Teenage Suicide - Essay Example

? Teenage Suicide Introduction Suicide as a cause of death among adolescents in the United States is increasingly capturing the attention of communities. Approximately 7.66 per 100,000 youth ages 15­-19 years commit suicide each year. Suicide is the third leading cause of death for youth and adolescents ages 15-24 years old, indicating that all youth are at great risk for suicide (American Association of Suicidology 1). Suicide is now the fourth leading cause of death for youth between the ages of 10-14 (Crosby 2). Suicide can affect all youth regardless of ethnicity or socioeconomic status; however, there have been rapid increases within specific ethnic groups. In order to address this issue among our high school age students, it is important to analyze who is at greatest risk, to identify risk factors, and to identify potential protective factors. Additionally, suicide prevention and early intervention programs implemented in schools should be assessed regarding their effectiveness. What is not effective should be modified accordingly. Ethnic Differences European American, African American, Hispanic, and Native American youth are all affected by suicide. Suicide among our youth is most prevalent for white males (Crosby, 5). According to the Centers for Disease Control, 73% of all suicides involving adults are white males. However, in the last two decades, among African American male youth ages 10-14, suicide rates have tripled and for ages 15-19 the suicide rate has doubled (Capuzzi 38). Additionally, the Centers for Disease Control has- identified that the Hispanic youth suicide rate is increasing. Furthermore, their rates of suicide ideation and attempts are increasing at staggering numbers (O'Donnell et al., 39-40). Native American youth also have history of a high rate of suicide attempts (Capuzzi, 38). Although the European American population has always represented the highest proportion of suicides among all ethnic groups, it is important to view all of our youth, regardless of ethnicity, as at-risk, considering the recent changes in suicide statistics in the last decade. Different factors contribute to the reasons for suicide attempts for each ethnic group. This needs to be considered when creating an effective youth suicide prevention and early intervention program. Currently, European American youth are the primary recipients of crisis intervention dealing with suicide in contrast with their Hispanic peers who are least likely to receive interventions (Kataoka, Stein, Leiberman, & Wong, 1444). This may be influencing the increases in suicide attempts and completions among this demographic group. Risk Factors for Suicide There has not been a specific profile created to early identify all youth at risk for suicide ideation or suicide attempts. The literature does suggest, however, that there are some common identifying characteristics to consider, although alone they are not indicators. Some common characteristics of youth may warrant the attention of adults to better evaluate these students for suicide ideation. Since suicide is the third leading cause of death for adolescents in the United States, it is key to train the community to identify those at risk. Stressors youth are dealing with may be the trigger for suicide attempts, which are often impulsive responses by youth to escape their problems (Crosby 2). The impulsivity of the act further indicates the need for early intervention among youth dealing with dramatic or life-impacting circumstances. Research has noted some behaviors that may be exhibited by a youth who has suicide ideation. These behaviors include, but are not limited to, the lack of concern for personal welfare, social changes, decline in school performance, including attendance patterns, change in eating and sleeping habits, a new preoccupation with violence and death, increased sexually promiscuity, and other risky behaviors, including substance use (Capuzzi, 40; Guo & Harstall, 11-15). Not all youth will display these warning signs and some may display just a few of them. This is why it is critical for school personnel to be alert to these behaviors, since they spend so much time with adolescents at school and have the opportunity to notice changes in a student's typical behaviors. Most (90%) of those who are suicidal often send out cues as a cry for help because they want someone to notice that they are hurting on the inside (Capuzzi, 41). Youth may throw out verbal cues to express how they are feeling in the form of sarcasm and hypothetical comments about their own death or perhaps about life for those around them if they died. As previously noted, there is not specific profile to identify at-risk youth for suicide attempts; however, all of these behaviors should be noted in youth as possible predictors during assessment. Research has shown that depression, feelings of hopelessness, and low self-esteem are potential indicators of suicide ideation and a cause for concern by adults (Capuzzi 41-43). Other factors to take into account include the personality of the adolescent. Common personality traits have been identified among youth who have attempted or completed suicide (Capuzzi, 43). These personality traits can be observed by those who spend time with the youth, including school staff. Some of these traits include low self-esteem, self-worth, hopelessness, high stress, a need to act out for attention, a need to achieve, guilt, depression, and poor problem solving skills (Capuzzi 41-43). Adolescents may also be depressed and exhibit traits of helplessness and feelings of negative self-worth (Capuzzi 43). Additionally, they may have poor communication skills, which will compound the reasons why they do not share with an adult their feelings regarding suicide (Capuzzi 43). School staff are also in a position to observe social behaviors that may indicate risk whether the youth chooses to attempt suicide, such as isolation from peers (Hazler & Carney 145-147). The Centers for Disease Control have recently identified new risk factors when assessing the likelihood of suicide attempts among youth. These new risk factors include abuse by a boyfriend or girlfriend, being offered illegal drugs at school, and the gender and ethnicity of the youth (Bae, Ye, Chen, & Rivers, 193-201). The higher suicide completion rate among males is attributed to the lethality of the means to carry out the suicide attempt (Snyder & Swahn, 19-25). Lethal means include firearms, which is the most common, followed by hanging or.self-strangulation (Capuzzi, 39). Young girls traditionally attempt suicide with non-lethal means such as ingestion or suffocation (Snyder & Swahn, 19-25). According to the Centers for Disease Control, Morbidity and Mortality Weekly Report, 1 in 5 youth suicide victims were under the influence of a substance (i.e., drugs and or alcohol) at the time of their suicide. Sexually active teens are at a greater risk for suicide attempts than not sexually active teens (Rector et al. 2-5). Specifically, Rector et al. concluded that approximately 14.3% of sexually active girls have attempted or thought about suicide. Similarly, it was identified that sexually active female teens also represent a high percentage (25.3%) of adolescents suffering from depression. This is significant information to assess since depression is linked with suicide ideation, suicide attempts, and suicide completion. This higher rate of depression among sexually active teen girls may also suggest why females are four times more likely to attempt suicide than their male counterparts (Rector et al. 2-5). Protective Factors Identifying risk factors for suicide ideation and suicide attempts among youth is essential; however, the evaluation of protective factors is also important when assessing the level of risk. Protective factors are the positive influences in a person's life. These protective factors have been identified as reasons why youth would not consider taking their own lives or engaging in other risk-taking behaviors (Forman & Kalafat, 399-402). Various protective factors include parental support, which is perhaps the most significant, community support, skills in problem solving, good self-esteem and nonviolent conflict resolution skills (Capuzzi 41-43; Beautrais, 1137-1140) Parental support means that youth are able to talk to their parents and other family members, including them in their lives. Even for those adolescents who do not have good parental support, having another positive adult in their lives can serve the same function (O'Donnell et al., 39-41). Perceived adult support would increase the chance that a youth who is having suicidal thoughts would express this to a trusting adult (O'Donnell et al. 39-41). This would serve as a stronger protective factor if the adult confided in had some knowledge or experience with mental health services, was able to assess risk for suicide, and possessed the skills to respond (O'Donnell et al., 39-41). Other protective factors include the youth's ability to problem solve, coping skills, and a sense of personal control (Thompson, Eggert, Randell, & Pike 742). Youth who are able to think through problems thoroughly and are resourceful in finding solutions to difficult situations when they arise are more likely to seek out healthful coping behaviors than those youth who are not and who thus may resort to suicide (Thompson, Eggert, Randell, & Pike 742-744). Additionally, cultural and religious influences can also serve as protective factors due to the negative stigma attached to suicide viewed by many cultures and religions (O'Donnell et al., 3-4). Suicide Prevention in Schools Youth attend school approximately 6-7 hours per day or longer if they attend any after school programs (King 132) and for this reason schools have a tremendous influence on our youth. While at school, youth have direct contact with other youth, teachers, school counselors, afternoon supervisory staff, and for some, direct contact with school administration (King 132). The most widely evaluated suicide prevention and early intervention program is SOS or Signs of Suicide (Goldrick, 2-3). The SOS program essentially has two components, including an education piece and a self-screening component to allow youth to identify their own symptoms (Aseltine & DeMartino, 446). The main component of the SOS program is to increase suicide awareness among the students (Aseltine & DeMartino, 446). The sole purpose of educating youth about the signs of suicide is to teach them more adaptive behaviors for dealing with depression or overwhelming stressors (Aseltine & DeMartino, 446). Evaluative reports documented that after students completed the SOS program, they self-reported fewer suicide attempts. Aseltine and DeMartino suggested that fewer suicide attempts may be attributable to the increased knowledge and awareness of depressive symptoms and thoughts of suicide. Conclusion Suicide among our youth is an increasing social problem and schools are the gateway to reaching troubled adolescents at risk for suicide attempts. Schools have access to youth, allowing them to observe behaviors and identify signs and symptoms for suicide. Awareness is the key in addressing this epidemic of youth suicide within our schools and within our communities, as identified by the suicide programs. It is most important for school staff, as well as youth, to know the signs of suicide risks and be able to communicate about suicide in an open environment without negative stigma. Schools can identify students displaying difficulty in dealing with social and educational stressors (Aseltine & DeMartino, 446) especially since a change in attitude and school performance is considered a strong indicator for depression and/or suicide ideation. Once those risk factors are identified, schools need to have a prevention program in place utilizing education about suicide, with an emotional component to let youth know that suicide is a serious problem in our society. Many school districts have existing suicide prevention programs in place; however, little has been done to truly assess the effectiveness of these programs. The SOS, or Signs of Suicide, program has endured more evaluations and has been deemed an effective approach to suicide prevention. New prevention and early intervention programs need to be designed with a strong evaluative component to better identify whether the program is in fact preventing youth from taking their own lives. Work Cited American Association of Suicidology, Youth Suicide Fact Sheet. Information Retrieved December 14, 2011 from http://www.suicidology.org/c/document_library/get_file?folderId=232&name=DLFE-24.pdf Aseltine, R. H., & DeMartino, R. “An outcome evaluation of the SOS suicide prevention program.” American Journal of Public Health, 94(3), (2004): 446-451. Bae, S., Ye, R., Chen, S., & Rivers, P. A. “New risk factors associated with suicide in adolescents.” The Brown University Child and Adolescent Behavior Letter, 21(5), (2005):193-202. Beautrais, A. L. “Life course factors associated with suicidal behaviors in young people.” American Behavioral Scientist, 46(9), (2003): 1137-1156. Capuzzi, D. “Legal and ethical challenges in counseling suicidal students.” Professional School Counseling, 6(1), (2002): 36-46. Centers for Disease Control and Prevention “School-associated suicides. United States, 1994-1999.” Morbidity and Mortality Weekly Report, (2004): 53,476­478. Crosby, Alex E. et al. “Suicidal Thoughts and Behaviors Among Adults Aged ?18 Years - United States, 2008-2009”. Morbidity and Mortality Weekly Report (MMWR), 60(SS13) (2011);1-22 Forman, S. G., & Kalafat, J. “Substance abuse and suicide: Promoting resilience against self-destructive behavior in youth.” School Psychology Review, 27(3), (1998): 398-407. Goldrick, L. “Youth suicide prevention: Strengthening state policies and school-based strategies.” National Governors Association Center for Best Practices, Issue Brief, April 18, 2005. Guo, B., & Harstall, C. Efficacy of suicide prevention programs for children and youth. Edmonton, Alberta, Canada: Alberta Heritage Foundation for Medical Research, 2002. Hazler, R. J., & Carney, J. V. “Empowering peers to prevent youth violence.” Journal of Humanistic Counseling, Education, and Development, 41, (2002): 129-149. Kataoka, S. H., Stein, B. D., Lieberman, R., & Wong, M. “Suicide prevention in schools: Are we reaching minority youths?” Psychiatric Services, 54(11), (2003): 1444. King, K. A. “Developing a comprehensive school suicide prevention program.” Journal of School Health, 71(4), (2001): 132-137. O'Donnell, L., O'Donnell, C., Wardlaw, D. M., & Stueve, A. “Risk and resiliency factors influencing suicidality among urban African American and Latino youth.” American Journal of Community Psychology, 33, (2004): 37-49. Rector, R. E., Johnson, K. A., & Noyes, L. R. “Sexually active teenagers are more likely to be depressed and to attempt suicide” A Report of the Heritage Center for Data Analysis. Washington, DC: Heritage Foundation, 2003. Snyder, H. N., & Swahn, M. H Youth violence research bulletin: Juvenile suicides, 1981-1998. Office of Juvenile Justice and Delinquency Prevention, 2004. Thompson, E. A., Eggert, L. L., Randell, B. P., & Pike, K. C. “Evaluation of indicated suicide risk prevention approaches for potential high school dropouts.” American Journal of Public Health, 91(5), (2001): 742-756. Read More