Suicide

Suicide is the second leading cause of death among kids and teens. “According to the most recent data, about 5,000 children and adolescents die by suicide – and those numbers are before the pandemic, which with the pandemic is exacerbating mental health concerns,” said Ravinderpal Singh, MD, a child and adolescent psychiatrist at Inova Kellar Center. “But suicide is preventable.”

The loss of social connection that children and adolescents experienced during the pandemic has had a devastating impact on youth mental health. “As we lost those avenues for social connection during the pandemic, we could see how vital those connections are for kids and teens, more now than we even understood before,” said Shruti Tewari, MD, child and adolescent psychiatrist at Inova Kellar Center. “To underscore the urgency of this issue, the U.S. Surgeon General has called for youth mental health and suicide prevision to be a public health priority.”

What factors put a child or adolescent at greater risk of having suicidal thoughts?

• A family history or personal history of self-harm or suicide attempts

• Adverse childhood experiences – trauma, abuse, financial instability

• Bullying, cyberbullying, isolation, rejection

• Acute loss or grief

• Neurodiversity (not because of the neurodiversity itself, but because of factors like bullying and isolation)

• LGBTQ+ identity (this group is four times as likely to attempt suicide, largely due to factors like discrimination and rejection)

• Access to any lethal means (such as firearms)

• A suicide in a friend group

What are some warning signs of suicidal tendencies to look out for?

• Changes in behavior – verbal expressions of hopelessness, feeling trapped or like the individual can’t go on

• Increase in substance use or other high-risk behaviors

• Increased withdrawal or isolation

• Changes in level of functioning – changes in eating, sleeping, physical appearance, hygiene, drops in grades

• Physical complaints including headaches, stomachaches, fatigue

• Changes in energy among kids who are already depressed – watch for changes in either direction

• Desire to give away belongings, lack of hope for the future, lack of planning for the future

Tips for teen suicide prevention

If you’re concerned about your teen or have noticed worrisome changes, here are some things you can do as a parent:

Ask questions, such as “Have you thought about hurting yourself? Are you feeling sad or depressed?” Although many parents tend to avoid using the word “suicide,” a direct approach is beneficial. “Talking about it directly and using the word ‘suicide’ makes it less shameful and scary for kids to talk about it,” Dr. Tewari said.

Get your child’s pediatrician involved – share your concerns with your child’s primary care provider, who can help with access to mental health supports and resources.

Empathize with your teen. “Kids live in a world that is really different from the one we grew up in,” Dr. Singh said. “They also don’t have the broader perspective that we as adults do, and they can legitimately feel that suicide is the only solution to their problem.”

Get to know your child’s friends – teens who are struggling may share their thoughts with friends first.

Teach your children how to express feelings from an early age – although females are more likely to attempt suicide, males are more likely to complete suicide, so giving both girls and boys the tools to express their feelings is key.

Be intentional about media use – particularly social media, as it can contribute to depression, anxiety, and bullying.

Bolster your child’s community – a feeling of belonging and connection is a major protective factor against suicide. Whether through church, community activities, family, or friends, help your child find community.

Tend to your own mental health – so your child can see a model of good mental health.

How do I know if my teen is in imminent danger of committing suicide?

Signs that a teen is in immediate danger include:

• Expressing suicidal thoughts with a plan and intent

• Communicating suicidal intent to multiple people

• Making threats on social media

If you see any of these signs, Dr. Singh said, “That individual needs immediate evaluation by a professional, either through a community service board or in an ER.”

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