Youth Warning Signs
It has been well documented that children exposed to violence, life-threatening events or traumatic losses are at greater risk for depression, alcohol and substance abuse, and suicide. In the aftermath of tragedies such as the terrorist attacks in New York and Washington, students may display warning signs of suicidal behavior. Parents and school personnel should be particularly observant of children and youth who may be more vulnerable because of individual circumstances. This includes youngsters who have experienced a personal loss, abuse, or previous traumatic event or who suffer from depression or other mental illness. Youngsters who have these risk factors and who have been directly impacted by or witnessed the attacks are most vulnerable.
Although many suicidal children and adolescents do not self-refer, they do show warning signs to their peers, parents or trusted school personnel. Never ignore these signs. Suicide can be prevented with proper intervention. Warning signs may not appear during the immediate aftermath of the terrorist attacks. Parents and school personnel must be good listeners and observers over the weeks to come.
Boys commit suicide more often than girls, but no one is immune. In one recent survey of high school students, 60 percent said they had thought about killing themselves. About 9 percent said they had tried at least once.
Why has the youth suicide rate gone so high in recent years?
- It's easier to get the tools for suicide (Boys often use firearms to kill themselves; girls usually use pills);
- the pressures of modern life are greater;
- competition for good grades and college admission is stiff; and
- there's more violence in the newspapers and on television.
Lack of parental interest may be another problem. Many children grow up in divorced households; for others, both of their parents work and their families spend limited time together. According to one study 90 percent of suicidal teen-agers believed their families did not understand them. (However, this is such a common teen-age complaint that other factors are playing a role, too.) Young people also reported that when they tried to tell their parents about their feelings of unhappiness or failure, their mother and father denied or ignored their point of view.
Suicide is rarely a spur of the moment decision. In the days and hours before people kill themselves, there are usually clues and warning signs.
Below are some guidelines for intervening with a suicidal student.
- Suicide notes.These are a very real sign of danger and should be taken seriously.
- Threats. Threats may be direct ("I want to die." "I am going to kill myself") or, unfortunately, indirect ("The world would be better without me," "Nobody will miss me anyway"). In adolescence, indirect clues could be offered through joking or through references in school assignments, particularly creative writing or art pieces. Young children and those who view the world in more concrete terms may not be able to express their feelings in words, but may provide indirect clues in the form of acting-out, violent behavior, often accompanied by suicidal/homicidal threats.
- Previous attempts. Often the best predictor of future behavior is past behavior, which can indicate a coping style.
- Depression (helplessness/hopelessness). When symptoms of depression include pervasive thoughts of helplessness and hopelessness, a child or adolescent is conceivably at greater risk for suicide.
- Masked depression. Risk-taking behaviors can include acts of aggression, gunplay, and alcohol/substance abuse.
- 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-mutilating behaviors occur among children as young as elementary school-age. Common self-destructive behaviors include running into traffic, jumping from heights, and scratching/cutting/marking the body.
- Inability to concentrate or think rationally. Such problems may be reflected in children?s classroom behavior, homework habits, academic performance, household chores, even conversation.
- Changes in physical habits and appearance. Changes include inability to sleep or sleeping all the time, sudden weight gain or loss, disinterest in appearance, hygiene, etc.
- Sudden changes in personality, friends, behaviors. Parents, teachers and peers are often the best observers of sudden changes in suicidal students. Changes can include withdrawing from normal relationships, increased absenteeism in school, loss of involvement in regular interests or activities, and social withdrawal and isolation.
- 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 focus on guns and other weapons, increased access to guns, pills, etc., and/or may talk about or allude to a suicide plan. The greater the planning, the greater the potential.
If your teen-ager has been depressed (also see Youth Depression), you should look closely for signs that he or she might be thinking of suicide:
- Has his personality changed dramatically?
- Is he having trouble with a girlfriend (or, for girls, with a boyfriend)? Or is he having trouble getting along with other friends or with parents? Has he withdrawn from people he used to feel close to?
- Is the quality of his schoolwork going down? Has he failed to live up to his own or someone else's standards (when it comes to school grades, for example)?
- Does he always seem bored, and is he having trouble concentrating?
- Is he acting like a rebel in an unexplained and severe way?
- Is she pregnant and finding it hard to cope with this major life change?
- Has he run away from home?
- Is your teen-ager abusing drugs and/or alcohol?
- Is she complaining of headaches, stomachaches, etc., that may or may not be real?
- Have his eating or sleeping habits changed?
- Has his or her appearance changed for the worse?
- Is he giving away some of his most prized possessions?
- Is he writing notes or poems about death?
- Does he talk about suicide, even jokingly? Has he said things such as, "That's the last straw," "I can't take it anymore," or "Nobody cares about me?" (Threatening to kill oneself precedes four out of five suicidal deaths.)
- Has he tried to commit suicide before?
If you suspect that your teen-ager might be thinking about suicide, do not remain silent.
Suicide is preventable, but you must act quickly.
- Ask your teen-ager about it. Don't be afraid to say the word "suicide." Getting the word out in the open may help your teen-ager think someone has heard his cries for help.
- Reassure him that you love him. Remind him that no matter how awful his problems seem, they can be worked out, and you are willing to help.
- Ask her to talk about her feelings. Listen carefully. Do not dismiss her problems or get angry at her.
- Remove all lethal weapons from your home, including guns, pills, kitchen utensils and ropes.
- Seek professional help. Ask your teen-ager's pediatrician to guide you. A variety of outpatient and hospital-based treatment programs are available.