A report from the Center for Disease Control and Prevention indicated a 30 percent increase in suicides in the U.S. between the years 2000 and 2016. While there are rising rates in all age groups, youth, between the ages of 15 and 24, are of particular concern; and the causes are likely complex. Increases in social media use, anxiety, depression, as well as the opioid epidemic are all potential and interweaving contributors. While researchers work to better identify which risk factors are contributing most to the uptick, we need to help the youth currently in suicide distress.
Suicide prevention is a national public health priority. Though there are evidence-based interventions for reducing suicidal ideation and preventing attempts, most people who have thoughts of suicide are not engaged in mental health services.
In fact, a systematic review found that only a minority of young people experiencing suicidal thoughts or self-harm present to any health-care services. It should be shocking that less than 30 percent of adolescents and young adults with current, past-year, or lifetime suicidal ideation, plans or attempts sought mental health services.
There are many reasons why suicidal youth might not get the formal help they need. They may think they do not need help, that their struggles are not severe enough to warrant intervention, or that their problems will go away over time and on their own.
Some youth, like adults, prefer self-management. They think they can go it alone, without any aid, or view seeking assistance as weak or cowardly. Others have such severe and profound hopelessness that it infiltrates their thinking, interfering with their ability to problem-solve.
It is also possible that youth with thoughts of suicide may not know who to talk to, which family members, friends or adults to approach for help, and whom to trust. They may also have no idea what mental health services entail and where to go for such treatment. Alternatively, they many get help from other youth similarly distressed, who are understandably not reliable help or effective.
One potentially promising way to alleviate suicide in youth is by implementing school-based suicide prevention programs in middle and high schools. These programs usually cover risk factors, warning signs, what to do if you know someone who tells you they are feeling suicidal and where to seek help if you are feeling that way.
The curriculums are delivered in a large assemblies or health classes, and utilize a variety of films, presentations and discussions. Importantly, these programs also require that schools set up ways to refer distress youth to appropriate help in their communities. These programs are not the only answer, of course, but they do seem to have a positive effect. In general, such school-based interventions show an improvement in youth knowledge about suicide as well as attitudes towards help seeking.
As a psychologist who works with individuals with severe, chronic emotional difficulties, including intense suicidal ideation and past attempts, I recognize that we need to go beyond the classroom and the mental health clinic. We need more of a team approach where family members, friends, schools, and faith communities, are provided education about suicide and work to support building reasons to live.
Expert consensus studies across a range of countries and cultures, including the U.S., broadly agree on how a family member or friend can provide assistance to a loved one who is suicidal. These suicide first aid guidelines include learning the warning signs of and risk factors for suicide. Having a calm, confident, reassuring affect and letting the person know that you care and want to help.
No one should ever ignore an adolescent who talks about feeling empty, hopeless or says they have no reason to live. When an adolescent talks about wanting to die or kill himself or herself, we need to believe them. And, we need to take it one step further, youth need to be supported in fully and honestly disclosing their thoughts of suicide, the seriousness in which they are considering suicide, and any plans for making a suicide attempt.
While significant scientific advancements have been made in regards to identifying those at risk for suicide and facilitating their entry into formal mental health treatment, this is not a resting point. Considerable work awaits. If we want to assist youth in reducing their psychological pain and preventing the loss of life, we need critical action and investment in the availability and affordability of mental health services.
If You Know Someone in Crisis: Call the toll-free National Suicide Prevention Lifeline (NSPL) at 1–800–273–TALK (8255), or text the Crisis Text Line (text HOME to 741741), both are available 24 hours a day, 7 days a week.
The service is available to everyone. It seems wise that every person put the information above in his or her phones. In addition, parents may want to help their child be prepared to help themselves and others by having access to these critical numbers.
Joan Cook is a psychologist and associate professor at Yale University who researches traumatic stress and clinically treats combat veterans, interpersonal violence survivors and people who escaped the former World Trade Center towers on 9/11.