measure of suicide ideation and behaviour may miss this link as they don’t differentiate between these stages. Studies that explore subcomponents of emotion regulation (such as the clarity, impulsivity and access to strategies) have shown that these are related to suicide ideation and attempts.
Suicide Attempts
In a time of rising stress, bullying, and trauma, suicide rates are climbing for teens as well. According to the 2021 High School Youth Risk Behavior Surveyopen_in_new, nearly one third of high school students reported seriously considering suicide in the past year.
Suicide attempts are serious and require immediate intervention. Threats of suicide should never be taken lightly, and children who express these thoughts or behaviors should be evaluated by a mental health professional right away.
Warning signs include sudden or dramatic changes in a child’s personality and behaviors, changes in eating and sleeping habits, an obsession with death or self-destruction, and a withdrawal from family and friends. Other red flags are a history of depression, a family history of suicidal behavior or a psychiatric disorder such as depression or anxiety, and being bullied or struggling with a sexual orientation that is not accepted by their community.
Having access to lethal means also increases the risk of a suicide attempt. Make sure guns are locked and other medications, including over-the-counter drugs, are out of reach.
Treatment
Many suicide attempts in youth occur in the context of family conflict. Whether the conflict is between parent and child, between sibling or within an intimate relationship, such as with a boy/girl friend, these conflicts can place excessive stress on teens that exceed their coping abilities. This is particularly true for teens who have experienced domestic abuse, major psychological and psychiatric illnesses, and/or frequent changes in family structure (e.g., divorce, remarriage).
Screening for suicide during health supervision visits and other appointments with adolescents is important, including a brief suicide safety assessment for anyone who screens positive. In addition, counseling on safe storage of firearms and medication is helpful to prevent suicide attempts. Psychotherapy approaches are also effective for reducing suicidal behaviors in youth, especially when these interventions involve the whole family. Lastly, it is important to remember that, in spite of common myths, suicide is not “a choice” and no one makes the decision to kill themselves.