The Hard Reality
In today’s world our youth face tremendous life pressures that put them at risk for a myriad of self-destructive behaviors. Many of our youth lack coping skills or healthy coping skills that can prevent devastating consequences like suicide. Although youth suicide rates have dropped since 1992, it still remains as the third leading cause of death among 10-19 year olds.
Completed suicides are only part of the picture. Other forms of suicidal ideation and behaviors are much more common and typically are exactly the kind of behaviors to watch for. Prevention and intervention in this area should not be taken lightly. It is estimated that for every youth who dies by suicide, 100-200 youth attempt it. Within a typical high school classroom it is likely that at least three students have attempted suicide in the past year. (Poland & Lieberman, 2002)
There are many risk factors that indicate red flags as long as people are educated about them and how to respond. Youth who are contemplating suicide frequently show warning signs of their distress. Parents, teachers, and friends are in a key position to pick up on these signs and get help. Most importantly never take these warning signs lightly or promise to keep them secret. It is better to err on the side of caution. There are some cases where one might just think a student is just asking for attention. Give it to them. I cannot stress this enough. All behaviors have a purpose. The key is to find ways to give them the right kind of attention. In most cases the individual is looking for signs that someone cares or is reaching out for help. Always take it seriously. However, don't overreact either. There is a fine balance here for the helping professionals. If in doubt, refer to whomever in your school is the most trained in mental health supports for students. This is typically your school psychologist, but could also be your school counselor or social worker.
Suicide Warning Signs
Many suicidal youth demonstrate observable behaviors that signal their suicidal thinking. These include:
· Suicide notes. These are a very real sign of danger and should be taken seriously.
· Threats. Threats may be direct statements (“I want to die.” “I am going to kill myself”) or indirect comments (“The world would be better without me”, “Nobody will miss me anyway”). Indirect clues could be offered through joking or through comments in school assignments, particularly creative writing or artwork. Younger children and those who may have some delays in their development may not be able to express their feelings in words, but may provide indirect clues in the form of acting-out, violent behavior, often with threatening or suicidal comments.
· Previous attempts. If a child or teenager has attempted suicide in the past, there is a greater likelihood that he or she will try again.
· Depression (helplessness/hopelessness). When symptoms of depression include strong thoughts of helplessness and hopelessness, a child or adolescent is possibly at greater risk for suicide.
· “Masked” depression. Sometimes risk-taking behaviors can include acts of aggression, gunplay, and alcohol/substance abuse. While some youth may not act “depressed,” their behavior suggests that they are not concerned about their own safety.
· Final arrangements. This behavior may take many forms. In adolescents, it might be giving away prized possessions such as jewelry, clothing, journals or pictures.
· Efforts to hurt oneself. Self-injury behaviors are warning signs for young children as well as teenagers. Common self-destructive behaviors include running into traffic, jumping from heights, and scratching/cutting/marking the body.
· Inability to concentrate or think clearly. Such problems may be reflected in classroom behavior, homework habits, academic performance, household chores, even conversation. If a student starts skipping classes, getting poor grades, acting up in class, forgetting or poorly performing chores around the house or talking in a way that suggests they are having trouble concentrating, these might be signs of stress and risk for suicide.
· Changes in physical habits and appearance. Changes include inability to sleep or sleeping all the time, sudden weight gain or loss, disinterest in appearance or hygiene.
· Sudden changes in personality, friends, behaviors. Parents, teachers and friends are often the best observers of sudden changes in suicidal students. Changes can include withdrawing from friends and family, skipping school or classes, loss of involvement in activities that were once important, and avoiding friends.
· Death and suicidal themes. These might appear in classroom drawings, work samples, journals or homework.
· Plan/method/access. A suicidal child or adolescent may show an increased interest in guns and other weapons, may seem to have increased access to guns, pills, etc., and/or may talk about or hint at a suicide plan. The greater the planning, the greater the potential for suicide.
What to Do
Youth who feel suicidal are not always likely to seek help directly. This is why it is important for parents, school personnel, and peers to be able to recognize the warning signs and take immediate action. When a youth shows signs they may be considering suicide, the following actions should be taken:
- Remain calm.
- Ask the youth directly if he or she is thinking about suicide.
- Focus on your concern for their wellbeing and avoid being accusatory.
- Listen. – This cannot be stressed enough.
- Reassure them that there is help and they will not feel like this forever.
- Do not judge.
- Provide constant supervision. Do not leave the youth alone.
- Remove means for self-harm.
- Get help: School staff should take the student to the designated school mental health professional or administrator. Peers should not agree to keep the suicidal thoughts a secret and instead should tell an adult. Parents should seek help from school or community mental health resources as soon as possible.
