Youth suicide is a complex issue. It can be influenced by many factors, and some teens are at greater risk than others.
Talk of suicide or thoughts of self-harm must be taken seriously. Any threat should be treated with a combination of therapy and medication. Risk factors for youth suicide include: a sense of isolation, depression and other mental disorders, substance abuse, and an environment of criticism.
Risk Factors
The “ingredients” that make a young person more or less likely to commit suicide vary from one individual to the next. Risk factors include previous suicide attempts, psychiatric illnesses (particularly depression), drug and alcohol abuse, conduct disorders and behavioral factors, family problems such as violence at home, lack of communication between parents and children, and the relative ease of access to lethal means.
It is also important to note that adolescent suicide is associated with impulsivity. Kids who are more impulsive have a greater risk of suicidal behavior, particularly if their impulsiveness is fueled by bio-neurological factors. Good problem-solving skills are a protective factor against suicide, and kids with stronger connections to friends and family are less likely to kill themselves.
Important life stressors such as relationship break-ups, peer rejection and the death of a loved one increase suicide risks in youths. This is especially true for traumatically injured youths who experience PTSD and depressive symptoms.
Warning Signs
Suicide is rarely a spontaneous choice. It is often preceded by clues and warning signs, which can be seen in behavior, words or actions. These might include a sudden change in mood, withdrawing from friends and family, writing about or drawing pictures of death or suicide, giving away personal items or increasing focus on weapons or medicines that can cause suicide.
Watch for these changes in your teen. Listen to what they say, and ask about them. Reassure them that you love and care about them, and tell them that help is available. Remove lethal weapons from the home, such as guns, pills or kitchen utensils. Support their treatment plan. And monitor the effects of their medicines, including antidepressants, which sometimes raise the risk of suicide. If their thoughts and feelings get worse, seek help right away. Never ignore threats of suicide or try to convince them not to be afraid. They are telling you that they are at risk and need help.
Treatment
If a youth is having suicidal thoughts or behaviors, they need to be treated by a mental health professional. This can be in the form of psychotherapy, medication or a combination of both. It also may include an extended hospital stay to make sure that the youth is safe.
Psychiatric treatment options for adolescents with suicide attempts or thoughts are focused on addressing emotion dysregulation and restoring hope. Often, young people who are at risk of suicide have trouble regulating negative emotions, like depression or anger. In addition, they often have difficulty experiencing positive emotions, like joy or love.
Family therapy approaches have also been shown to be effective in treating suicidal adolescents. One such treatment is called Attachment Based Family Therapy (ABFT), which focuses on improving communication and perspective taking in families. This is important because adolescent behavior can be influenced by family attachment and reactivity.
Prevention
Many suicide prevention strategies focus on reducing depression and anxiety and providing access to effective treatments. These efforts are important for all youth, but they may be particularly helpful for adolescents who are at risk.
It is essential to provide constant supervision when a youth expresses suicidal thoughts or behaviors. It is also crucial to seek expert help and not to try to keep these issues a secret.
Psychiatric illnesses such as schizophrenia and bipolar disorder often have their onset in adolescence. A person with these conditions is at much higher risk for suicide than the general population.
Laws that support the LGBTQI community have been linked to a lower suicide rate in adolescents. In addition, studies that encourage youth to imagine their future in a realistic and mentally tangible way – such as those conducted by YSM researcher Pauline Goger and Rachel Nam – have the potential to generate hope. This is an area of research that requires collaboration and cultural sensitivity to be successful.