Preventing teen suicide: What to know, what to ask and what to do

May is recognized as Mental Health Month across the U.S.
Chronic health conditions affect millions of Americans, in fact, almost half of adults will experience a mental illness during their lifetime and half of all mental disorders begin by the age of 14. Childhood depression is more likely to persist into adulthood if left untreated. In Pennsylvania, more than 12 percent of youths age 12 to 17 report suffering from at least one major depressive episode in the past year. The adolescent population faces numerous hurdles racing to adulthood, however, the risk of self-destruction is a crisis that has escalated exponentially in recent years. In 2015, suicide became the second leading cause of death among individuals aged 15-34 (right behind accidents and surpassing homicides).
Research points to the rationale that teens commit suicide because they do not believe there is a reason to live and that the world will be better off without them. Young people who struggle to navigate school, family, friends, relationships, a fragile self- image, and the mounting pressures of looming adulthood, all under the harsh glare of social media, may experience thoughts about suicide. However real the urge is to selfdestruct, with proper support, this impulse can be stopped.
Some believe that talking about suicide will lead to and encourage the risk. The reverse is true, when someone talks about committing suicide, they may be giving a warning that should not be ignored. Generally, individuals will not report suicidal ideation, but 70 percent communicate their intentions or wish to die to others. To keep teens who are at risk safe, it is important to recognize the warning signs and ask questions: n Talking or writing about suicide, even jokingly n Withdrawing from friends and family n Sudden changes in appearance or hygiene n Behaving recklessly and taking risks n Worsening school performance n Noticeable changes in eating or sleeping habits n Not making or confirming plans for the future or making final arrangements
Crisis of any form doesn’t occur spontaneously; it is the final stage along a continuum of heightened anxiety, stress and emotional upheaval. There are triggers or circumstances that create a heightened condition of distress. At such times a person’s reasoning capacity may become seriously diminished and behavior may become rebellious or destructive. A person in crisis is often unable to solve problems or process information rationally without help. Behaviors of persons in crisis are sometimes erratic and unpredictable to a point that they may constitute a danger to self and others. The greater the number of triggers the greater the risk.
Crisis can be triggered through a spectrum of situations including: n Family trauma/destabilization or conflict with parents n Clashes with peers or authorities which can often be fueled by social media n Academic Failure n Recent moves/transitions n Impulsive responses to grief or loss (relationship breakups; being ostracized by peers)
Another significant risk factor is adolescent brain development. The pre-frontal cortex is the last part of the brain to fully develop; it controls impulses, organization, moral reasoning, emotional stability, concentration and prioritizing. This integration begins around age 17 and is not completed until the mid to late twenties. This development impacts adolescent decision-making and problem solving. The behavior of young adults is guided more by the part of the brain that drives emotions and less by the part of the brain that controls reasoning. Therefore, adolescents are more likely to act on impulse, misread or misinterpret social cues and emotions, get into accidents of all kinds, and engage in dangerous or risky behavior. Adolescents are less likely to think before they act and pause to consider the potential consequences of their actions.
It is the adults in the lives of these young adults who are responsible for breaking through the stigma to confront teens decision to suicide — the decision to choose a drastic and irreversible response to a temporary circumstance. What you know, ask and do can provide a reason to move past the crisis and make a difference. n Trust your instincts; listen n Let the adolescent know you are concerned n Ask direct questions and do not promise to keep a secret n Call for help; do not leave the teen alone while you wait for help to arrive
One key to reducing fatalities is to block access to lethal means. Actions including installing gun locks and safes and barriers on bridges can reduce death rates.
Behavioral Health Services at Sharon Regional Medical Center provides comprehensive treatment services for high risk adolescents through a continuum of crisis intervention services including: n Psychiatric Liaison Services provided in the Emergency Care Center — The emergency response team is skilled in providing crisis assessment and can link you and your loved ones with various levels of professional support. n Psychiatric Inpatient Center — A multidisciplinary team of psychiatrists, psychiatric clinicians, nurses, social workers, and mental health counselors provide thorough Psychiatric and Medical Assessments; Stabilization of acute crisis and 24-hour hospitalbased nursing care and observation. n Partial Hospitalization Programming — Intensive group centered program which promotes crisis resolution, self-harm reduction strategies, and managing emotional distress, in an outpatient day treatment environment established to help teens stay safe while remaining within their home and community.
Behavioral Health Services also provides community, in-home and school-based programming for children with mental health issues and specializes in addressing the clinical needs of adolescents with autism spectrum disorders; as well as outpatient psychiatric medication management.
If you or someone you know is in crisis, call 911 or go to the nearest emergency room for assessment. Or, for more information call, Sharon Regional Medical Center at 724-983-3911 or visit www.sharonregionalmedical.org/ behavioralhealth.
The National Suicide Prevention Lifeline at 1-800-273-TALK (273-8255). It is available 24 hours a day, 7 days a week, from anywhere in the United States.
Michele Fuleno, M.Ed., is the Behavioral Health Clinical Quality Director at Sharon Regional Hospital.