Suicide among adolescents: general overview
According to the generally accepted definition, suicide is considered to be “a fatal self-injurious act with some evidence of intent to die” (Bilsen, 2018). Nowadays, it is the second most prevalent cause of death among adolescents in the US and worldwide, accounting for about 800,000 lives globally (Purmand et al., 2018). Among young people, this issue becomes especially acute due to several factors. The substantial changes occurring with the transition from high school to college or university, along with the experience of first romantic relations, often lead to significant stresses. Under these circumstances, a teenager needs support and understanding, which they do not always get. Moreover, sometimes excessive expectations may result in additional pressure and make a person feel hopeless and unable to find a way out.
Suicide rates on the rise
As it was already mentioned, suicide is the second leading death cause for US adolescents. Moreover, its rates are alarmingly rising. According to the US Centers for Disease Control and Prevention, suicide rates had been gradually decreasing up to 2007 (Curtin & Heron, 2019). Then, the trend changed completely. By 2017, the suicide rate among teenagers aged 15-19 increased by 67%, and the same rate for the ones aged 10-14 almost tripled (Curtin & Heron, 2019). Besides, the figures on suicide attempts are even more dramatic. According to the Youth Risk Behavior Surveillance for 2017, 17.2% of students seriously considered suicide, and 7.4% of students actually attempted to commit it (U.S. Department of Health and Human Services Centers for Disease Control and Prevention, 2018).
Additional important statistics
Rounding up the statistical part of this presentation, it is worth saying a few words about the highest risk groups and main suicide methods. The surveys show that suicide ideas are twice as popular among girls as boys, but boys have three times as many finally lethal cases as girls do. This results from girls choosing less-lethal methods to attempt suicide. In addition, the popularity of suicide ideas among sexual minority teenagers is more than two times higher than among the average ones. As for the methods, the most popular ones are suffocation and the use of firearms. This shows the importance of firearms control as one of the possible ways to reduce suicide.
Key suicide factors
A suicide attempt can be caused by a number of factors, or often a combination of several of them. Some of the factors are common among all age groups, and some are specific for young people and related to their particular environment. From a general point of view, most of the causes can be attributed either to mental factors, family factors, or factors related to school and social environment.
Mental and personality factors
Most researchers currently agree that suicide ideation is often linked to certain personality features and even mental disorders. In about 90% of suicides, a mental disorder is found to be one of the contributing factors (Bilsen, 2018). The most common one among such mental disorders is depression. Another factor commonly contributing to suicide cases is alcohol and drug abuse, which is especially common among older males. However, in addition to the mental disorders that require specialized treatment in many cases, it is worth mentioning impulsivity as a personality trait common for many suicides. While for adults, the decision to commit suicide is usually a well-thought one; for teenagers, it may be a result of strong emotions a person can not control. Therefore, impulsivity should be among the key indicators in assessing suicide risk.
Family factors
The previous group of factors mainly dealt with the aspects which define a person’s susceptibility to suicide. But the question of whether they will commit it or not largely depends on social and life matters. The first and foremost of them deals with the family surrounding. Research shows that severe conflicts with parents are found preceding about 40% of suicide cases. However, not only direct conflicts but also a lack of communication and parents’ failure to give the necessary emotional support can have a significant impact. In addition, teenagers from families with cases of home violence, substance abuse, etc., are the ones belonging to the high-risk group. They require special attention from their friends, schoolmates, teachers, and health specialists.
Social and school factors
Unfortunately, school and social environment nowadays also largely contribute to the rising suicide rates. One of the characteristic phenomena of today’s school life is bullying. This includes both direct physical or verbal influence and assaults via the internet known as cyber-bullying. As the Youth Risk Behavior Surveillance shows, 19% of students got bullied during the preceding school year, and almost 7% had to miss at least one school day due to safety concerns (U.S. Department of Health and Human Services Centers for Disease Control and Prevention, 2018). Research proves that bullying has a direct correlation with significant psychological consequences and even suicides. Another current trend is the promotion of suicide on the internet. The stories of suicides committed by celebrities quickly become popular on social media and often result in numerous subsequent suicide attempts among teenagers. Besides, there are many pro-suicide groups and forums detailing suicide methods. A recent study shows that from 2007 till 2014 “the number of websites that included information on suicide methodology tripled, whereas websites designed to provide support to those contemplating suicide decreased by half” (Pourmand, 2018).
What can a health care advocate do?
So, the data given before paints quite a grim picture. A logical question is what a health advocate can do to improve the situation. The role of a health care advocate covers main aspects which are identifying the problem and trying to mitigate it both on a personal level and in society. These aspects will be further detailed in the following slides.
On-time identification of the problem
As for any health issue, the task of solving it starts with diagnosing a problem. In the case of suicide, it may be quite tricky, as sometimes people do not notice anything until the outcome occurs. So, waiting is not an option, and health care advocates must behave proactively in searching for alarming symptoms, especially among the mentioned high-risk groups. This includes interviewing students looking for mood disorders, possible cases of substance dependence, and acute stresses and problems. Such interviews should also involve speaking about the general situation in school and the community. Additional information should be received from parents and relatives to get a more detailed picture. In addition, fully confidential helplines should be available for students, where they can leave their complaints.
Social problem mitigation ways
After the problem is detected, the next step for a health care advocate is to find ways to deal with it. This should usually start with conversations with family and school teachers and management. Any cases of bullying or psychological pressure should be excluded. Proactively engaging the susceptible person in social activities may also be very helpful. In most cases, relieving the acute stresses helps to resolve the issue. Additionally, the work in this direction should cover some general influence aspects such as monitoring websites for suicide-promoting content. Finally, advocating for imposing restrictions on gun possession, especially for families with substance abuse problems, could largely affect the availability of firearms, which are used in over 40% of suicides, as seen before.
Medication as a last resort
Unfortunately, in some cases, the solutions mentioned above may be insufficient. In the case of adolescents with previous suicide attempts and severe unresolved issues, as well as the ones showing signs of serious mental disorders, specialized care may be required. The work of a health care advocate is to timely detect the need for it and forward the person to the appropriate doctor. High-risk cases may require hospitalization where the full psychiatric assessment will be conducted under a controlled environment, and the relevant treatment will be provided. It should be noted that uncontrolled use of antidepressant medications is strongly discouraged as they may even increase the likelihood of suicide.
References
Bilsen, J. (2018). Suicide and youth: risk factors. Frontiers in Psychiatry, 9(540), 1–5. Web.
Curtin, S., & Heron, M. (2019). Death Rates Due to Suicide and Homicide Among Persons Aged 10–24: United States, 2000–2017 [Data set]. U.S.
Department of Health and Human Services Centers for Disease Control and Prevention. Web.
Pourmand, A., Roberson, J., Caggiula, A., Monsalve, N., Rahimi, M., & Torres-Llenza, V. (2018). Social media and suicide: a review of technology-based epidemiology and risk assessment. Telemedicine and e-Health, 25(10), 1–9. Web.
U.S. Department of Health and Human Services Centers for Disease Control and Prevention. (2018). Youth risk behavior surveillance – United States, 2017. Web.Â