Many young people of all races, ethnicities, genders and sexual orientations die by suicide each year. Boys attempt suicide more often than girls, and when they do, they are 3 times more likely to die.
Kids who are considering suicide usually show warning signs that can be recognized by parents, teachers and school personnel. These include:
There are a number of things that can increase the risk that a youth will engage in suicidal behavior. These include a history of mental health problems, especially mood disorders like depression and anxiety, and other psychiatric conditions that may make the youth break from reality and hear voices that seem to tell them to kill themselves (psychosis). Drug or alcohol abuse is also a risk factor. A history of bullying at any age can be a red flag. Other risk factors are a family history of suicide, and having easy access to lethal means of self-injury.
There are also many protective factors that can reduce the risk of a youth engaging in suicidal behavior. Kids who feel loved and supported, and who have good problem-solving skills are less likely to think about killing themselves. Other protective factors are a sense of connectedness to their parents, to other adults and to their community; involvement in healthy activities; good grades; and strong friendships.
Parents, teachers and friends are often the first to notice warning signs of suicide in their children. These include sudden changes in friends, withdrawal from social activities, grades and school performance, poor hygiene, loss of interest in food and weight gain, and the presence of death and suicidal themes in drawings, homework, journal entries or conversations. Youth who have a psychiatric disorder, particularly depression, are at higher risk for suicide. So are youngsters who have a history of abuse, domestic violence or life-threatening events, or a family member who committed suicide.
Those who have access to lethal weapons also are at increased risk. If a youth talks about suicide, listen to him without judgment and with the belief that he is not alone. Suicidal thoughts and previous suicide attempts are loud, clear cries for help that require response. Getting treatment early can be the difference between life and death. Effective care includes a combination of one-on-one counselling and medical treatment for depression.
Children and adolescents who are suicidal often present with major psychological or psychiatric symptoms, including depressed mood, suicidal thoughts, self-injury and/or suicidal behaviors. They may also have a significant history of abuse, neglect and/or maltreatment. These experiences can lead to feelings of hopelessness and despair that are beyond their coping abilities. Conflicts with parents, boy or girl friends or other important people in their lives can also increase suicide risk.
Psychotherapy, such as family therapy or individual and group psychotherapy, has been shown to be effective in reducing the risk of suicide. Screening programs in schools and communities can help identify youth at risk, and these can include general suicide education, peer support programs, and crisis centers or hotlines.
A comprehensive public health approach is needed to prevent suicide among youth. Protective factors such as a sense of purpose, close relationships with family and peers, cultural or religious beliefs that discourage suicide, and access to mental health care can all reduce the risk for suicide.
Pediatric health clinicians, adults working with youth in school and community settings, and families can all play a role in youth suicide prevention. These individuals should be knowledgeable about the risk factors for suicide and how to identify them, know local professional resources for assistance, take all suicidal threats seriously, and encourage youths at risk to seek help from a mental health specialist.
Prevention efforts should also include education that is developmentally appropriate and addresses critical social determinants of health, such as family stability, homelessness, substance use, adverse childhood experiences (ACEs) and trauma, and racial disparities. Activities that restrict access to lethal means of suicide, such as firearms and drug overdose, should be part of prevention programs.
It is important to note that suicide prevention efforts are not effective in all instances. When someone has a genuine suicidal intent, they will not wait until the right time to act and must be helped immediately. Fortunately, the majority of suicides are preventable.