Suicide Awareness and Prevention

Jordan Killpack, MA, NCC, CMHC

Adolescence is defined by change, development, growth, and discovery and all too often is a time of angst, anxiety, depression, and struggles to understand one’s self.  In 2014 suicide was the second leading cause of death among young people ages 13-19 (CDC, 2014).

The good news is that overall, America’s child and teen mortality rate is moving in the right direction.  For the year 2015, there were 25 child/teen deaths per 100,000 living in America, representing a 22% decrease since 2005.  However, 74% of children/teens that dies between the ages of 15-19 died due to accident, homicide or suicide. (Annie, 2018).

The current research on suicide awareness and prevention among adolescents points to causes of suicidal distress including psychological, environmental and social factors.  Mental health is the leading risk factor for suicide including depression, substance use disorders, and other mental health disorders. More than 90% of those who die by suicide have one or more of these risk factors.  It is important to note that suicide risk often occurs in combination with external circumstances that may overwhelm at-risk teens who are unable to effectively cope with challenges inherent with adolescence due to predisposing vulnerabilities such as mental health disorders.  Some of the most notable of these factors include disciplinary problems, interpersonal losses, family violence, sexual orientation/identity struggles, and being a victim of bullying (CDC, 2018).

Warning Signs and Symptoms of Suicide and Suicidal Thoughts

The National Institute of Mental Health (NIMH) suggests that understanding the warning signs of suicide is a key component in prevention.  The following are considered warning signs and symptoms that may be present in an individual contemplating or planning suicide:

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty, hopeless, or having no reason to live
• Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun
• Talking about great guilt or shame
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable pain (emotional pain or physical pain)
• Talking about being a burden to others
• Using alcohol or drugs more often
• Acting anxious or agitated
• Withdrawing from family and friends
• Changing eating and/or sleeping habits
• Showing rage or talking about seeking revenge
• Taking great risks that could lead to death, such as driving extremely fast
• Talking or thinking about death often
• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, making a will

Many individuals may have some of the risk factors but do not attempt suicide.  It is important to note that suicide is not a normal response to stressors. Suicidal thoughts or actions are a sign of extreme distress, not a harmless bid for attention, and should not be ignored.

The first line of defense is often family members or friends who are frequently the first to recognize the warning signs of suicide and can be the first step toward helping an at-risk individual find treatment with someone who specializes in the diagnosis and treatment of mental health concerns.

The NIMH suggests the following action steps for helping someone in emotional pain:

1. Ask: “Are you thinking about killing yourself?” It’s not an easy question but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
2. Keep them safe: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal meanscan make a difference.
3. Be there: Listen carefully and learn what the individual is thinking and feeling. Findings suggest acknowledging and talking about suicide may in fact reduce rather than increase suicidal thoughts.
4. Help them connect: Save the National Suicide Prevention Lifeline’s number in your phone so it’s there when you need it: 1-800-273-TALK (8255). You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
5. Stay Connected: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.

Additional, helpful resources/ideas:

Instant access: It may be helpful to save several emergency numbers to your cell phone. The ability to get immediate help for yourself or for a friend can make a difference.

• The phone number for a trusted friend or relative
• The non-emergency number for the local police department
• The Crisis Text Line: 741741
• The National Suicide Prevention Lifeline: 1-800-273-TALK (8255).

Free eBooks and Brochures

• Suicide: A Major, Preventable Mental Health Problem, this fact sheet answers some common questions about suicide and suicide prevention among teens and young adults.
• Suicide in America: Frequently Asked Questions, this brochure covers suicide risk in people of all genders and age groups.
• Understanding Suicide,a fact sheet from the Centers for Disease Control and Prevention

Treatments and Therapies

Research has shown that there are multiple risk factors for suicide and that these factors may vary with age, gender, physical and mental well-being, and with individual experiences. Treatments and therapies for people with suicidal thoughts or actions will vary as well. NIMH has focused research on strategies that have worked well for mental health conditions related to suicide such as depression and anxiety.

Psychotherapies

Multiple types of psychosocial interventions have been found to be beneficial for individuals who have attempted suicide. These types of interventions may prevent someone from making another attempt. Psychotherapy, or “talk therapy,” is one type of psychosocial intervention and can effectively reduce suicide risk.

One type of psychotherapy is called cognitive behavioral therapy (CBT). CBT can help people learn new ways of dealing with stressful experiences through training. CBT helps individuals recognize their own thought patterns and consider alternative actions when thoughts of suicide arise.

Another type of psychotherapy, called dialectical behavior therapy (DBT), has been shown to reduce the rate of suicide among people with borderline personality disorder, a serious mental illness characterized by unstable moods, relationships, self-image, and behavior. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations.

NIMH’s Find Help for Mental Illnesses page can help you locate a mental health provider in your area.

Medication

Some individuals at risk for suicide might benefit from medication. Doctors and patients can work together to find the best medication or medication combination, as well as the right dose (NIMH, 2018).

References

Annie E. Casey Foundation (2018) America’s child and teen mortality rate is moving in the right direction. Retrieved from https://www.aecf.org/blog/americas-child-and-teen-mortality-rate-is-moving-in-right-direction/?gclid=EAIaIQobChMIyqX82ICQ3QIVxVx-Ch0svw5tEAAYAiAAEgL0ovD_BwE

Beautrais, A. (2005). National strategies for the reduction and prevention of suicide. Crisis: The Journal of Crisis Intervention and Suicide Prevention.26(1);1-3

Centers for Disease Control and Prevention (2014). Leading causes of death reports, national and regional, 1999–2014. Retrieved from webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html

National Institute of Mental Health (2018).  Suicide Prevention. Retreived from https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml