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Teen Suicide: “The Time for Secrecy Is Over”

teens in school hallway

Editor's Note: This story was updated Aug. 4 with new CDC data showing the rate of suicide for teen girls in 2015 had reached a 40-year high.

July 25, 2017 -- As a freshman at Northview High School in Duluth, GA, 15-year-old Will Trautwein was a leader among his army of friends, says his father, John. He had good grades, played lacrosse, and -- a skilled pianist and guitarist -- wrote music for his band. He was strong, popular, smart and happy, his father says. So, when Will took his own life in October 2010, his parents were shocked.

“As far as I was concerned, Will was successful in every aspect of his life. I had no idea about suicide, depression, mental illness,” Trautwein says. “They weren’t in my vocabulary. We had no idea he was struggling in any way.”

After his son’s death, Trautwein built his Will to Live Foundation, which supports school suicide awareness and prevention initiatives, “on the concept that it’s easier for kids to talk to their friends than to adults,” he says.

As the rate of teen suicides continues to rise, public officials have been ramping up their prevention efforts as well. With suicides broadcast on social media and programs such as Netflix’s 13 Reasons Why streaming on the devices of America’s teens, the once taboo topic is demanding attention.

“The time for secrecy is over,” says Trebor Randle, special agent in charge of the Georgia Bureau of Investigation’s Child Fatality Review Unit. “It’s now time to be bold in our awareness, our education, and our attempts to save children.”

In Georgia, the number of teens who take their lives annually has risen during most of the last 5 years. When teen suicide deaths in Georgia climbed to 51 in 2015, policymakers and state agencies redoubled their prevention efforts. The state has recorded 23 cases through July, Randle says.

This coincides with rising rates nationwide for the past decade among all young people ages 10 to 24. In these age groups, the number of suicides increased by 23 to 200% from 1999 to 2014, with the pace of increase picking up in 2006. Adolescent girls ages 10 to 14 saw the sharpest increase in suicides: Rates tripled over those 16 years. New CDC data looking at suicide rates from 1975 to 2015 shows that it hit a 40-year high for teen girls in 2015. Another recent study found that hospital admissions for suicidal thoughts and actions among children and teens doubled from 2008 to 2015.

Suicide is also the second leading cause of death for people ages 15 to 24.

Speaking out about suicide counters a common misconception that talking about suicide can cause suicide. “Asking a friend or family member about suicide is not going to give them the idea to complete it,” says Christine Morrison, a licensed mental health counselor and head of supervision at Crisis Text Line. The organization offers free crisis intervention via text message.

A National Crisis

The causes of suicide are complex. Experts warn parents and teachers not to try to boil it down to a single cause, such as a breakup with a girlfriend or boyfriend. Instead, it’s typically a number of reasons, one of which could be depression.

“There appears to have been an increase in episodes of adolescent major depression, which could be playing a role,” says Richard McKeon, PhD, chief of the suicide prevention branch in the Division of Prevention, Traumatic Stress and Special Programs at the Substance Abuse and Mental Health Services Administration. “But then the question becomes: What’s driving an increase in major depressive episodes?”

Recent studies report a link between social media use and depression, anxiety, and low self-esteem. Young people try to reach impossible standards by comparing themselves with others on social media, which is shown to be associated with depression. Social media can be an all-too-powerful vehicle for bullying and shaming.

In 2013, Canadian teen Rehteah Parsons killed herself after photos of her alleged gang rape were posted on social media. The family of Brandy Vela, a Texas teen, blames her 2016 suicide on cyberbullying as well. The teen was frequently harassed by anonymous text messages and mocked on a fake Facebook profile that had been set up in her name.

“Every single mistake that Will ever made, there was a fear that it would be on YouTube, on Snapchat, on Facebook,” said Trautwein. “They know that if they mess up, everyone will know about it by lunchtime. I did not have to deal with that when I was growing up.”

There’s a lot of pressure on young people, Trautwein adds, to be perfect.

Trends in the timing of suicidal thoughts might point to school pressures as a reason, too.

“Weekday evenings from 8 p.m. till 2 a.m. the next day, texts are 10 percent more likely to be about suicide. Late Sunday nights into Monday morning have the highest rates of discussions about suicide,” says Morrison of Crisis Text Line.

Summertime and weekends, on the other hand, are slow. Morrison speculates that suicide-related crises peak on the days and in the hours that kids are in school or thinking about returning to school, such as late Sunday night.

“Prepare for the week ahead. Have open conversations with your teenagers about the responsibilities and stresses of the upcoming week and help them break those down into small, manageable pieces, day by day, moment by moment,” Morrison says.

A Statewide Response

Though 14 teen suicides in Georgia happened in just 2 months this year, investigators have no evidence that the deaths are related or represent a “cluster.”

“Suicides have been happening,” says Randle. “Our kids have been attempting to take their lives. They’ve been voicing suicidal thoughts for some time. The public just isn’t aware.”

The deaths prompted Georgia state agencies to expand school faculty training. The Georgia Bureau of Investigation, Department of Education, and Department of Public Health joined forces to host suicide prevention summits in school districts where teen suicides had happened for 3 consecutive years: Macon, Rome, Gainesville, and Gwinnett County. Nearby schools sent teams of representatives to the summit.

State law also requires that all educators in the state complete 2 hours of youth suicide awareness and prevention training each year to recognize the warning signs and to learn how to respond.

While it’s crucial to give teachers suicide prevention tools, experts say teens themselves are likely the most powerful weapon against the public health crisis. “Kids talk to other kids,” says Randle. “They don’t necessarily talk to other adults.”

School suicide prevention curricula for middle- and high-school students teach them how to recognize signs of suicide in their friends and what to do when they see those signs. The mantra of these programs is ACT:

  • Acknowledge that this is a warning sign of suicide.
  • Care by showing your friend concern.
  • Tell a trusted adult.

The trusted adult could be a parent, coach, teacher, or school counselor.

“We want our students to know that we are here to support them,” says Candace Ford, executive director for counseling, psychological and social work services for Fulton County Schools in Atlanta. “If you’re at risk, you’ve got a trusted adult right here in the building that can help you.”

The message is getting across. “Very often, after we do the curriculum, students come forward,” Ford says. “They self-identify or they identify other children whom they perceive to be at risk.”

At that point, the school notifies the parents and connects the family with counseling, medical care, or other appropriate services.

Know the Signs

Four out of five teens who attempt suicide give clear signs that may be obvious to health professionals but not to parents and friends. Here are some red flags. Most people will show more than one sign. They might:

  • Talk about wanting to die
  • Get affairs in order, say goodbye to people, give away belongings
  • Look for a way to commit suicide
  • Talk about feeling hopeless or having no purpose
  • Talk about feeling trapped or in unbearable pain
  • Talk about being a burden to others
  • Increase drug or alcohol use or other risky or reckless behaviors
  • Appear unusually anxious or agitated
  • Sleep too much or too little
  • Withdraw from or lose interest in usual activities, interests, or relationships
  • Show rage or seek revenge
  • Display extreme mood swings
  • Get falling grades
  • Change their behavior

“If you have suspicions that your child is suicidal, then check it out,” says Ford. Some authorities recommend that parents monitor Internet and social media activity as a rule of thumb. Ford suggests that parents investigate the following:

  • Check out your child’s social media posts and the posts of people they follow.
  • Talk to your child’s teachers or schedule a meeting with the school.
  • Find out what your child’s friends are telling their parents about your child.

There is help for people with depression or who are at risk of suicide. If you see any warning signs in your child or someone else’s, here’s what you can do:

  • Take talk of suicide seriously.
  • Prevent access to weapons, prescription drugs, alcohol, or any other means.
  • Do not leave the person alone.
  • Call a state or national suicide prevention hotline. In Georgia, call the Georgia Crisis and Access Line at 1-800-715-4225. Nationwide, call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255).
  • Take the person to an emergency room or other medical or mental health professional.

Talk to Your Children

The topic of suicide is out there. It’s on television, streaming, on the Internet, and on social media, whether parents talk about it or not. What’s more, studies show that suicidal thoughts and attempts increase when suicide is covered in the media. Recently, two California families blamed the TV show 13 Reasons Why, which was renewed for a second season and highly criticized by suicide prevention experts, for their children’s suicides.

A recent study found that internet searches for terms like "how to commit suicide" and "commit suicide" increased after the show aired. They also increased for "suicide hotline" and "suicide prevention."

“Use it as a road in,” says Morrison. “Those shows are the perfect rapport-building, natural in-road to talking about suicide directly, which is one of the key things that parents can do to manage a suicidal child. In an open-ended way, ask how the child feels about that news story or that TV show and whether they can relate. Let the child guide the conversation.”

Talking about suicide and emotional pain will not make someone suicidal or more suicidal. “If anything, it’s going to give support and open the door to support them further when you ask directly about what’s going on,” Morrison says.

Use news stories and TV programs as teaching moments. Understanding why experts found 13 Reasons Why harmful can help parents know important points to address. Here’s what critics say:

  • The program includes graphic details on how the main character ended her life. Research shows that for at-risk viewers or readers, the chance of suicide can rise if what they're watching or reading includes a detailed explanation of the cause of death. “A vulnerable kid looking at it can see it as a how-to manual,” says McKeon.
  • The plot line implies that seeking help is futile. Tell kids that that the guidance counselor’s response on the show is inappropriate and isn’t typical. By contrast, when an episode of teen drama One Tree Hill dealt with suicide, characters called the National Suicide Prevention Lifeline, and the episode was followed by a public service announcement about the hotline. “We got 700 calls within 5 minutes when that aired,” says McKeon.
  • The suicide is depicted as an act of revenge, which experts say is not an accurate explanation for it. Explain to children that suicide is not a common response to life’s challenges and that there are healthy ways to cope with pain.

For more talking points to discuss with your child, visit the website of Suicide Awareness Voices of Education.

'Know It And Show It'

Before a child ever shows signs of suicide risk, parents can create a culture of empathy and understanding that could help prevent their son or daughter from going down that road.

Trautwein stresses to parents that life is harder for young people now than it was when he was growing up. Today’s teens are under constant social media scrutiny, and competition for everything from sports teams to college admission is tougher. Parents should let their children know they understand that. “Know it and show it” is his motto.

Looking back, Trautwein recalls that his son had trouble sleeping. “That was the only sign that we missed. We didn’t know that could be a sign of depression or a potential sign of suicide.”

Trautwein’s approach with his son Will was constant enthusiasm and positivity about all the new opportunities that were available to him.

“Will was probably thinking ‘What’s wrong with me? My dad thinks all this is great. Why don’t I think it’s great?’ ” Today, Trautwein’s message to his children is different. “I say, ‘Wow, this is really hard. I didn’t have to do this when I was growing up. It’s OK to think it’s hard. It’s OK to not be OK.’ ”

 

Resources:

  • National Suicide Prevention LIfeline: 1-800-273-8255
  • Crisis Text Line: Text "CALM" to 741-741
  • Suicide.org: List of suicide hotlines by state

 

 

WebMD Article Reviewed by Hansa D. Bhargava, MD on July 25, 2017

Sources

John Trautwein, founder, Will to Live Foundation, Atlanta.

Trebor Randle, special agent in charge, Child Fatality Review, Georgia Bureau of Investigation, Atlanta.

Richard McKeon, PhD, chief, Suicide Prevention Branch, Division of Prevention, Traumatic Stress and Special Programs, Substance Abuse and Mental Health Services Administration, Rockville, MD.

Candace Ford, executive director, counseling, psychological and social work services, Fulton County Schools, Atlanta.

Reporting on Suicide.

The Jason Foundation.

CDC: “Increase in Suicide in the United States, 1999–2014.”

CDC: "QuickStats: Suicide Rates for Teens Aged 15-19 Year, by Sex -- United States, 1975-2015."

Substance Abuse and Mental Health Services Administration: “Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.”

News release, Georgia Bureau of Investigation.

Suicide Awareness Voices of Education: “13 Reasons Why Talking Points.”

Ayers, J. JAMA Internal Medicine, July 31, 2017.

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