Pathways to prevention
Over the last three decades, the suicide rate for all Americans has been rising slightly. However, among American teenagers, the rate of suicide is increasing far more rapidly and dramatically. According to the Centers for Disease Control (CDC) teen suicide increased by nearly two percent over a twenty-four month period. Furthermore, not only is the rate of suicide increasing but thoughts of suicide by teens are on the rise. Of the teens surveyed by the CDC, 15.8 percent indicated they had seriously considered suicide, up from 13.8 percent two years earlier. Today, suicide is the third leading cause of death for 15-24 year olds and is the second leading cause of death among college students. Even though the trend alarming, it is one which can be reversed. Suicide is a preventable cause of death.
Here are ten pathways to prevention which parents and other significant adults in the life of a teenager can use to guide and support a desperate young person.
- Recognize the warning signs of depression. Nearly 6,000 teenagers end their lives each year. It is the third leading cause of death among teenagers. Key issues of teen stress are family discord, separation or divorce, excessive academic and social pressures; a painful loss such as a relationship break-up, the death of someone close, relocating to a different city. These stresses can trigger deep depression. As a significant adult in the life of a teenager, be on the alert for the warning signs of depression. Mental health professionals identify the following as some key signs that a person is severely depressed: Sleeping more or less than usual. Eating less or more than normal. Feeling restless and agitated. Having trouble concentrating or making decisions. Easily hurt feelings; crying a lot. Abusing alcohol and other drugs. Losing interest in activities which used to bring pleasure. Persistent sad, anxious or “empty” mood. Feelings of pessimism, hopelessness. Decreased energy, fatigue, being “slowed down.” Feelings of worthlessness, guilt, helplessness.
- Listen compassionately. When teens are stressed and hurting, they need and want to talk. Be an adult whom your children or your children’s friends can speak with. Be willing to listen. Your listening will be therapeutic and can save a life. At a funeral service for a young man who ended his life by suicide, the boy’s mother pleaded with the young people in attendance to “please talk to someone, anyone, if something was bothering them.” She also challenged adults to “sit down with their children and ask what’s happening in their lives. If the children are troubled about something and don’t want to discuss it, they should be encouraged to speak with a teacher, minister, rabbi, priest, relative, friend - someone - so they can get help in resolving whatever conflicts they are experiencing.”
- Be direct. If you suspect a teen is contemplating suicide, don’t hesitate to ask directly, “Are you thinking about committing suicide?” That opens the door for a depressed teen to respond honestly and share how they are feeling. A recent study published by the National Institute of Mental Health, identified the four best questions to ask teenagers at risk for suicide: i) In the past few weeks, have you felt that you or your family would be better off if you were dead? ii) In the past few weeks, have you wished you were dead? iii) In the past week, have you been having thoughts about killing yourself? iv) Have you ever tried to kill your self. Don’t buy into the myth that talking about suicide will only make a person more likely to do it. Not talking about suicide is what often pushes a person over the edge because not talking is what bottles up the depression, isolation, loneliness and fear. Talking openly and honestly allows the person to get the feelings out resulting in experiencing comfort, relief and hope.
- Believe it. When a teenager indicates they have suicidal feelings, believe it. In his book, Suicide, Rabbi Earl Grollman offers this wisdom: “Accept the possibility that the person may really be suicidal. Don’t assume that she or he isn’t the ‘type’ or ‘really wouldn’t do it.’ The temptation is to deny the possibility that someone you care about would take his or her life. But that’s how thousands of people - of all ages and races and economic groups - commit suicide. And, don’t allow others to mislead you into ignoring a suicidal situation. If you believe someone is in danger of taking a life, act on your own judgment. The danger that you might be embarrassed by overreacting is nothing compared to the danger that someone might die because you failed to intervene.”
- Respond gently and with compassion. When listening to a teenager who may be suicidal, respond with gentleness and compassion. Treat him or her the way you would want to be treated if you were severely depressed and feeling hopeless. Don’t criticize or argue. For example, rather than responding to a young person by saying “You’ve got to be kidding. You’re going to kill yourself because your math scores are low?” a better response is to say: “Let’s talk about solutions other than suicide.” Similarly, never argue with a suicidal teenager. That young person is already at an emotional breaking point and needs a friend, not an adversary. Do all you can to communicate friendship, understanding and caring.
- Avoid expressing shock and disapproval. “Saying something like How can you feel that way? or But suicide is a sin! will probably only make the person feel worse,” note authors Bernard Frankel, PhD., and Rachel Kranz in their book Straight Talk About Teenage Suicide. “No one chooses suicide because they think it’s a good idea - they choose it because they feel they have no other choice. They are already more upset that they feel this way than you are, even if they are acting calm and secure.” Rather than expressing shock or disapproval, permitting the person to express his or her feelings is a more constructive approach. Depressed people who can talk about their feelings openly and honestly often find the intensity of their emotions become defused by the simple sharing of feelings.
- Remind desperate teens they have other choices. Too often, depressed teens conclude they have only one choice, and that is suicide. If you suspect they are thinking about suicide, remind them they have other options. Teen often benefit from the reminder that there are ways to end their pain without ending their lives. The reality is that they have many other choices. They can reach out to people who can help them through the crisis. They can call a hot line, call a friend, call a teacher, call a spiritual leader, call a doctor, call a hospital, call the police.
- Help them see and sense hope. Sadly, suicide is a permanent solution to a temporary problem. If a teen is so troubled, that they say “there’s no hope,” try to balance their negative thinking by stressing the positive. “Yes, I understand you may feel this way now, but perhaps you’ll feel differently later today, or tomorrow or next week. Maybe you’ll receive a phone call which will lift your spirits or a piece of mail which will help you see things differently. Perhaps what you’re needing is just a minute, a week or a month away.”
- Never leave a suicidal teen alone. Once you have determined that a teenager is a high risk for suicide, don’t leave him or her alone. “Stay with the person or ask someone else to stay with him or her until the crisis passes or until help arrives,” says Rabbi Grollman. “It may be necessary to call a hospital emergency room or outpatient clinic.” Once that crisis has passed, Rabbi Grollman, advises entering into a “suicide contract” with the teen. “That means asking the person to promise that she or he will contact you prior to attempting suicide in the future so that the two of you can discuss available alternatives. It may sound strange, but it can be very effective.”
- Get professional help. A key aspect for breaking suicidal thoughts is to get professional aid for a desperate teen. Friends can behelpful and supportive, but often lack expertise and experience. Suicidal teens should be taken for professional help. Good professional adult helpers include: clergy, physicians, psychologist, psychiatrist, and other therapists.
Twelve Suicide Warning Signs
- Suicide threats and/or previous suicide attempts.
- Statements indicating a death wish.
- Pre-occupation with and asking questions about dying.
- Putting affairs in order.
- Giving away personal items.
- Personality changes and unusual behavior.
- Loss of interest in usual activities.
- Withdrawal, isolation, moodiness, anger, crying.
- Statements about feeling hopeless, helpless, worthless.
- Loss of interest in friends.
- Increased alcohol/drug use.