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PREVENTION OF
YOUTH SUICIDE
Youth suicide generally occurs in the context of the
youth's emotional, family and social environment.
Prevention and intervention strategies of youth
suicide will need to take these factors into
account.
Although the utopian concept of a society devoid of
stress, family or social problem is unlikely, it
does not mean that one should not strive for a
better physical and emotional environment for our
young people. Better education, employment, self
development and leisure opportunities are just a few
examples where we can help our youths to reduce
their stresses. This decrease in stress and
promotion of well-being is primary prevention. The
early intervention when a problem arises, e.g. the
prompt management of depressive symptoms, is known
as secondary prevention. The prevention of
complication, e.g. suicide as a result of
depression, is known as tertiary prevention. Any
effective preventive pro gram should include these
levels of prevention.
WHAT CAN PARENTS DO TO PREVENT YOUTH SUICIDE?
There are several things that parents can do to
prevent youth suicides. Some of these are general in
nature whilst others are more specific.
| 1. |
Form a good
relationship with the youth. |
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During early childhood development,
children generally bond with their
parents and they have a good and
trusting relationship. They grow up
trusting their outside world and see it
as a safe place where they can continue
to grow and develop. This growth reaches
its peak during adolescence. The youth
needs to come to terms with rapid
physical growth; conflicts between
parental and peer values and ideals;
emotional and physical intimacy with the
opposite sex and the uncertainty about
his/her future career. These
"developmental tasks" can generate a
great deal of pressure but most young
people complete them successfully
without too much difficulties.
Despite popular belief to the contrary,
most teenagers do want a close
relationship with their parents even
though they may not admit to it openly.
The relationship with their parents may
have changed in form and content but it
is in fact a continuum of their past
relationship. Parents have to grow and
change in parallel with their teenagers.
It is a two way process. If the
relationship is there, teenagers
generally acknowledge and respect their
parents' values and they want their
advice and support, especially at times
of stress.
A good relationship will open up
communication between the youth and
his/her parents. This can be a life
saving safety valve to the depressed and
troubled teenager. Support and early
intervention can be effected before the
youth contemplate suicide as an option.
Relationship between teenagers and their
parents can be improved by:
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Providing a stable, safe physical
and emotional home environment.
This may seem obvious but
unfortunately this is not always the
case as exemplified by the problem
of homeless youths. With many
families breaking up and dispute
over the custody and access of
children, the teenager may become
the "pawn" of the parental battle.
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Spending quality time with young
people.
"Quality time" is a cliche
frequently used in child rearing
literature and it is met with a
certain degree of cynicism. However,
a good relationship between a youth
and his/her parents cannot occur
unless they spend time together. It
is common to hear parents and
teenagers talk about their constant
arguments about everything. The
amount of time spent in conflict is
huge. Why not spend some of this
time having fun together?
-
LISTENING to teenagers, not only to
what is being said, but also to the
covert messages.
Teenagers commonly complain that
their parents are keen to give
advice but they don't listen to
their points of view. Messages sent
by teenagers may at times be
tangential, contradicting and
confusing. Parents will need to
"de-code" these scrambled messages
to get in touch with their
children's feelings. In many
instances this may mean an
interpretation of their body
language. Non-verbal action can
"talk" much louder than
conversational language.
- Being
supportive and not intrusive.
There is a fine line between being
supportive and being intrusive. It
is important for parents to
acknowledge the upset and distress
shown by their teenage children, but
not interrogating and demanding to
know the "secrets" of their
distress. Teenagers will generally
talk to their parents about their
problems when they are ready.
Respect the fact that they can solve
many problems on their own without
the support of others. Support is
there for them to use but it must
not be imposed on them.
-
Encouraging the appropriate
expression of emotions.
Many teenagers tend to either hide
their emotions or they show them in
an explosive manner, thus leading to
their parents' comments about their
moodiness. Encourage them to show
and share their feelings of joy,
happiness, excitement in their
successes. They can then show and
share their sadness, anxiety,
distress and disappointment. Both
"positive" and "negative" feelings
must be contained so that they are
not running wild and out of control.
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2. |
Early
intervention in stressful situations. |
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Severe emotional symptoms are frequently
found in individuals facing or following
significant life events. Youths facing
court appearances, family break-up,
important examinations or those who have
been sexually abused, expelled from
school, rejected by love ones are a few
examples of common stressful situations
to which young people are subjected.
Support from parents and others is
particularly important to prevent
despair and suicidal ideation. This can
be achieved by being in touch with the
youth's emotional state. Just because
teenagers don't show their feelings
readily, it does not mean that they are
not concerned about impending major life
events or feel distressed after a
personal disaster. Have empathy with
them. They want to be understood by
their parents. Sensitive listening and
appropriate advice or debriefing will
help.
The successful negotiation and
resolution of a stressful situation can
be a confidence booster to the youth.
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| 3. |
Take suicidal
threats seriously. |
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Whether a youth has "genuine" suicidal
intent or not, take all suicidal threats
seriously. Don't trivialise any suicidal
threat. In many instances, the threat is
a cry for help - "I am not coping". If
this is ignored, the youth may decide to
act out his/her threat. It is much safer
to be cautious.
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| 4. |
Early detection
and management of psychiatric illness. |
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Like suicide, psychiatric illnesses
carry with them stigmas and myths. Many
major psychiatric disorders, e.g.
schizophrenia, bipolar affective illness
and anorexia nervosa have their onset in
adolescence. Drug induced psychosis is
another important condition in this age
group. These conditions, which are
responsive to treatment, carry with them
a higher risk of suicide if they are not
managed early and appropriately.
Without describing each psychiatric
condition in detail, the following
symptoms should be taken seriously by
parents:
- Severe and
persistent depressive mood
- Severe
agitation and panic attacks
-
Hallucination - The hearing of
"voices" or seeing things in the
absence of external stimulus.
- Delusion -
a fixed and false belief system that
is alien to the person's family and
cultural background.
- Grossly
elated mood
- The
excessive pre-occupation with
certain ideas (e.g. cleanliness or
body weight) to the point of
affecting the person's daily
functioning.
The presence of
any of these symptoms may indicate the
onset of an underlying psychiatric
illness. With the support and
encouragement of parents, the youth may
agree to professional advice. A proper
assessment is required to plan ways to
help the young person.
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| 5. |
Appropriate
intervention after a suicide attempt. |
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All suicide attempts should be taken
seriously, particularly if the youth has
planned the suicide. Don't dismiss the
attempt as an attention seeking
behaviour. The seriousness of the
attempt is related to the intent of the
youth rather than the method of self
harm. Proper assessment is required
after the attempt and this will
generally mean professional
intervention.
Apart from the suicidal youth, parents
and other family members will also need
a great deal of support and their needs
must not be forgotten.
Parents can do several things to help
their teenager after a suicide attempt:
- Ensure the
physical safety of the teenager.
- Be
available to support the teenager.
- Be caring
but don't be over-protective.
- Close
observation but not being intrusive.
- Return to
routine as soon as practical.
- Removal of
potentially dangerous
substance/weapon.
- Discuss
issues relating to the attempt only
at the initiative of the youth, i.e.
no interrogation.
- Seek help
and advice. Don't sweep the problems
"under the carpet".
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| 6. |
Be vigilant of
changes in behaviour. |
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Be
wary if there is a sudden excessive
elevation of the youth's mood in someone
who was previously severely depressed.
This does not necessarily mean that the
youth is getting better. The youth may
have in fact finally decided to commit
suicide and there is a sense of relief
and therefore the improved mood and
activity level. The youth may give away
his/her precious possessions or ask the
parents to go out so that he/she can
carry out the suicide act.
A teenager who is grossly agitated is
also at risk. The agitation can be
caused by drug, depression, anxiety or
psychosis. In this instance, the suicide
act may be the youth's attempt to
relieve the internal distress and
agitation. Watch out for the youth who
paces the floor and acts like a "cat on
a hot tin roof".
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| 7. |
Seek advice or
help from professionals if in doubt. |
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It
is not easy for parents to come to
accept that their teenager is
emotionally troubled, not to mention
suicide attempt. Parents tend to blame
themselves and ask themselves many "if
only" and "why" questions. Professional
assistance is frequently required for
not only the teenager, but also the
family. Clinical psychologists, general
medical practitioners, psychiatrists,
and competent youth counsellors are some
professionals who are available for
consultation and advice if there is any
doubt that a youth is at risk of
suicide.
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| 8. |
Removal of
firearms or unnecessary medicines. |
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Lethality of attempted suicide is
related to the method employed to harm
oneself. Any potentially lethal material
for suicide should be removed from the
home environment especially if there are
teenagers who are depressed or stressed.
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References:
American Academy of Pediatrics
http://www.aap.org/advocacy/childhealthmonth/prevteensuicide.htm
Youth Suicide Prevention Education Program
http://www.yspep.org/
American Association of Suicidology
http://www.suicidology.org/displaycommon.cfm?an=3
United Way of Connecticut
http://www.infoline.org/Crisis/howhelp.asp
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