Children and adolescents may experience suicidal thoughts when they are suffering from an underlying psychiatric illness. The warning signs include: a change in eating or sleeping patterns, giving away possessions and feelings of hopelessness and helplessness.
Parents can prevent youth suicide by taking all threats seriously and removing lethal weapons, such as guns and pills, from the home. Also, by discussing mental health with children and teens and providing them with support services.
Risk Factors
There are a number of risk factors that contribute to youth suicide at the individual, family, and community/environment level. These include a lack of social support (e.g., from parents and peers), academic stressors, bullying, and physical/sexual abuse. Additionally, a history of suicidal thoughts and behavior (ideation and/or attempts) increases the risk as well as a history of non-suicidal self-injury.
Other risk factors include a history of major psychiatric disorders, including schizophrenia, anorexia nervosa and major depression, and the presence of comorbid anxiety and mood disorders. Often, the first symptoms of these conditions present in adolescence.
Also, access to lethal means, such as firearms and pills, can increase the risk of suicide. Finally, cultural and religious beliefs that discourage suicide can lower the risk. It is important for healthcare providers, especially those that care for adolescents and teens in acute care settings, to recognize these risk factors and signs of suicide. In addition, it is important to know when a patient might benefit from a mental health referral.
Triggers
In addition to normal developmental changes, a youth’s life may be influenced by stressful events or relationships that can contribute to suicidal thoughts and behavior. These factors can include a family or relationship conflict, loss of a job, a drug or alcohol use problem or the death of a loved one.
In the 2021 YRBS, it was found that more than one third of high school students reported persistent feelings of sadness or hopelessness and almost half seriously considered suicide. Girls were more likely to report these feelings and have a history of making an attempt than boys.
It is important to watch for warning signs such as a change in personality, a drop in school performance, withdrawing from family and friends, an increase in irritability or a preoccupation with death. It is also important to limit access to lethal means, including medication and firearms. Young children can move quickly from thoughts of suicide to an attempt.
Prevention
The goal of prevention is to decrease risk factors and increase protective factors at varying points along the social ecology. Prevention strategies are needed that target multiple levels of intervention – school-wide efforts to promote healthy behaviors and a positive school climate (Tier I), interventions specific to students at high risk for suicide or those who have attempted it (Tier II), and specific support and procedures for dealing with a student in crisis or at high risk (Tier III).
Youths who have made an attempt at suicide should be taken seriously, especially if they had planned their act. They may need a medical checkup to rule out life threatening illnesses, and then treatment to address the underlying mental health issue. They also need careful supervision and limit access to potential lethal items such as medication and firearms. Many communities have medicine disposal programs, and it is important to talk to your local pharmacist about this.
Treatment
Suicidal youths often experience a variety of traumatic life events that may trigger suicide risk factors. These include the dissolution of a relationship, marriage, and other familial relationships, job loss, and family moves that disrupt social networks and friendships.
Young people who talk about or threaten suicide should be taken seriously. This includes direct, indirect, or vague threats such as comments in a social media post or text message. They should be encouraged to seek expert help immediately, and parents can be very helpful by going with them to their appointment or making arrangements for a visit in advance.
Research has shown that certain psychotherapeutic treatment options can reduce suicide risk. One approach focuses on building protective factors at the individual-, family-, school-, and community-levels, and is called the Youth Support Team (YST) intervention. This approach has been compared with a hospitalization and routine aftercare treatment (TAU) in a randomized trial involving 156 adolescents who were referred to a psychiatric emergency department for suicidal thoughts or behavior.