Amy V. Maus, MSW, LCSW

They are called deaths of despair. Deaths by suicide, alcoholism, and/or drug overdose, especially heroin, are on the rise. Seemingly everywhere one looks these days, there is a new, alarming report from the medical community, a shocking celebrity death, or a tragedy among friends and neighbors. For generations, we have assumed that life expectancy in America would continue to lengthen, buoyed by advances in medical care and improved standards of living. But recent statistics have called that assumption into question – for many groups in states across our country, life expectancy is measurably falling. When examined, it is these deaths of despair driving the declines.

Suicide among American children and adolescents are following a similar pattern. According to the National Center for Health Statistics, after decades of nearly consistent decline, suicide rates have increased steadily from the late 90’s through today among both genders and all ages 10-74. Death by suicide among adolescents and young adults is now the secondleading cause of death in middle school, high school, and college, exceeded only by accidents. Suicide is now responsible for the deaths of more American 10-24 year olds each year than all natural causes combined.

In 2017, the latest year for which full statistics are available, 517 children ages 10-14 died by suicide, as did 2,052 youth ages 14-18. The deaths of 17 children ages 5-10 were ruled intentional suicide that year; even our elementary schools are not immune. Who can forget the death of 8-year-old Gabriel Taye of Cincinnati, whose death made the national news? The boy, found unconscious after being assaulted and bullied in his school restroom, hanged himself to death from his bunk bed two days later.

In all, roughly 29,000 Americans’ deaths were ruled suicide in 1999, compared with over 45,000 per year now. Suicide rates among youth are now growing at about 2% per year and have been doing so since 2007, the year that saw both the Great Recession and the sale of the first smart phones. When considering adolescents, it’s the latter that worries most medical and mental health professionals. Among young people, there is a clear correlation between time spent on social media and rates of depression and anxiety. The devices that claim to connect us seem to have the opposite effect: loneliness. Bullying, sexual harassment and trauma, and the lack of sustaining, intimate social relationships – all of which are associated with youths’ use of smart phones and social media – are also serious risk factors for suicide.

Which youth die by suicide? Although girls attempt suicide two to three times more often than boys, boys complete suicide three to four times more often than girls. The difference is primarily due to the lethality of the method used; males tend to choose more lethal methods. The most frequent suicide method for males involves firearms, while poisoning – medication overdose – is the most frequent method chosen by females. Overall, firearms account for almost 50% of all American suicides.

It is critically important to understand that, of both genders, young people who take their own lives often do so impulsively. The common stereotype of someone who dies by suicide is a person who sinks further and further into depression over time, eventually planning suicide. This, however, is a stereotype for adults. In adolescents, 50% of suicide deaths are believed to be impulsive, after a triggering situation – a romantic break-up, a humiliation online, an academic failure, or similar experience. In these suicides, fewer than ten minutes elapse between the thought and the action of suicide. This means, of course, that access to a lethal method is the determining factor in these situations. The #1 risk factor for adolescent suicide has been the same for over a generation – access to loaded firearms. In the United States, a youth with unsupervised access to a loaded gun is 32 times more likely to die by suicide than a youth without such access.

How can we as parents, educators, and other caring adults protect the young people in our lives, knowing that kids can and do attempt suicide impulsively? Several strategies and protective factors have been found effective:

  • Restrict access to highly lethal means, such as firearms. Simply restricting access saves lives. Suicidologists estimate that gun locks save more adolescent lives each year than do depression screenings.
  • Restrict access to alcohol and drugs. Alcohol use and suicide are highly correlated, in both adolescents and adults. Even youth who do not usually drink will often ingest alcohol prior to a suicide attempt, which impairs judgement and increases impulsivity.
  • If you want to know, ASK. You can never plant the thought of suicide in a youth’s mind by asking if they are thinking of suicide. The most important question that we can ask of a potentially suicidal youth is, “Are you thinking of suicide?”
  • Take all suicide threats seriously. It is a myth that adolescents who talk about suicide just want attention. Nothing could be further from the truth. 80% of youth tell someone about their intentions, directly or indirectly, in the week before a suicide attempt. When friends or classmates report that a peer is posting about suicide or making threats online, family members and school professionals should assume that serious risk exists and take immediate action.
  • Access mental health care that includes suicide assessment. A child who may be at-risk for suicide needs immediate suicide risk assessment by a qualified mental health or medical professional. Ongoing counseling, with a therapist that the youth likes and will talk to, can be a lifeline during the turbulent throes of adolescence.
  • Increase family support. Parents are strongly encouraged to spend time with their children one-on-one and away from screens. Have dinner together, go camping as a family, shoot hoops in the driveway, or whatever activity your family loves to do together. Everyone – parents included – needs time away from cell phones. Kids need limits on screen time and increased time with the people that care about them in real life.
  • Connect to school. When teachers reach out to a student who doesn’t seem much invested in school, when they show special interest in that student, they are increasing the protective factor of school. For many of our boys, especially, coaches can make a huge difference in this factor. When schools discipline students, we have to be very careful about the words we choose – making it very clear we still want relationship, even as we demand that behavior changes.
  • Share the crisis text line number. Young people today are far less likely to actually place a phone call to a hotline. But in a time of crisis, they can and do text the national crisis text line. Ask youth to put its number – 741741 – into their phone. While they may never need it, they can share it with a friend or classmate who does, in the moment. A trained hotline worker is always a text away, and they immediately access local authorities, family members or the school when they believe a child is at risk.

Counseling services are available at West County Psychological Associates for children, adolescents, adults, and seniors with a wide variety of emotional, behavioral, and relationship concerns, including depression and suicidal thinking. Training is available for school personnel on the school’s role in suicide awareness and prevention. You may reach our office at (314) 275-8599.

Amy Maus, MSW, LCSW received her Master of Social Work degree from Washington University and is a Licensed Clinical Social Worker in both Missouri and Illinois. She specializes in services to schools, including work within public and private schools in urban, suburban and rural settings, and enjoys providing presentations and workshops to school-related groups of all sizes. Along with two WCPA colleagues, Amy co-authored and published The Care Team Approach, a book for school professionals.

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