Dr Asha Pemberton
World Suicide Prevention Day is recognised today. Teen suicide is preventable and there are several interconnected factors which work to protect vulnerable young people from escalating suicidal thoughts into action or behaviour. Resilient teenagers are able to manage adversity. Healthy self-esteem, positive self-concept and setting goals create resilience and should be supported through the adolescent years. Family support, school connectedness and a strong spiritual and religious foundation all work to strengthen the resilience of teens and youth.
Development of a range of personal, family and school-based initiatives enable recognition and intervention in young people in distress. Appropriate identification of at-risk youths and then prompt management of depression, eating disorders, anxiety, schizophrenia and other behavioural disorders are critical. We recognise that changes in access to education and schooling, have removed some of the support young people traditionally gained and this has added to the current stress that our teens are experiencing.
Teen suicide is devastating and unfortunately a growing health concern, worldwide. The risk factors for teen suicide vary with age, gender, genetics and negative life events. Ongoing mental illness whether untreated or ignored is the leading risk factor. Female adolescents make attempts at suicide and engage in self-harming behaviour more frequently than males, but males are more likely to use violent methods and therefore die more often than females from suicide.
While there is no single cause for attempted suicide or suicide in young people, risk factors in combination with external circumstances that overwhelm an already vulnerable adolescent create the potential for this to occur. Young people who are unable to cope with the challenges of adolescence due to undiagnosed or untreated mental health concerns are vulnerable. These include depression, alcohol and substance use disorders, eating disorders such as anorexia nervosa and bulimia nervosa and schizophrenia.
Modern adolescent life is stressful. Negative life events including child maltreatment and abuse, interpersonal losses, family violence and sexual orientation and gender identity crises add stress to already overwhelmed youth. Other risk factors include a family history of mental illness or suicide, impulsive or aggressive personality traits, access to weapons and firearms and exposure to other people, including other adolescents who have attempted or died by suicide or glamorise this behaviour. Navigating the pandemic, online education, social isolation and grief are all new triggers with which young people have to contend.
Many young people who are struggling with self-harming and suicidal thoughts demonstrate observable behaviour which can point to their ongoing states. There often are signs. These include a preoccupation with death, making suicidal notes or plans including posts online and on social media platforms, loss of interest in friends or previously enjoyed activities, and change in personality. Personality changes include becoming sad, irritable, withdrawn, excessively sleep and apathetic. Other aspects of their lives and behaviour can also provide signs, which include changes in school performance, changes in sleeping patterns, loss of appetite or overeating, erratic behaviours and difficulty concentrating or making decisions.
When threats of suicide are made, friends and families often are scared yet unsure how to react, what to do, or whether to take such comments seriously. Always take them seriously. Whenever suicidal thoughts, threats or self-harming behaviour (including cutting, skin-burning or intentional over-dosing of medication) is noticed by anyone, peers, teachers, relatives, young people should be promptly referred to a healthcare provider for a mental health evaluation. Even if you have doubts about the seriousness of the threat, consider it an emergency and take appropriate action.
Teens themselves who are contemplating suicide and are aware of worsening thoughts and feelings should seek immediate help from family, and health care or mental health care professionals. In the wider community of Tobago, continued awareness and recognition of teen suicide is an important aspect of prevention. Everyone who has a role in the life of a young person can potentially intervene to save a life.