Here are a few numbers we need to reckon with: the number of suicide deaths among people aged 15-24 years and over 36 years in the United States.
As you can see in this graph After a sharp decline in the late 1990s, the number of suicide deaths among young people (measured in deaths per 100,000 people) increased, according to the Centers for Control and Disease prevention by 2008, reaching a new high in 2017.
Lately, suicide rates have increased in nearly all US states across all age groups. However, the epidemic of juvenile suicide is particularly severe even for experts who deal with it.
There are many hypotheses about what drives him around. These include the changing ways in which young people interact in digital spaces, economic stress and the consequences of the 2008 recession, increasing social isolation, suicide bullying and the fact that teenagers can more easily search for suicide methods online.
Two other enormous public health problems of our time also play a role. Children of opioid users seem to be at higher risk of suicide. The same applies to young people who live with a weapon in a house.
But the bottom line is that nobody really knows why. However, this does not mean that further suicides can not be prevented.
For one of the most common causes of death (suicide is the second most common cause of death among adolescents, tenth overall), research on suicide prevention policy is not as solid and financially secure as one might hope. Of 295 disease research areas managed by the National Institutes of Health Funds, suicide prevention in 2018 ranked 206th. The study of the West Nile virus, in which about 137 people die annually, is higher.
But I've talked to several mental health researchers, and they all say we do not need to know the exact causes of teenage suicide trends to help.
These solutions are not easy: some require political momentum that the country may not be able to muster. But I've found that there are many concrete ways parents, psychologists and schools can help. Importantly, there are also political solutions that could potentially help.
But first, I think it useful to analyze the events.
Suicide deaths are just the tip of the iceberg.
Suicide is a topic that is difficult to write about.
And it's not just the pain and grief that comes with thinking about so much loss. This is because we can potentially aggravate the problem if we do not write carefully about it. (In fact, you may have seen a current example: There are some inconclusive research that Netflix has shown .13 Reasons why caused more children to commit suicide by presumably glorifying and normalizing it .)
So that's why it's important to make it clear: Suicide rates are rising does not mean that suicide is normal or usual. (If you learn that suicide is "normal", it makes you feel better.) It's still rare. In 2017, 6,241 suicide cases occurred in people aged 15 to 24 years. Most of them were men, but more and more young women are dying this way.
Overall, according to the CDC, about 16 percent of adolescents consider suicide at a given year. "This is an epidemic," says Mitch Prinstein, director of clinical psychology at the University of North Carolina, Chapel Hill. And death is just the tip of a sad iceberg. Among them is a rising tide of pain in young people.
The number of teenagers diagnosed with clinical depression increased by 37 percent between 2005 and 2014. Suicide attempts that are not always fatal are also increasing. Here is a disturbing example. A recent study published in the Journal of Pediatrics estimated that by 2018, nearly 60,000 girls aged 10 to 18 years were trying to poison themselves. In 2008 there were almost 30,000. Very few of these poisonings were deadly, but they represent a tremendous amount of emotional trauma.
"We see much more children with mental health problems in schools, be it anxiety, trauma, depression, eating disorders, emotional difficulties, much more." says James Mazza, a youth suicide murder investigator at the University of Washington. "Few of them will die because of suicide. … Our schools need to focus more on mental wellbeing or teach children and adolescents skills to deal with the emotional desegregation they experience during puberty.
So, how to act?
I'm sure the following solutions are not exhaustive, instead they were mentioned most frequently and most extensively in my discussions, and they seem to have the most robust research that their
Restricting access to weapons and drugs can clearly prevent suicide.
The most outspoken and far-reaching policy tool for reducing suicide deaths is least used: limiting access to deadly means People can not access tools such as firearms and drugs to harm themselves, there are fewer deaths.
In the United States, that means gun control.
We hear a lot in the news about how weapons incidents of mass murder or Manslaughter but weapons are more common every year involved in suicides as in murders. "Adolescents who live in a house with access to a firearm are much more likely to die of suicide," says Jonathan Singer, president of the American Association of Suicidology and a professor of sociology at Loyola University Chicago.
There is good evidence that stricter arms control on suicide would save lives.
After New Zealand passed strict arms control laws in 1992, "suicides related to firearms, especially among adolescents, fell significantly," a 2006 study found. Rates dropped from four to 100,000 in the 15- to 24-year age range late 1980s to about one in 100,000 in the early 2000s. (Overall, research has shown that suicides are not counterbalanced by suicide by other deadly means in a decline in suicides.)
"As a measure at the population level, limiting access to firearms is one of the best solutions," says Singer. "Does the country want to do that? No.
Another simpler option is the so-called "lethal restriction counseling" for families with a child who may be at risk of suicide. This consultation, which usually takes place after a psychiatric emergency in a hospital, involves discussing with parents how much access their children have to firearms or poison and then suggesting ways to make their homes safer.
Yet many children (perhaps more than half, according to a study) are released from hospital without their families receiving such counseling. And many are fired into homes containing deadly drugs and firearms.
Restricting access to lethal drugs not only restricts access to firearms. This could also mean restricting access to lethal medicines.
Confronting the opioid epidemic could reduce access to pills to potentially overdose. Taking home opioids alone – which are prescribed to each family member – is associated with an increased risk of overdose.
However, it's not just prescription drugs that are potentially dangerous. Research has shown that it would also be helpful to change the packaging of certain over-the-counter medicines. In the UK, when a popular over-the-counter painkiller in blister packs (in which the pills need to be taken out one at a time) was repackaged instead of bottles (making it easy to pour out many pills at once), the following resulted in fewer deaths from overdosage by this drug.
Although these measures would save lives, according to Singer, they do not necessarily contribute to people feeling they have a "livable life."
But there are some possible interventions too.
Just asking a teenager if he feels suicidal can help.
Perhaps the most obvious place to implement measures to save the lives of teens is the school.
For teenagers, "one-third of their day is spent in the classroom," says Samuel Brinton, director of advocacy and government affairs at the Trevor Project. "Teachers are most likely to have the opportunity to recognize the warning signs and intervene appropriately," he says.
Ideally, schools would have three levels of prevention programs: programs that help to prevent suicide in the student body; programs to detect and intervene in children; and strategies to deal with the consequences of suicide or tragedy in a school To help children deal with it and to make sure they do not commit suicide.
Is there a perfect standard program for all these areas? Unfortunately, not. "There is no program," says Jane Pearson, chair of the Suicide Research Consortium at the National Institute of Mental Health. "The field is trying to figure out how to put these things together and what's efficient for schools."
That said, it can be helpful to simply ask the children if they feel right and to investigate suicide.
"There has long been a myth that the mere question of a child's suicide could put an idea in the head and increase the risk," says Prinstein. "And we now know that this is completely wrong."
Screening teenagers asks them direct questions: Have you been feeling saddened for more days than ever in the last few weeks? Did you ever wish you were dead? Have you been thinking about ending your own life in the last few weeks?
Adolescents answering "yes" may be advised of additional counseling (in particular, dialectical behavioral therapy seems to be useful to help people deal with suicidal thoughts). A study examining screenings in a group of more than 1,000 ninth-graders in Connecticut found that such screening combined with mental health education could reduce the number of suicide attempts over the next three months.
"Well, that's just one study," says Singer. "One of the challenges of talking about" Well, what is the evidence, what is the data? It's time to develop programs, it takes time for school districts to be ready to do something that has no evidence base, and then it takes time and money to do that Getting research that proves it works or that it works does not work. "
Training as a gatekeeper can help teachers identify needy students.
So many people who die from suicide had no contact with them Schools can be a way to fill some of the gaps.
But it's a challenge, one hurdle is that the schools are run locally, each district needs to implement the programs individually, and unfortunately, not all school districts have that Money or the resources for it, and it may be that not all parents are satisfied with the idea that their schools are asking their children for suicide States have laws that require suicide prevention training for schools and staff, but not all. Here, teachers and school staff are trained to detect and recognize vulnerable students and receive further guidance.
There is indeed some good nationwide data on the training of gatekeepers, thanks to a law called the Garrett Lee Smith State / Tribal Youth Suicide Prevention and Early Intervention Grant Program, suicide in 2003. The program provides grants, with schools can use many types of suicide prevention programs.
Overall, the program seems to have helped, regardless of what the schools spend the money on. "Studies have shown that districts receiving these grants had a lower rate of suicide attempts among juveniles and deaths from suicide than districts that did not receive funding," states a recent review by the American Psychological Association.
But, in particular, data from the Garrett Lee Smith scholarships show that the number of suicide cases and attempts has dropped by one year in countries where gatekeeper training has been conducted. "Unfortunately," a recent Current Opinion in Psychology review of evidence for suicide prevention claims, "the effects were not sustained; suicide rates and suicide attempts did not differ … two years after training."
This means that additional, ongoing training may be required or that it may be difficult to remain vigilant over such a long period of time. Again, the research is not a perfect answer. But it is at least optimistic.
Again, there are other ways to intervene. And no single intervention needs to be used in isolation. Schools should also know that there is research showing that a mere homosexual alliance – a club that promotes the inclusion of LGBTQ youth in schools and generally safe spaces for everyone – the suicidal risk of both LGBTQ identified teenagers (the it may decrease) with a higher suicide risk than peers) and those who do not. Which shows that inclusive, supportive environments are important.
Parents and adults in communities may be authorized to act.
Policies do not have to be just for young people. They could also address their parents and other adults in communities to form safety nets.
"All parents should talk about suicide with their child," says Prinstein.
Kathryn Gordon, a clinical psychologist and researcher who recently gave up her academic career for a private practice, says parents can learn to "listen without judgment." Just listening, she says, can be a first step.
As a parent, she says, it's easy to want to solve the problem immediately. "But children often see this as dismissive or unpleasant [ing]," she says. "When you are open-minded and listening, children and adolescents can often start to solve problems themselves or they will ask for help."
One of the most hopeful studies – which could possibly influence politics – The Recently Published Suicide prevention study has recently shown that adults can actually make a difference in saving lives, although the results may not be immediately visible.
The study involved adolescents who had been taken to the hospital after suicide attempts. These adolescents were asked to nominate up to four caring adults, who were then trained to talk to suicidal adolescents and ensure that they follow the treatment. After personal training, adults received several months of phone support to meet the challenges of a troubled teenager.
More than a decade after the intervention, the researchers re-examined their problems by looking at death certificates. It turned out that the adolescents who received the interventions more than a decade ago were less likely to die. "To our knowledge, no other intervention in suicidal adolescents has been associated with reduced mortality," the authors of the study wrote. The results were modest and must be repeated.
Cheryl King, a researcher on suicide prevention at the University of Michigan who conducted the intervention, suggests the children have nominated the adults. Maybe that's what makes them think about the connections they have with others – and opens a door to strengthen them.
The intervention also causes adults – not all parents of the child – to be more proactive. "The truth is, it's not easy for grown-ups to go there, turn around, talk to them, and try to help suicidal teenagers," says King. "We have always asserted that their role is only to be a caring person and that they are not responsible for the decisions of the adolescents." Perhaps more programs could address parents and adults in the community to better protect the youth.
Overall, I think the lesson is easy. Teenagers can be reminded that there are people in their lives who take care of them. They feel at home, at school, or ideally wherever they go. And it can help.