Adolescent Suicide - Research Paper Example

? Adolescent Suicide Even though suicide rates among all generations are growing as time goes on, teenage community seems to be the most problematic one. Teenagers during their developmental stages do not think much about the importance of their lives when some kind of problem occurs to them. Even silly problems will be perceived as complicated ones and they may take decision to commit suicide to escape from such problems. In many cases, substance abuse, momentary lapse of emotional control, lack of counseling, negligence from parents and beloved ones, stressful events are motivating teenagers to commit suicide. Teenagers with family history of suicide show more tendencies to commit suicide. Nursing professionals can help teenage community immensely in preventing suicide. They can help teenagers to solve their physical as well as mental problems with the help of proper medications and counseling. This paper analyses the reasons of teenage suicide and the nursing implications with respect to this social problem. Adolescent Suicide Suicide is the third leading cause of death in 15 to 24 year olds, and the third leading cause of death in 10 to 14 year olds. According to the National Institute of Mental Health (NIMH): There are 25 attempted suicides to one completed suicide - with the ratio even higher in youth and the strongest risk factors for attempted suicide in youth are depression, substance abuse, and aggressive or disruptive behaviors (Teen Suicide, n.d). It is impossible to know the teenager who committed suicide first in this world. It is also impossible to predict who could be the last teenager to commit suicide. However, it is possible to conclude that suicide rates among teenage community are growing day by day because of various reasons. A few decades before, suicide rates among teenagers were not a big problem as it now. “Of every 100,000 young people in each age group, the following number died by suicide: Children ages 10 to 14 — 0.9 per 100,000; Adolescents ages 15 to 19 — 6.9 per 100,000; Young adults ages 20 to 24 — 12.7 per 100,000” (Suicide in the U.S.: Statistics and Prevention, 2010). According to Miller & Berman (2010), suicide has increased over 60% worldwide during the last half century (Miller & Berman, 2010, p.2). Although child death rates are decreasing steadily during the last few decades, youth suicide rate travels in the opposite direction in United Sates. Reasons for adolescent suicide and nursing implications According to Shilubane et al. (2012), “Lack of knowledge of available counselors, conflicts in interpersonal relationships, perceived accusations of negative behavior, inadequate social support, past family and peer suicide attempts and poor living circumstances were factors found to be related with suicide attempts” (Shilubane et al. 2012, p.177). As mentioned earlier, many teenagers are committing suicide because of a momentary lapse in emotional control. For example, love affairs or dating relationships are common among current teenagers all over the world and the case of America is also not an exception. Teenagers who have feeble mental power or self-confidence may think about committing suicide when their love affairs break. They may not bother too much to think about substituting the lost relationships with another one at that moment. For them breaking of their dating relationships is the end of the road. Nursing professionals can help teenagers to overcome the emotional catharsis at various moments in their life. Many studies have proved beyond doubt that lack of availability and access to counseling is the major reason for increased suicide rates among teenagers. Counseling should be done at individual levels and family levels to educate the public about how to overcome stressful events and avoid suicides. Family nurse practitioner (FNP) is a respected profession in America now and these professionals can help the community in general and teenage community in particular in overcoming the tendencies of suicide. Poor living condition is another motivating factor for teen suicide. Teenagers have a habit of comparing their living standards with that of his/her friend’s living standards. If the friends are leading superior life, he/she may curse the destiny and try to finish the life. Such people develop vengeance towards the society which is responsible for making their living standards pathetic. They may develop a feeling that this world is intended only for the rich people and poor people do not have space in it. Such thoughts will get accumulated in the minds and the final outcome could be a suicide attempt. Since, nurses are professionals who interact with people belonging to rich and poor communities; they can identify the persons vulnerable to suicide tendency. It is necessary to give special care to such people while nurses come in contact with them somehow. The thoughts about lack of social support often motivate the teenagers to commit suicide. The interventions of nurses may help them to think about the social care extended to them by the society and the government. According to a study conducted by Li et al. (2012), to explore the indirect relations between gratitude and suicidal ideation and suicide attempts; The odds of suicidal ideation and suicide attempts were lower among adolescents who scored higher on gratitude, after controlling for demographic variables. Self-esteem mediated the relations between gratitude and suicidal ideation and suicide attempts, while the mediating role of coping efficacy was not significant. Moreover, stressful life events moderated the mediated path through self-esteem. This indirect effect was stronger for adolescents low on stressful life events than that for those high on stressful life events (Li et al., 2012, p.155). Lack of self-esteem or self-belief seems to be the major reason for the increased suicide rate among teenagers. It should be noted that the living standards of current younger generation is much better than that of the younger generations of the past. As a result of that current younger generation is facing less bitter experiences in their lives compared to the younger generations in the past. Thus, their mental preparedness for facing tough life situations are less compared to the younger generations in the past. It should be noted those younger generations in the past developed lot of self-confidence as a result of their intense and continuous struggle for existence and survival. On the other hand, current younger generation is facing fewer obstacles in their life for achieving their goals. For example, poverty, diseases and lack of food and shelter were some of the major problems faced by the younger generations in the past. These problems are fewer in number nowadays because of the higher living standards all over the world. Nurses can help teenage community in building their self-esteem. They should make the teenage community capable of dealing with tough life situations. Teenagers usually may not reveal their problems to their family members. However, they may reveal their problems to anyone who are in deep relations with them. Nurses should try to establish deep relations with the teenage community to identify their problems. They should also make sure that these relationships should never cross the limits. For example, if a nurse establishes deep relations with a teenager of opposite sex, he/she may get infatuated towards the nurse. Nurses should take extreme care to avoid such problems while dealing with teenagers. According to Brent et al. (2011), “Depression is the psychiatric disorder that is most closely related to suicidal ideation and behavior. About 80% of adolescent suicide attempters and 60% adolescent suicide completers have a mood disorder” (Brent et al., 2011, p.14) In 2008, adolescents made 23,124 visits to the emergency department (ED) for drug-related suicide attempts, and young adults made 38,036 such visits; of these visits, 23.0 percent (5,312 visits) among adolescents and 17.6 percent (6,700 visits) among young adults involved antidepressants. Among ED visits for suicide attempts involving antidepressants, more than two thirds of visits by adolescents (68.4 percent) and more than three fourths of visits by young adults (78.0 percent) involved other substances in addition to antidepressants. One tenth (10.2 percent) of visits by adolescents and nearly one fourth (22.6 percent) of those made by young adults involved antidepressants in combination with alcohol. One third (32.9 percent) of visits for drug-related suicide attempts made by adolescents and one half (49.4 percent) of visits made by young adults resulted in hospitalization (Substance Abuse and Mental Health Services Administration (DHHS/PHS), 2011, p.6). The above findings clearly reveal the close associations of teenage suicide, substance abuse, drug addiction and alcoholism. Substance abuse destroys the ability of the teenage community to think in the right direction. In fact many teenagers are taking shelter in alcoholism or drug use to get rid of their frustrating thoughts. In fact teenagers have superstition that alcohol or the drugs have the ability to cure mental injuries. Thus they will rely on these items when they face challenges in life. In fact addiction of any kind may destroy the ability of a person to think in the right manner. Nurses that work in substance abuse care should have good knowledge in pain management, both physical as well as mental. Physical pains can be managed with the help of medicines; however, mental pains can be managed with the help of medications as well as counseling. “Because addiction is both a mental and physical disease unique to each patient, substance abuse nurses should be knowledgeable about both general medicine and specialized addiction related medicine, as well as be able to customize their treatment programs to their patients” (Substance Abuse Nurse, 2012). The attitude of the nurses towards the patients is important in managing substance abuse victims. Nurses should show a sympathetic approach towards such patients rather than blaming them for their mistakes. Nurses should realize that these victims may have nothing left in their lives and any bullying or harassment attempts from the nurses may reinforce their desire to commit suicide further. Six hundred eighty adolescents completed suicide between 1997 and 2007, of whom 12 had parents who had previously died by suicide. In 10 of the 12 suicidal parent-adolescent dyads, the same suicide method was employed by parent and adolescent. Of seven adolescents whose age at parental suicide was 15 years or above, six used the same suicide method as their suicidal parent had. On the contrary, of 12 exposure-nonexposure suicidal adolescent dyads, the same method was used in only four. Adolescents exposed to parental suicide are more likely to use the suicide method employed by their suicidal parents than the method used by adolescent peers with no exposure to parental suicide (Lu et al., 2011, p.685). The above findings clearly indicate that heredity plays an important role along with the environment in causing suicide tendency among teenagers. In other words suicide tendency is inherited in some cases and therefore those cases should be treated differently by the nursing professionals while giving counseling. Nursing professionals should explore the family histories of the patients before providing counseling to them. Case study will help them to formulate feasible strategies to each teenager come in contact with them. No two individuals are alike either physically or mentally. This principle should be kept in the minds of nursing professionals before they start counseling sessions to teenagers. “No one moment, no single event is enough by itself to create a suicidal crisis. Instead multiple events and situations, known as risk factors combine to increase the chances that a person will consider and attempt a suicide” (Brent, 2008, p.3). In other words, nobody will think about committing suicide if they face only one miserable or stressful incident in their life. In fact multiple stressful events generate the feeling of committing suicide in the minds of the people. Majority of the adults and older generation are matured enough to overcome the impacts of multiple stressful incidents; however, same thing cannot be said about the teenage community. Teenage community usually approach life experiences emotionally. They don’t have many experiences to cope up with stressful incidents. They don’t know how to tackle bitter experiences. They may think that suicide is the only way to escape from problems. Nurses should recognize that the thinking patterns of teenagers are extremely different from that of older generation. Based on the above awareness, they should custom made strategies for each generation while providing counseling to them. In other words, the words which soothe older generation may not soothe the younger generation. Nurses should make sure that they are using the right words while dealing with the problems of teenagers. According to a study conducted by Kukoyi, et al. (2010) among 342 adolescents aged 10–19 years from 19 schools, the following results were yielded. Multivariate analysis showed that a history of self-violence, violent thoughts toward others, mental health diagnoses other than depression, and a history of sexual abuse were positively associated with suicide attempt. Sexual abuse, mental health diagnoses other than depression, self-violence, and ease of access to lethal substances/weapons were positively associated with suicide ideation (Kukoyi, et al. 2010, p.317). Sexual abuse is another reason for increased violence among teenagers. It should be noted that sexual exploitation of teenage community is taking place more in the current decade than ever before. Both male and female teenagers are equally vulnerable to sexual exploitations. Girls usually exploited sexually by family members or other relatives whereas boys are mostly exploited by antisocial elements in the society. In any case, sexual exploitation motivates teenagers to commit suicide. Even though sex hormones are hyperactive during adolescence, it doesn’t mean that teenagers are ready to have sex with anybody. In fact they may readily participate in sexual activities if the opposite sex is attractive to them. In other words, forced sex is unacceptable to teenage community. Teenagers who were victims of forced sex may think about committing suicide. Nurses, especially the FNP’s should gather more details about the teenagers and their problems while they visit homes. They should help teenagers who are sexually exploited by others in all possible ways. As mentioned earlier, in order to identify such sexual exploitations in families, FNP’s should establish deep relations with the teenagers in the family. Conclusions Even though the society is advancing rapidly, suicide rates among teenage community is increasing rapidly. Even though better healthcare helped thousands of people to extend their life span, social evils, stressful events, lapse in emotional control, lack of self-esteem and self-confidence are forcing teenagers to think about committing suicide. Current younger generation is leading a much more compact and lavish life than the younger generations in the past. Therefore their ability to adjust with stressful life incidents is less than that of the older younger generation. Thus suicide rate among current younger generation is increasing rapidly. Nurses, especially those who are working as Family Nurse Practitioner (FNP) can do many things in preventing or reducing adolescent suicide rates. They should try to establish deep relationships with the teenagers who are in touch with them to get proper awareness about the problems facing by them. They should make sure that their relationships with the teenagers never cross the limits of therapeutic relationships between a patient and a healthcare professional. They should give enough guidance and counseling to those teenagers who are facing tough life situations so that these teenagers will never think about committing suicide. References Brent D.A. MD FAAP ABPN, Poling, K.D. LCSW & Goldstein T.R. PhD. (2012). Treating Depressed and Suicidal Adolescents: A Clinician's Guide. Publisher: The Guilford Press; 1 edition (March 1, 2011) Brent, D. (2008). Eight Stories Up: An Adolescent Chooses Hope over Suicide. Publisher: Oxford University Press, USA; 1 edition (April 14, 2008) Kukoyi, O.Y.; Shuaib, F. M.; Campbell, F.S; Crossman, L. & Jolly, P. E. (2010). Crisis: Suicidal ideation and suicide attempt among adolescents in Western Jamaica: A preliminary study. The Journal of Crisis Intervention and Suicide Prevention, Vol 31(6), 2010. pp. 317-327 Li, D., Zhang, W. & Li, X. (2012). Gratitude and Suicidal Ideation and Suicide Attempts among Chinese Adolescents: Direct, Mediated, and Moderated Effects. Journal of Adolescence, v35 n1 p55-66 Feb 2012 Lu, T.H.; Chang, W.T.; Lin, J.J & Li, C.Y. (2011). Suicide Method Runs in Families: A Birth Certificate Cohort Study of Adolescent Suicide in Taiwan. Suicide & Life-Threatening Behavior, Dec2011, Vol. 41 Issue 6, p685-690, Miller D.N. & Berman, A.L. (2010) Child and Adolescent Suicidal Behavior: School-Based Prevention, Assessment, and Intervention. Publisher: The Guilford Press; (Lay-Flat Paperback) edition (December 14, 2010). Shilubane, H.N.; Ruiter, R. A. C. and Bos, A. E. R. (2012). Psychosocial Determinants of Suicide Attempts among Black South African Adolescents: A Qualitative Analysis. Journal of Youth Studies, v15 n2 p177-189 2012 Suicide in the U.S.: Statistics and Prevention, (2010). Retrieved from http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention/index.shtml Substance Abuse and Mental Health Services Administration (DHHS/PHS). Emergency Department Visits for Drug-Related Suicide Attempts Involving Antidepressants by Adolescents and Young Adults: 2004 to 2008. The DAWN Report Substance Abuse and Mental Health Services Administration. 2011 6 pp. (ED525062) ERIC Substance Abuse Nurse (2012), Retrieved from http://www.nursingschools.net/profiles/substance-abuse-nurse/ Teen Suicide (n.d). Retrieved from http://medicalcenter.osu.edu/patientcare/healthcare_services/mental_health/mental_health_about/children/suicide/Pages/index.aspx Read More