Youth suicide is a serious public health concern. It is important to understand the epidemiology, risk factors and warning signs of this problem.
Look for changes in a teen’s behavior that may indicate depression or thoughts of suicide. You should also watch for frequent themes of death or suicide in a teen’s writing, school assignments and social media activities.
Risk factors
A child at risk for suicide needs a medical checkup to rule out life-threatening health problems. They also need a psychological evaluation and treatment until they are stable. This often takes place at an inpatient facility to ensure their safety. Treatment depends on the cause of their suicidal thoughts and attempts, but can include family therapy, medications and psychotherapy. They may also be given a psychiatric evaluation and a thorough physical examination to determine whether they are at risk for other illnesses.
The risk factors for youth suicide are varied and complex. For example, a person’s underlying biological temperament can contribute to their vulnerability. A traumatic childhood can also increase the likelihood of suicide in later life. A case-control study in Australia found that job loss and unemployment were significant risk factors for suicide. This is especially true for young people who have poor problem-solving skills. In addition, stress from prejudice and discrimination is a known risk factor for suicide among LGBTQ+ youth.
Symptoms
The teen years are an emotional time with major life changes, increased stress and feelings of hopelessness and worthlessness. Often, these feelings lead to substance abuse. A person who does not have coping skills and is under the influence of drugs or alcohol is at increased risk for suicide.
Parents and teachers should pay attention when students have a sudden change in their behavior, such as withdrawal from family and friends, declining academic performance or loss of interest in school activities. Also look for a preoccupation with death or suicidal thoughts in conversations, homework or artwork.
Encourage your child to talk about their feelings and listen carefully. Reassure them that their problems can be worked out and tell them you will help them get the expert treatment they need. Keep lethal weapons, such as guns and pills, out of their reach. Remove all items from the home that could be used to commit suicide, such as ropes and sharp objects.
Treatment
A comprehensive treatment plan should be developed for youths with suicidal thoughts and behaviors. Depression is a common diagnosis in suicidal youths and is often treated with antidepressant medications. Youths with other psychiatric illnesses such as bipolar disorder, borderline personality disorder/features and a history of drug abuse may need more intensive treatment.
Family psychosocial interventions have shown promising results in reducing suicide risk in adolescents. One such approach is called Attachment Based Family Therapy which seeks to improve communication, perspective taking and problem solving in families. It also has a strong component of addressing family attachment issues because it is well-documented that insecure family attachment is associated with increased risk for suicide.
Prevention efforts focus on increasing access to mental health care for at-risk youths. These strategies include active strategies such as training school and community gatekeepers, establishing crisis centers and hotlines, and passive strategies such as lowering barriers to self-referral. Interventions that seek to build and educate social support networks have also shown promise in reducing suicide risk among adolescents. For example, the Youth-nominated Support Team (YST; King et al., 2006) has been shown to decrease continued suicidal thoughts and behaviors.
Prevention
Children and youth who live in a family with good mental health and social support can be protected from suicide. They also benefit from schools with trained staff and procedures for identifying and helping students in crisis.
Youths who have a psychiatric condition, such as bipolar disorder or anorexia nervosa, that is not properly treated can experience a high risk of suicide. In addition, many suicides in teens and young adults occur in the context of a relationship conflict such as a fight with a parent, boyfriend/girlfriend or other significant other.
Never agree to keep a youth’s suicidal feelings a secret and always take any threat seriously. Even threats that may seem less complete or dangerous can be a cry for help and should be taken seriously. Encourage a youth to develop a personal safety plan (e.g., time spent with friends/family, check-in points with significant adults, plans for the future) and provide ongoing supportive care.