Youth suicide is a serious issue with the highest rates among boys and girls. Teens who die by suicide often exhibit warning signs such as sudden irritability or sadness, changes in sleeping habits, withdrawal from friends and family members, and preoccupation with thoughts of death and suicide.
Many youths at risk of suicide have access to lethal substances and objects. To reduce suicide risks, limit access to guns and other weapons in the home.
Risk Factors
Adolescents experiencing a traumatic injury or other life adversity are at increased risk for suicidal thoughts and behaviors. In fact, adolescent suicide rates are 40% higher in trauma centers compared to non-trauma center hospitals [45].
A history of mental health disorders, particularly depression and post-traumatic stress disorder (PTSD), is also an important risk factor for adolescent suicide. Other risk factors include prior suicide attempts and the severity of current ideation. Other community-level risk factors include rural communities and the presence of firearms in homes, which can increase risk for adolescent suicide [26].
Family dynamics can also impact suicide behavior. For example, research indicates that compensated family functioning is associated with a decreased risk for suicidal behaviors in adolescents, while depressed symptoms in adolescents who live in dysfunctional families have a higher rate of suicide attempts [81]. In addition, previous studies have shown that high parental bonding and affection are protective against suicide behavior in teens.
Symptoms
Suicide is rarely a spur-of-the-moment decision, and young people often show warning signs. These include:
Changes in school performance, work habits, friendships and social withdrawal. Increasing absenteeism from family activities, increased sleeplessness and changes in appetite. A sudden interest in death and suicide, with themes appearing in classroom drawings and work samples. Giving away personal items for no apparent, logical reason. Frequently complaining of physical symptoms, such as stomachaches and headaches that do not respond to treatment; drinking or drug abuse; frequent arguments with family members; a desire to isolate from others; and a history of depression, anxiety or trauma are all risk factors.
Any young person who expresses suicidal thoughts, behaviors or plans should be taken seriously and evaluated by a mental health professional. Lehigh Valley Reilly Children’s Hospital child and adolescent psychiatrists can assess the risks and provide an evaluation and care plan. A psychiatric evaluation is especially important for those who have had previous suicide attempts.
Treatment
In addition to reducing risk factors, there are many things that can help to prevent suicide in youth. These include promoting mental health, education and awareness, training gatekeepers in different domains of life (i.e., teachers, coaches, community leaders, and parents), limiting access to means of suicide and providing support after a suicide attempt.
If a teenager makes a threat to kill themselves, it should be taken seriously. It is important to get them expert help right away.
Some warning signs to look for are a sudden extreme elevation of mood, giving away treasured possessions or asking for their parents to go out so they can carry out their threat, agitation or a pattern of sleeplessness. These can be symptoms of a severe psychiatric illness such as psychosis, schizophrenia or bipolar disorder. These can be treated with medication, therapy or a hospital stay. Often it is best to treat the underlying condition before trying to prevent a suicide attempt.
Prevention
Many of the prevention strategies that work to reduce suicide among adults can be applied to youth. This includes screening for suicide risk in all ED settings and better linkage to care after discharge, including screening for depression and other mental health conditions.
Educators and community leaders can help prevent youth suicide by promoting awareness, taking action and encouraging others to do the same. They can also help by recognizing the warning signs and knowing what to do when someone demonstrates them.
Take any suicidal thoughts or behavior seriously, no matter what the person says. If they say they are going to kill themselves, they need a medical checkup to rule out life threatening physical problems and then a mental health evaluation and treatment until the person is stable. Treatment usually involves hospitalization to allow for close supervision and monitoring of symptoms. This may include family therapy as well. This often helps the young person to rethink their thoughts and behaviors.