Suicide among Youth

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Feb 20, 2024

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Running head: SUICIDAL CHILDREN AND YOUTH 1 Suicidal Children and Youths Shani White Jackson State University

SUICIDAL CHILDREN AND YOUTH 2 Suicidal Children and Youths Over the years, the statistics about suicide has become quite alarming. According to research, suicide is the third leading cause of death for young people aged 15-24 and a growing problem among youth aged 5-14 (Kroning & Kroning, 2016). In a study conducted by JAMA Pediatrics , suicide among United States children has become the 10th leading cause of death for elementary school-aged kids (Kroning & Kroning, 2016). According to the America Foundation of Suicide Prevention (2016), over 500,000 teenagers attempted suicide due to self-harm, this is about 5,000 teenagers per year. Approximately 336 youths in the state of Mississippi lose their lives each year to suicide. Mississippi is ranked 34th tied with Utah in deaths related to suicide. Regardless of the myths and fairy tales that are told, suicide and suicidal behaviors occur in all age groups, ethical backgrounds, races, and socioeconomic. The contributing factors of suicide can be complex and may include an assortment of biological, social, psychological, environmental, and cultural risk factors. All too often, there is a lack of communication between society (parents and teachers) and youth. This leads to a lack of knowledge about how to recognize the warning signs of suicide. For decades, suicide has been labored as a taboo subject. Many fears of stigma and discrimination surrounding suicide cause they not to seek help. In 1999, Dr. David Satcher, Surgeon General of the United States of America, unveiled a compelling report on youth suicide to the frontline caregivers of the nation. The program came about after the 1999 Columbine incident that focused on children’s behavior and their sometimes inability to cope with stress. In his report, Dr. Satcher encouraged families, schools personnel,

SUICIDAL CHILDREN AND YOUTH 3 and the public health communities to become proactive in the role of preventing youth suicide. Dr. Satcher felted this was no time to let guards on youth suicide. In a suicidal youth, depression and anxiety are the unique symptoms. Although the core symptoms are the same in teens as they are in adults; the symptoms changes with age. A teen will experience moody or rebellious, but when the signs are sadness, persistent high anxiety or repeated serious behavior episodes, this will requires further evaluation (O’Neill, Ennis, Corry, & Bunting, 2018). There are signs that have failed to be recognized, because of the lack of suicide prevention education and awareness. Youth are in danger of becoming marginalized when there is no profession to provide the needed services and contribute to society. If the need of suicide prevention is not met a growing number of children and teens are going to continue suffer needlessly because the need for prevention is not met. Although, suicide is a tragedy within itself because of the loss of lives and the emotional heartbreak the family members suffer. The biggest tragedy of suicide deaths is they are preventable. Traditionally, suicide has been a primary concern of the mental health field due to the connection of such factors as depression. Scenario On the night of October 7th, 2016, the lives of Charles and Lorie Wells changed forever when they discovered that their sixteen year old daughter, Christy, had attempted to commit suicide by taking a combination of over the counter drugs. Two years previous, Christy was diagnosis with bipolar depression and had an obsession with death since the 9th grade. She was a slender female who presented herself as shy, avoiding eye contact and demonstrating poor social skills except on social media. Christy’s mother reported she had difficulty sleeping, decreased energy, irritable mood and trouble with her appetite. For instance, Christy would only

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SUICIDAL CHILDREN AND YOUTH 4 fall asleep if her mother slept with her. Due to constant harassment for her peers and father, she often stated she felt worthlessness, lonely, and hopelessness. In addition, Christy’s friends and family did not understand the turmoil she was suffering with following a split from her boyfriend. After tearfully calling a friend to say she was feeling down and needed a hug, Christy Wells took her own life in the family’s garden in an ‘act of impulse.’ After her attempted suicide, Charles and Lorie often expressed disbelief at the act. Traumatized by the horrific and tragic situation, the Christy’s parents searched desperately for answers as to why their youngest daughter would feel so lost, that she felt suicide was his only option. Sample Treatment Plan 1. PROBLEM: Bipolar depression and family conflict as manifested by sadness, irritability, poor esteem, low energy, poor communication, and suicidal ideation. There is poor communication between Christy and her father, frequent rude comments towards her mother and frequent arguing between Christy and her sister. Mrs. Wells was asked to record for week the number of time her father attempted to talk to her about concerns; she was cruel and withdrawn. Also, Mrs. Wells was asked to record how many times Christy was rude toward herself and her sister, Tiffany. Rude behavior toward the mother included eye rolling, hostile or sarcastic tone of voice, and making comments such as “pretending to be a family.” During the one week, Christy was hostile or withdrawn toward her father 9 times and was rude with her mother and sister 25 times in one week.

SUICIDAL CHILDREN AND YOUTH 5 2. GOALS a. Christy and her parents will develop a safety plan/no self-harm contract. b. Christy will report no suicidal thoughts/attempts for 3 consecutive weeks. c. Christy will learn to identify maladaptive, negative thoughts and how to replace them with more positive, adaptive thoughts. d. Family will establish routine times in the week for communication and/or family related activities. e. Christy and her family will learn communication and conflict skills. 3. STRATEGIES OR INTERVENTIONS: Reduce family conflict and increase positive family interactions. This will be measured by reducing withdrawn/hostile interactions with her family to one (1) time a week and the family will report at least one positive interaction/family activity per day for 4 consecutive weeks. 4. TYPE OF COUNSELING Christy will receive Individual therapy to learn and implement coping skills and to help her to identify process and resolve feelings and concerns. Christy’s parents and her sister will participate in family therapy and follow through on homework assignments to improve family functioning. Helpful Techniques Another agency that will be involved in providing services to Christy is her school, Murray Hill High School. The school has recently implemented a suicide training and educational

SUICIDAL CHILDREN AND YOUTH 6 program for students that may maybe suicidal or have attempted suicide. This program will be known as Silent Secrets Suicide Training and Educational Program. The Silent Secrets Suicide Training and Education Program (3STEP), a non-profit 501(c) (3) will serve Mississippi as a focus and a channel to prevent suicide throughout the school systems. Silent Secrets will develop a comprehensive Suicide Prevention program in K-12 schools across the State. Silent Secrets will be built upon the “call to action” vision of that will full a range of strategies, starting from prevention and early intervention will be targeted to Mississippi of all ages, from children and youth to adults and older adults. In order to effectively reduce suicides and suicidal behaviors, schools along with the communities need prevention services to promote health and address problems long before they become a crisis. If in the end, a crisis situation does occur a coordinated system of services also needs to be in place. This plan will serve as a blueprint for action at the local and state levels. The plan will be intended to guide the work of policy makers, program managers, providers, funders, and other in bringing the systems together in order to better coordinate their efforts. Along with a course of action to enhance needed prevention and intervention services as well as postvention, or services provided after a suicide or suicide attempt that offer follow-up care for survivors. The core strategies of the plan’s framework will consist of encompass education, clinical and professional organizations, public health, community-based initiatives, media, youth serving organizations, legislation, and the public-at-large. School administrators, mental health representatives, public health representatives, and others will be able to provide feedback on the plan and its resources. This method will ensure that the plan and its resources are well-targeted and useful to gatekeepers (Calear, Christensen, Freeman, Fenton, Busby Grant, van Spijker, &

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SUICIDAL CHILDREN AND YOUTH 7 Donker, 2016). National, state and local resources will be provided in order to support local prevention efforts with important tools for suicide prevention and postvention practice. This will allow the plan to be both functional and useful within a wide variety of settings. Silent Secrets will focus on three levels of youth: elementary, middle, and high school students. At each level the focus with be slightly difference for example, the elementary students will address issues related to emotional development such as bullying by peers, depression, and anxiety. Middle school students will be taught to recognize signs in their friends and themselves as well. For this program, high school student will be the main focus. By the time a student reaches the high school stage, the teacher will plays the vital role in the student’s life. Classroom Presentations Through the program the students will be taught the warning signs of suicide, which will include a suicide questionnaire, DVD presentations, and handouts. The format of the program will be in threefold 1) through the Suicide Questionnaire the staff will correct the myths about suicide 2) will provide information on warning signs of depression and 3) will help students identify a trustworthy adult in their lives with whom they may form a connectedness. (See Appendix A for the Suicide Questionnaire and Warning Signs of Suicide and Depression Handouts). The basic philosophy of this program will be to equip a student to help a troubled friend or manage their own emotional state. The part of the presentation process will be geared toward Suicide Questionnaire. The questionnaire will allow students to evaluate themselves or friends to determine if they could be suffering from unaware depression. This questionnaire portion will be discussion sessions, instead of having question/answer sessions. The final step of the presentation process will focus

SUICIDAL CHILDREN AND YOUTH 8 in on the message of what to do if a student or friend is feeling depressed. Students will be shown a DVD video presentation of warning signs and the role a student can play if they are faced with a suicide attempt or suicidal ideations. Students will receive information pertaining to mental health assistance, community resources, and crisis lines for future assistance. (Contact information for these resources is located in Appendix B). It is important to remember during the presentations there may be students who have experience a suicidal attempt or have suicidal ideations (Rojas, Leen-Feldner, Blumenthal, Lewis, & Feldner, 2015). In any case, a counselor will be on stand-by to further assist in the process. Lastly, the students will be asked to complete evaluation forms and no suicide contracts. The evaluation forms will allow the director and others to receive feedback on what the students thought was useful doing the presentation and what could be improvement for future sessions. The students will also be asked to sign a no suicide contract; this contract is a clear agreement that the student will not commit suicide before take other actions such as contacting the crisis hotline. Rojas, Leen-Feldner, Blumenthal, Lewis, and Feldner (2015) suggested “no suicide” contracts cannot take the place of formal suicide risk assessments.

SUICIDAL CHILDREN AND YOUTH 9 Annotated Bibliography Calear, A., Christensen, H., Freeman, A., Fenton, K., Busby Grant, J., van Spijker, B., & Donker, T. (2016). A systematic review of psychosocial suicide prevention interventions for youth. European Child & Adolescent Psychiatry, 25 (5), 467-482. doi:10.1007/s00787- 015-0783-4 In this article, a review was conducted to examine the effectiveness of school, community and healthcare-based interventions in reducing and preventing suicidal ideation, suicide attempts and deliberate self-harm in young people aged 12-25 years. A research was conducted by PsycInfo and several databases in December 2014to identify random psychosocial interventions for youth suicide. A total of 13,747 were identified and screened for inclusion in the database. Further quality research is needed to strengthen the evidence-base for suicide prevention programs in this population. Kroning, M. & Kroning, K. (2016). Teen depression and suicide: A silent crisis. Journal of Christian Nursing, 33 (2), 78-86. doi: 10.1097/CNJ.0000000000000254 Often undetected depression and suicide among teenagers is a serious problem. Recent study discovered 17% of high school students have contemplated suicide. This article relays the tragic death of a 17-year-old, along with symptoms of depression and suicide in adolescents; treatments including protective factors, psychotherapy, medications; and implement interventions methods for addressing this huge but silent crisis.

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SUICIDAL CHILDREN AND YOUTH 10 O’Neill, S., Ennis, E., Corry, C., & Bunting, B. (2018). Factors Associated with Suicide in Four Age Groups: A Population Based Study. Archives of Suicide Research, 22 (1), 128- 138. doi:10.1080/13811118.2017.1283265 Many life events and circumstances can lead to death change throughout the life course. In this study, specific age groups within those who have died by suicide are compared in terms method of suicide, sex, occupation, mental disorders, prior suicide attempts, and life events prior to death. During this research was determined that hanging was a very pronounced method of death within the under-20 age group. Understanding the factors associated with suicide across age groups is essential to informing suicide prevention strategy and programs and the development of more nuanced and effective interventions. Rojas, S., Leen-Feldner, E., Blumenthal, H., Lewis, S., & Feldner, M. (2015). Risk for Suicide Among Treatment Seeking Adolescents: The Role of Positive and Negative Affect Intensity. Cognitive Therapy & Research, 39 (2), 100-109. doi:10.1007/s10608-014-9650- Risk for suicide among adolescents remains a serious public health concern. To address this gap in the current study evaluated the unique associations between dimensions of affect intensity and risk for suicide in a sample of adolescents ages of 13-17 seeking treatment. As calculated, low and high negative affect intensity accounted for unique adjustment in adolescent suicide risk. Findings are discussed in terms of the theoretical and applied implications of both positive and negative affect intensity in the framework of adolescent risk for suicide.

SUICIDAL CHILDREN AND YOUTH 11 Appendix A Handouts PART I - SUICIDE QUESTIONNAIRE Circle True (T) or False (F): T F 1. People who talk about suicide never attempt suicide. T F 2. Once a teenager attempts suicide, he/she has a higher risk for attempting again. T F 3. Teenagers who use drugs or alcohol are not at a greater risk for committing suicide. T F 4. Never use the word suicide when talking to your friend because using the word may give him/her the idea to do it. T F 5. Women attempt suicide more often than men. T F 6. A person who seems dramatically better after a period of depression is no longer at risk for suicide. T F 7. Russian Roulette, reckless driving, and other high risk behaviors that could lead to death may be ways to attempt/commit suicide. T F 8. There are no warning signs before suicide takes place. T F 9. More men complete suicide than women. T F 10. Gay/lesbian youth have a higher risk of attempting suicide than straight youth. T F 11. A friend who has lost a loved one or has broken-up with their boyfriend/girlfriend would not consider suicide as an option. T F 12. Suicide is the third most common cause of death among adolescents and young adults in the United States.

SUICIDAL CHILDREN AND YOUTH 12 PART II - WARNING SIGNS OF SUICIDE AND DEPRESSION 1. Sadness and crying 2. Lack of energy 3. Inability to concentrate, or make decisions 4. Threatening suicide or talking about suicide 5. Expressing a desire to die 6. Recurring themes of death and self-destruction in poetry composition, writing assignments or artwork 7. Making final arrangements, such as giving away possessions, expressing farewell, and writing a will 8. Feeling depressed: unhappy, hopeless, worthless, guilty, low self-esteem, loneliness, and boredom 9. Sleeping more or less than normal 10. Showing a real change in appetite - eating much less or much more 11. Pulling away from friends, hobbies, job, and social activities 12. Changing personality suddenly and having mood swings 13. Acting disruptive in class or exhibiting violent outbursts 14. Taking more risks (e.g., increase in alcohol or drug use, reckless driving) 15. Abusing drugs or alcohol 16. Neglecting

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SUICIDAL CHILDREN AND YOUTH 13 Appendix B Additional Resources SOS (Signs of Suicide) High School Suicide Prevention Program One Washington Street, Suite 304; Wellesley Hills, MA 02484-1706 Tele: (781) 239-0071/Fax (781) 431-7447 http://www.smhinfo@mentalhealthscreening.org  To be used in conjunction with the suicide prevention program, a DVD Depression Screening Inventory , is offer for a nominal fee. Paraclete Press P.O. Box 1568; Orleans, MA 02563 Tele: 1-800-451-5006/Fax 508-255-5705 http://www.paracletepress.com/contact.html  Produces DVD, A Cry for Help: How to Help A Friend Who Is Depressed or Suicidal Jewish Family Services Mississippi State University – Meridian 1000 Highway 19 North; Meridian, MS 39307 Tele: 601-484-0166  Offers free unlimited outpatients mental health services to students and their families

Suicide among Youth

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