Youths with good problem-solving skills and strong connections to family and friends are at lower risk. They also have limited access to lethal means of suicide.
Talk of suicide should always be taken seriously, whether or not a plan is evident. Signs to watch for include changes in sleep patterns, withdrawn social behavior and a desire to give away personal possessions.
Risk Factors
Many youth suicides result from an interaction of background personal and family factors and a specific significant life event that becomes intolerable. This can be caused by anything from an argument with a parent or boyfriend/girlfriend to a physical or psychiatric illness, bullying and/or sexual abuse.
Kids who have good problem-solving abilities and strong connections to family, friends, and the community are less likely to try to kill themselves. People with a mental illness or who have been misusing drugs and alcohol are more at risk for suicide.
Some major psychiatric disorders increase the risk of suicide in youths, especially in young people who have their first episode in adolescence. For example, some people with schizophrenia hear voices that tell them to kill themselves (auditory hallucinations) even though they may not want to die. The same is true for severe depression, where a person may feel that they are better off dead because of the suffering of those they leave behind.
Warning Signs
During adolescence, kids and teens go through major physical, social and emotional changes that can make them feel overmatched, helpless or hopeless. They can also feel overwhelmed by stress from school, family and friendships and by negative peer influences and bullying.
Talking about suicide, making a suicide plan or trying to hurt oneself are serious warning signs. If a youth talks about suicide, or even hints at it, parents should take the threat seriously. It is important to remember that suicide is a permanent response to a long-term problem and that it cannot be resolved with a quick fix or by trying to outrun the issue.
It is also important to watch for signs of depression, which can often be mistaken for suicidal behavior. Some teens might become sad, withdrawn or irritable for no obvious reason and might change sleeping patterns or eating habits. If the symptoms are severe, they may need help from a mental health professional.
Treatment
Regardless of whether the youth has genuine suicidal intent, it is essential to take any threat seriously. In many cases, the threat is a cry for help and can be treated by a thorough mental health evaluation and treatment plan. Psychiatric illnesses such as schizophrenia, bipolar disorder and anorexia nervosa often first appear in adolescence. They can be very dangerous and if untreated can lead to suicide.
The family environment also plays an important role in the development of adolescent suicidal behavior. The disruption of family structure and relationship dynamics can contribute to feelings of isolation, hopelessness, and a lack of appropriate coping skills.
Interventions that aim to strengthen and educate social networks have shown some promise in reducing suicide attempts. One such program is the Youth-nominated Support Team (YST; King et al, 2006). This approach involves adolescents nominating supportive adults and then educating them on how to respond when the adolescent becomes suicidal. This has been shown to reduce suicide attempts in adolescent at high risk for suicide.
Prevention
Young people of all backgrounds are at risk for suicide. This is a preventable health problem. Pediatric health clinicians and others who work with youth can help by learning the warning signs and promoting strategies for prevention.
A range of prevention programs have been shown to reduce suicide rates, including adolescent depression screening, general education about suicide (including risk factors and warning signs), and training school and community gatekeepers. Programs that foster peer support and social skills among high-risk adolescents or young adults can also help, as can programs to facilitate referral to mental health services.
Protective factors can lessen the impact of risk factors, such as family and peer support, healthy problem-solving abilities, and a sense of purpose. Schools, where many kids spend most of their time, can play a key role in prevention by providing support services and offering a safe space for talking about difficult feelings. Lastly, it is important to make sure that kids do not have easy access to lethal weapons or other means of self-harm, as half of all suicide attempts by adolescents and young adults are fatal.