Studies have suggested that that parents and teens may underestimate the risk of suicidality in their community. In my practice, parents are often surprised when I disclose to them that their child has had suicidal thoughts. Many parents still seem willing to overlook problematic behavior and excuse it as adolescent angst or identity issues. Failure to adequately recognize teen depression and suicidality is a serious issue. According to one study suicide is the third leading cause of death among teens.
Risk Factors
Risk factors for teen suicide are well known. They include the use of illegal drugs and alcohol, relationship issues, and depression. Adolescents struggling with sexual orientation issues are at especially high risk. One survey found that 28% of gay and bisexual males and 20% of gay and bisexual females had made suicide attempts. One should not underestimate familial factors. A family history of depression or bipolar disorder should always be treated as a red flag, especially when accompanied by other warning signs.
Screening for Suicide Risk
Dramatic changes are clearly the most obvious indicators that something is amiss. This may include changes in personality, aggression (both verbal and physical), break up with a romantic partner, school avoidance, or withdrawal from groups and activities. Sometimes changes are more gradual, like changes in peer affiliation, a decline in grades, and reducing participation in extracurricular activates. Other warning signs include changes in sleep or appetite, trouble concentrating, disorganized and confused thinking, writing notes, songs, or poems about death or suicide, talking about and joking about suicide, and reduced quality of homework.
Actions to Take
Talk about it! Do not be afraid to use the word suicide. Making an empathic connection is reassuring to teens. Ask if the individual has made a plan. Alert the parents. They must maintain close proximity to their child and remove all dangerous items from the household, including medication. Obviously, don’t minimize the adolescent’s distress. Remind the teen that their behaviors and decisions will have a lifelong impact on their family. Refer the adolescent to a mental health professional right away.