Teens & Suicide

• Suicide ranked as the 2nd leading cause of death for young people ages 15-24 .—
• Each year, approximately 4,320 youth die by suicide.
• Rates are higher for older youth aged 20-24.
• Each day in the U.S there’s an average of over 5,400 attempts by teens in grades 7-12.—
• Over 14% of high-schoolers have considered suicide and almost 7% have attempted it.—
• 4/5 teens who attempt have given clear warning signs.
• Male youth die by suicide five times more frequently than female youth.—
• In 2013 White males accounted for 70% of suicides. Native American/Alaska Native youth have the second highest rate across ethnicities.
• LGBT youth are estimated to have two-three times the rate of attempted suicides than their heterosexual peers.—
• The majority of youth who died by suicide used firearms (60% of deaths). Suffocation was the 2nd most commonly used method

(CDC 2013, National Center for Injury Prevention and Control. Web-based Injury statistics Query and Reporting system (WISQARS) {online]. [cited October 2015]).

• Depression. Substance Abuse. BipolarDisorder
• Early childhood physical or sexual abuse.
• Having high expectations and standards (grades, relationships, etc.).
• Strong sense of failure, low self esteem, feelings of worthlessness.
• Narcolepsy: 40% of people with narcolepsy kill themselves.
• Wanting to go“home,” utopian visions, “Avatar syndrome.” Beware of spiritual bypass.
• Victim of bullying or cyber bullying (are 2-9 times more likely to consider suicide.)
• Any survivor of a suicide.
• A romantic break-up or loss of any kind.
• Previous suicide attempts.
• Firearms in the house.
• Anti-depressants: FDA proposed that makers of antidepressants update existing black box warning labeling to include warnings of increased risks of suicidal thinking and behavior in youth ages 18 to 24 during initial treatment (generally the first one to two months).

1. Invitations for help: may be subtle, but most people send them out. The trick is to listen and watch for them as openings to offer help.
2. Notice any odd comments about a lack of future. “Everyone would be better off without me.”
3. Notice any comments about hopelessness. Example: If a student is feeling hopeless about the future  never getting better, you might say: “So you are really feeling down.Sometimes when people feel like this, they have thoughts of suicide. Are you thinking of suicide?”

1. Are you thinking of killing yourself?
2. If yes: {acknowledge their pain} Do you have a plan?
   • WHEN are you planning on killing yourself?
3. HOW are you thinking of killing yourself?
   • Do you have the means?
   • How did you acquire the means?
   • Have you thought of any other ways of killing yourself?
4. Have you ever tried to kill yourself in the past?
   • When was the last attempt? When was the first attempt?
   • What happened? What were the means?
   • What happened before each attempt? Is there a pattern?
   • How did the attempt get stopped? How did you recover from the attempt?
5. Do you have access to a gun?
6. Screen for any use of drugs or alcohol.

1. Get other adults involved: school counselors and parents.
   • For hands on support or questions you can call the Suicide Hotline at 1 800 Suicide; 1 800 784 2433.
2. Call: Emergency Response Team (ERT) or Psychiatric Emergency Team (PET) to have them make an evaluation :1 800 854 7771.
   • Do “damage control” at this point.
   • Watch for shaming behavior by teachers, and other persons in authority.
3. In extreme, immediate situations, call 911 to have client admitted to the hospital

1. Never be indirect or roundabout. Always ask for concrete specifics. Don’t let vague comments slip by you.
2. Ask about their reasons for dying.
3. Ask about their specific thoughts about death. What do they think will happen when they die? What are their death fantasies.
4. How do they think their family and friends will feel when they are dead?
5. Tease out and reflect ambivalence.
6. Establish “buffers” and links to resources.

• People at risk for suicide are almost always unsure or ambivalent about suicide. Meaning, they have some feelings and reasons for dying and they almost always have some reasons for living. The reasons for dying are usually obvious. Reflect back and summarize, very straightforwardly, their most current and pressing reasons for dying. “You can’t keep living because….”
• The quickest way to get to the reasons for living is to listen to their  reasons for dying. The person may not recognize their reasons for living  yet. Part of your job is to help the person at risk, express, identify,  and confirm their reasons for living.But you need to first understand the death side.
• Know that the fact that they’re talking about their suicidal thoughts means they want help. If they didn’t, they wouldn’t talk about it.
• Ex: If a person is talking about how he has nothing to live for, you might say: “It sounds like you’re really yearning for something to live for. Let’s talk about that. What might that be?”
• Identify positive tendencies, personal strengths, & opportunities.
• Who or what will the person miss most if they are gone?
• What is the best part of their life?
• How did they solve serious problems previously?
• What would they most look forward to if the immediate pain and problems could be addressed?
• Is there any desire to delay suicide and see if other solutions can be found?
• Emphasize the ambivalence — since the student is undecided, the best solution is to put off making a decision about suicide until a clear answer is possible.
• Be persistent but don’t over do it.

• Increase ego-strength and sense of self. Who are they? What do they like/dislike etc…
• Hook into narcissistic tendencies:
  • “Discover their guiding dreams and fantasies and hook their narcissistic attention to their own imaginative selves…I try to fascinate them with the  riddles of their dreams and imaginations so that they postpone the ending (suicide) in order to satisfy their curiosity about themselves.” (Litman, p.47)
• Focus on life purpose. Many youth feel suicidal because they feel lost  and confused about life, and the meaning of their life. Help them construct meaning, identify their strengths and gifts, and find a purpose to their own unique life. Life purpose exercise. Give them a taste of their potential and then their wasted potential if they throw that away.
• Help peel away the blinders of constricted vision by planting seeds for the future.
• Help develop community and increase resources for the student. Increase buffers.

‘‘Suicide often arises not from a hatred of life, but from a lust for it, a desire for things to be otherwise, for life to be full when it appears not to be.’’

-Levine &Levine, 1989, p.215

• Often times, the sensitive child in the family is bearing the  mother’s depression, mental illness, existential despair, lack of purpose, and unconscious resentment about being a mother. Her own longing to die. The child unconsciously absorbs this energy  and carries her pain in order to take care of the mother in the hopes of healing her.
• Ask about the student’s mother and her mental/emotional well-being. What trauma did she experience that she may be passing on to her child? Did the mom want children? Or was client’s birth an accident
• Help the student differentiate between what’s his/her pain vs. his/her mother’s.
• Guided visualization for giving her pain back, with compassion and love.

• Core belief of never ‘being good enough’.
• Absent father or father who is not emotionally and physically present or attentive to the child’s needs.  Lack of attunement and mirroring.
• A feeling of needing to prove one’s self in order to gain approval from the father. However, never getting it and working harder and having extremely high expectations for accomplishments and achievements. Can create a sense of hopelessness.

• PET Team & ERT Team: 1 800 854-7771. (Put in phonebook).
• 1 800 Suicide
• 1 800 273 Talk
• Teen Line: (310) 855- 4673or 1 800 8528336
• www.Suicidology.org
• www.afsp.org
• Suicide and the Soul — James Hillman.
• Understanding the Motivation for Suicide from a Transpersonal Perspective — Sarah Neustadter,PhD. http://www.scribd.com/doc/37648994/Trans-Personal-Suicide
• Kafkaon the Shore — Haruki Murakami
• Norwegian Wood — HarukiMurakami
• The Elegance of the Hedgehog — Muriel Barbery