Youth Suicide: The Silent Epidemic Dianne McKissack, MA, LMFT September 2013
O bjectives Participants will be able to identify the difference � between the realities and myths associated with teen suicide. Participants will be able to identify risk factors and � warning signs associated with youth suicide and will be able to implement appropriate interventions. Participants will learn ways to make a difference in their � communities in order to end the silent epidemic of teen suicide. Participants will identify resources to educate the � community and healthcare field about youth suicide prevention. 2
The faces of suicide…. 3
W hy Talk About Suicide? � Suicide doesn’t discriminate by gender, age, race, ethnicity, education, or socioeconomic status. There is no typical suicide victim! � Suicide is the most preventable form of death in the U.S. today. � Arkansas ranks 13 th in the nation in suicide deaths. 4
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W hy Talk About Youth Suicide? � 1 in 5 high school students reported seriously considering suicide (N IMH). � Every 2 hours and 15 minutes a person under the age of 25 completes suicide (N IMH). � IF our children were dying from an illness at this rate, we would be screaming for a vaccine!!! 6
Prevalence of Suicide � According to the NIMH… ◦ 11 th leading cause of death ◦ 3 rd leading cause of death among youths ages 15-24 ◦ 4 th leading cause of death among children ages 10-14 ◦ Every week 100 teenagers commit suicide in the US ◦ More teenagers and young adults died from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, flu, and chronic lung disease COMBINED. Each year as many as 5 to 8 percent of U.S. children and � young adults attempt suicide, according to the U.S. Centers for Disease Control and Prevention. In 2010, 4,867 youths between the ages of 10 and 24 died by suicide, making it the second leading cause of death for people in this age group. 7
Prevalence of Suicide � Research has shown that young females are more likely to attempt suicide; whereas, young males are more likely to commit suicide (NASW ). � The National Institute on Mental Health (2010) reports that more than 90% of people who die by suicide have depression, other mental disorders, or a substance-abuse disorder. � According to a 2012 report from the Centers for Disease Control and Prevention, 13.5 percent of Hispanic female students in grades 9-12 admitted attempting suicide - significantly higher than their black and non-Hispanic peers. 8
Myths versus facts… � MYTH: People who talk about suicide don't complete suicide. � FACT: Many people who die by suicide have given definite warnings to family and friends of their intentions. Always take any comment about suicide seriously . 9
Myths versus facts… � MYTH: Suicide happens without warning. � FACT : Most suicidal people give many clues and warning signs regarding their suicidal intention. 10
Myths versus facts… � MYTH: Asking a depressed person about suicide will push him/her to complete suicide. � FACT: Studies have shown that patients with depression have these ideas and talking about them does not increase the risk of them taking their own life. 11
Myths versus facts… � MYTH: “People who attempt suicide and do not complete suicide are just trying to get attention and are not really serious.” � FACT: N ot true: To a certain degree, they are trying to get attention and help for the pain they are experiencing. A suicide attempt is an attempt to seek help! All attempts should be taken seriously regardless of severity….. 12
Risk Factors � Suicide may occur with one or a combination of risk factors. The greater the risk factors the greater the risk. � Suicide ideation, thoughts, or suicide are not normal responses to stressful events � Depression, mental illness, and substance abuse ◦ O f the suicide completions in youth, 60% suffer from depression. ◦ Alcohol – 50-67% associated with suicide attempts. 13
Elevated Risk in Youth Perfectionists – rigid perfectionism � Learning disabled – twice the emotional distress and � females twice as likely to attempt suicide Loners – usually show signs of being troubled � Low self-esteem – “everyone would be better off without � me” Depressed youth – 60% of those who commit suicide are � clinically depressed Students in trouble � Gay and lesbians – don’t feel safe in schools � Abused children � Alcohol and drug users � Bullied students � 14
Teen Suicide Risk Factors � Anger and aggression – strong connection between interpersonal violence and suicide… � Self-mutilation – cutters � Situational crises – 40% are associated with an identifiable event, i.e. boyfriend breakup � Lack of cohesion in the home � Strong feelings of stress � Struggling with classes – perceive teachers as not understanding them or caring about them � Poor relationships with peers 15
O ther Contributors to Teen Suicide • Social networks – Facebook, twitter • Bullying – According to recent studies, between 20-40% of U.S. teenagers report being bullied three or more times during the past year. • The Internet danger – YouTube � Suicide chat rooms � Instructions on methods � Solicitations for suicide pacts 16
Support for Teens � Teens who turn to school (21%) or community (24%) sources of support and advice are twice as likely to have attempted suicide than teens who turn to family members. � This high rate may be a result of a breakdown in the family networks of troubled teens, who then turn to or are referred to outside sources. 17
Becoming Aware: WARNING SIGNS � Talking about suicide (at any level) or making a plan… “I’d be better off dead!” - “You won’t have me around to pick on!” � Making suicidal gestures… i.e. putting a “finger gun” to their head � Statements about hopelessness, helplessness, or worthlessness � Strong wish to die or preoccupation about death; Hinting at “not being around” in the future… saying goodbye, visiting, calling, or contacting significant people . 18
Becoming Aware: WARNING SIGNS � Displaying symptoms of depression/behavioral changes: moodiness, hopelessness, lack of participation in social interactions/withdrawal, anger, changes in appetite, appearance, dwindling academic performance, not turning in assignments, and relationship problems � Sudden mood swings including moving from a depressed mood to suddenly feeling calmer, happier, and more energetic � Increased alcohol and/or other drug use � Previous suicide attempt � Giving things away 19
Warning Signs of Suicide Mnemonic IS PATH WARM I Ideation Threatening to hurt or kill him/herself or talking of wanting to hurt or kill him/herself Looking for ways to kill him/herself by seeking access to firearms, pills, or other means Talking or writing about death, dying, suicide when these actions are out of the ordinary S Substance Abuse Increase or excessive substance use P Purposelessness No reason for living; no sense of purpose in life A Anxiety Anxiety, agitation, unable to sleep, or sleeping all the time T Trapped Feeing trapped – like there is no way out; resistance to help H Hopelessness Hopelessness about the future W Withdrawal Withdrawing from friends, family ,and society A Anger Rage, uncontrolled anger, seeking revenge R Recklessness Acting reckless, engaging in risky activities, seemingly without thinking M Mood Change Dramatic mood change 20
Mental Healthcare Facts Adolescents with psychopathology who also experience � psychotic symptoms have a nearly 70-fold increased odds of acute suicide attempts, according to new research. This information, the authors noted, may help develop clinical markers for suicide risk and should improve suicide assessment success. The results of the prospective cohort study was published in J AM A Psychiatry (Psychiatric Times, 2013). State governments spend about $900 million dollars per � year on medical costs associated with completed suicides and suicide attempts by individuals up to 20 years old. (N ASW, 2009) 21
Mental Healthcare Facts � Most adolescents considering suicide or who have attempted suicide do not receive specialized mental health services, according to NIMH. � According to NIMH researchers…. Although between 50% and 75% of those teens who reported having suicidal ideation had recent contact with a service provider, most had only three or fewer visits, suggesting that treatment tends to be terminated prematurely. � The study results suggest that risk assessment for suicide should be integrated into routine physical and mental health care for teens and that even if adolescents are in treatment they should continue to be monitored for suicidal ideation and behaviors . 22
Prevention… � A set of four questions that takes emergency department nurses or physicians less than 2 minutes to administer can successfully identify youth at risk for attempting suicide, reported a study by N IMH researchers that was published in the December 2012 issue of the Archives of Pediatrics and Adolescent M edicine. 23
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