A Call to Action: Suicide Prevention

By Jessica Luevano

I worked as a crisis counselor on a suicide prevention crisis line for almost three-and-a-half years. What I found to be frustrating was the lack of services available to individuals with suicidal ideation.

Although I could provide an ear and kind words to the individuals who would call our line, I knew that when they got off the phone with me they would still have to deal with overwhelming stressors and lack of support from anywhere else. Furthermore, stigma continues to be a barrier even to be able to share these dark feelings. I felt particularly concerned about the youth and compelled to get the data of adolescent suicide attempters out to the community.

Statement of the Problem

According to the American Association of Suicidology (2008), every 131 minutes a person under the age of 25 successfully completes suicide: approximately 12 youth suicides each day. In the United States, suicide is the third leading cause of death for young people aged 15 to 24 (CDC, 2007). This has proved to be a very serious public health problem, with 4,600 youth lives lost each year (CDC, 2007).

However, this outstanding number of deaths is not the only problem; many more youth survive suicide attempts than successfully complete the act (CDC, 2007). A national survey of youth in grades 9 to 12 in public and private schools in the United States conducted by the Centers for Disease Control (CDC) shows that in 2007, 16 percent of students reported seriously considering suicide, 13 percent reported creating a plan, and 8 percent reported trying to take their own life in the 12 months preceding the survey.

With history of previous suicide attempts noted as a major risk factor for young people, the development of suicide prevention programs specifically for those who have previously attempted appears significant in addressing the public health problem before us. According to the American Foundation for Suicide Prevention (2012), 20 to 50 percent of people who kill themselves had previously attempted suicide. This reveals how those who have previously attempted suicide are at a much greater risk of successfully taking their lives. The stigma of suicide has made it uncomfortable for many people to speak openly about the topic and this is no different for adolescents. Even with a steady increase of reported youth suicide deaths and attempts over the decades, very few outlets exist for adolescents to be able to discuss their thoughts and feelings in regards to the topic without scrutiny. Support is one of the most important aspects of suicide prevention for all age groups. Experiencing a group that provides a forum for the discussion of this topic and for peer support would assist in breaking through the stigma and allow adolescents other available options for coping.

Although there is not much research on effective interventions for suicidal adolescents, a study of adolescents who had made repeat suicide attempts revealed that group treatment involving interpersonal therapy, cognitive therapy, and dialectical behavior therapy can be effective in reducing the occurrence of reattempts (Wood et al., 2001). Furthermore, educating young people about how to identify and effectively respond to triggers that initiate the suicidal ideation allows for the implementation of a safety plan to avoid attempts in the future. Many people attempt suicide because they believe it is the only option they have.

Adolescent Suicide Attempt Survivors

Vander Stoep et al. (2011) studied co-occurring depression and conduct disorder in a community sample of adolescents and its relationship with risk for subsequent suicidal ideation and behavior of these individuals. A community sample of 521 sixth graders who self-reported symptoms of depression and conduct disorder were evaluated. Over the course of the next couple of years — from 6th to 8th grade — these children would receive in-home assessments every six months to track their suicidal thoughts and behaviors. Consistent with their hypothesis, the researchers found that compared to adolescents presenting with symptoms of depression only, conduct problems only, or low psychopathology, those with co-occurring depression and conduct problem symptoms had the highest risk of suicidal ideation, recurrent suicidal behavior, and suicide attempts in the future. According to the researchers, the results of the study suggest that knowledge of an adolescent’s status in regard to symptoms of depression and conduct problems could help identify a high-risk subgroup. Furthermore, it suggests that once these adolescents with presenting symptoms for both are identified, it becomes very important, in treatment, for clinicians to make systematic, periodic assessments for suicide ideation.

Skarbø, Rosenvinge, and Holte (2006) researched the relationship between alcohol problems, mental disorder and mental health among suicide attempters years after treatment by child and adolescent outpatient psychiatry. The study included former patients who received emergency treatment in child and adolescent outpatient clinics for mental health problems. These patients were then interviewed five to nine years after this treatment and completed questionnaires about indicators of mental health. The researchers found that mental health status and mental health at the follow-up differed between individuals who had attempted suicide attempts in the follow-up period, those reporting one or several lifetime suicide attempts, and whether or not those with a suicide attempt reported intent to die. Particularly, at the follow-up, the attempters had more alcohol problems and more mental disorders than the non-attempters. These findings reveal how essential assessment is in providing effective treatment.

Jessica Luevano is an MSW Candidate, California State University, Long Beach. She can be reached at jluevano4@gmail.com.

References

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2007) Web-based Injury Statistics Query and Reporting System (WISQARS). Retrieved from www.cdc.gov/ncipc/wisqars.

American Association of Suicidology. (2008) Youth Suicide Fact Sheet. Retrieved from www.suicidology.org.

American Foundation for Suicide Prevention. (2012) Risk Factors for Suicide. Retrieved from www.asfp.org.

Skarbø, T., Rosenvinge, J. H., & Holte, A. (2006). Alcohol problems, mental disorder and mental health among suicide attempters 5–9 years after treatment by child and adolescent outpatient psychiatry. Nordic Journal of Psychiatry, 60(5), 351-358.

Vander Stoep, A., Adrian, M., Mc Cauley, E., Crowell, S. E., Stone, A., & Flynn, C. (2011). Risk for Suicidal Ideation and Suicide Attempts Associated with Co-occurring Depression and Conduct Problems in Early Adolescence. Suicide & Life-Threatening Behavior, 41(3), 316-329.

Wood, A., Trainor, G., Rothwell, J., Moore, A., & Harrington, R. (2001). Randomized Trial of a Group Therapy for Repeated Deliberate Self-harm in Adolescents. J Am Acad Child Adolesc Psychiatry 40:1246-1253.