There is a lot that we know about suicide prevention and care for youth. Parents, teachers and coaches, community leaders and many others can make a difference.
Kids who have good problem-solving skills and strong connections to their family, friends and their community are less at risk of suicide.
Risk Factors
In the last decade, suicide deaths and attempts have risen among youths ages 10 to 24.5 These increases are more pronounced in adolescent males and females, American Indian or Alaska Native youth, and those from historically disadvantaged communities that experience social/environmental stressors and discrimination (see Table 1).
Risk factors for suicide include mental health problems like depression or anxiety and drug or alcohol use; having access to lethal means of self-harm, including guns; and a history of past suicide attempts. Other risk factors include family or community conflict, bullying or trouble at school.
Kids with strong connections to family, friends and other supportive people are at lower risk for suicide. They are also more likely to be able to see ways to solve their problems in healthy, non-violent ways. Other protective factors are having good problem-solving abilities, feeling hopeful about the future, and knowing who to talk to about their worries. This clinical report updates a previous Blueprint for Youth Suicide Prevention1 to help health care providers identify and support youth who may be at risk for suicide. The blueprint outlines a 3-tiered pathway for identifying and supporting youth who are at risk, including a brief screen using a validated measure and a brief suicide safety assessment for anyone who screens positive.
Treatment
Despite the challenges, there are treatment options for youth suicide, including psychotherapeutic approaches with documented benefits and effective medication treatments for disorders associated with suicidal thoughts/behaviors. Also, a number of school-, telehealth-, and community-based programs are available for screening and intervention.
Adolescence is a time of intense cognitive, emotional and social change that includes rapid physical growth; conflicts between parental values and expectations and the values of peer group; sexual experimentation; sex changes; and new roles involving education, employment, relationships and living arrangements. These changes often lead to depression and/or suicidal thoughts and behaviors.
Signs that a young person is at risk include being sad or withdrawn, changing sleep patterns, becoming more irritable, expressing more anxiety or anger, and giving away possessions. Unlike adults, young people do not usually “get better” or stop having suicidal feelings. They may, however, feel relief and express relief by improving their activity level or making more frequent requests for food or drink.
Prevention
Adolescents face many developmental tasks that generate stress. They need to come to terms with rapid physical growth; conflict between parental and peer values and ideals; emotional intimacy with the opposite sex; and future career choices. When these stresses are combined with mood disorders, such as depression, suicidal thoughts increase.
In addition, kids who have experienced abuse or violence in their families are more likely to be at risk of suicide. Likewise, separation from loved ones due to death, divorce, military service or loss of stable housing can trigger feelings of hopelessness and despair in some youths.
All suicide threats should be taken seriously, whether made verbally or by comment on social media. A suicide attempt is a clear cry for help and can have fatal consequences, especially if the person uses a lethal substance or weapon. Community prevention strategies include responsible media reporting to minimize sensationalization of suicide; training gatekeepers (such as teachers, doctors and police officers) to recognize warning signs; and promoting healthy coping mechanisms and help-seeking behaviors.
Support
Educating students about suicide prevention can help reduce the risk of youth suicide. Schools are a natural setting to provide education and training for students on how to recognize warning signs of suicide, and where to turn for help when someone is struggling.
School staff should always seek the help of a trained mental health professional when a student expresses suicidal thoughts or behavior. They should ask for a suicide risk assessment, warn and inform parents and provide them with resources.
Supportive relationships and community connectedness can help protect individuals against suicide despite the presence of risk factors in their lives. These supports may include social programs for specific population groups (such as older adults or LGBT youth) and activities that foster emotionally supportive relationships. Family support and cohesiveness, with effective communication and problem-solving skills, is also important. Other important supports are cultural and religious beliefs that discourage suicide, as well as coping and support networks in the community.