Suicide – It’s Not Just An “Adult” Problem
Every year during Well-Child-Checkups starting at age 11, preteens and teenagers are given a screening form for depression and anxiety. Many practices (including my own) use a screen called PHQ-9. This short form asks patients to rate how often they experience certain symptoms that are red flags for possible depression on a scale of 0 (not at all) to 3 (nearly every day). At the end of this screening form are two very important questions:
Has there been a time in the past month when you have had serious thoughts to ending your life?
Have you ever, in your whole life, tried to kill yourself or made a suicide attempt?
Let me tell you how heartbreaking it is to see those boxes marked “yes.” To see this young person across from you either shut down or start to cry when you ask for more information. To know that this 11, or 13, or 17 year old has contemplated – or tried! – taking his or her own life. To see looks of shock on parents’ faces who had no idea, or looks of defeat in those who know but don’t know what else to do.
It’s heartbreaking, and it is shocking to see how much more frequently it has been happening over the past few years. Many “well checks” are overshadowed by mental health concerns that were previously unknown to parents, and must be evaluated and treated promptly.
Rates
A report published in the journal Pediatrics in 2016 named suicide as the second leading cause of death in adolescents 15-19 years old. Suicide was a mental health crisis in teenagers long before the covid pandemic and resultant mental health explosion. Combining the increased stress and social isolation of the pandemic with rising rates of mental health diseases across all ages as well as significant lack of access to mental health professionals, leads to a recipe for disaster and heartbreak in our youth.
Girls are about twice as likely as boys to report that they have seriously considered or attempted suicide, however boys are more likely to complete a suicide attempt.
Risk factors
There are certain known risk factors for teen suicide that can help parents to recognize at-risk teens.
- Prior suicide attempts
- Depression and other mental health issues (ie – anxiety, PTSD)
- Substance abuse, including alcohol
- Stressful social circumstances and experiences (ie – parental divorce, physical or sexual abuse)
- Bullying, including cyberbullying
- Sexual orientation and gender identity
- Racism
- Exposure to suicide in a friend or family member
- Access to lethal means (ie – guns or weapons in the house, accessible medications)
How to help
There are many ways parents can help teens who are at-risk for suicide.
- Pay attention – note sudden changes in your teen’s behavior. Withdrawing from social circles and activities, from typical family activities, and from school activities are all warning signs that something is going on that needs to be addressed
- Listen – if your teen reaches out to you to talk, be there and truly listen to what they have to say. Try to avoid interjecting with unhelpful statements such as “you don’t really mean that.”
- Monitor social media – at all times, remember that YOU are the parent. Be vigilant about social media risks of bullying and negativity. Monitor sites your teen is visiting online, comments made on their social media accounts, activities they are participating in. Be prepared to take away access to these online platforms if necessary.
- Encourage social activity – spending time with friends and family can have a positive benefit
- Remove lethal means – this is not an article on gun control, but if you have guns in your house LOCK THEM UP. Remove rope and bungee cords. Lock away all medications, even over the counter ones. Keep sharp objects – knives, razors, box cutters – in a safe and hidden location.
- Seek professional help immediately – this may be the Pediatrician if there are concerns for depression but not suicide. If your teen makes comments regarding suicide in any way, he or she should be immediately evaluated in a mental health facility or emergency room. Contact your teen’s Pediatrician for help in where to go.
Suicide hotline
For many years now there has been a national suicide prevention hotline, but in 2022 the number has changed to something very easy to remember and therefore hopefully more accessible. Similar to the three digit emergency number 911, the new Suicide & Crisis Lifeline is toll-free, available 24/7, and three digits long:
988
There are also local resources, prevention centers, and crisis centers available, though these will change based on your location.
Final thoughts
Pediatrics is all about prevention – of illness, of developmental delay, of injuries. Now, more increasingly, we must include prevention of suicide as well. Like all other forms of prevention, this must be a group effort between Pediatricians, parents, patients, and other specialists. Please do not hesitate to reach out for help if you are concerned about your teen.
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