YOUNG ADULTS AND SUICIDE

1. YOUNG ADULTS AND SUICIDE Amy Danusiar Hadeal Salamah

2. INTRODUCTION/HISTORICAL UNDERSTANDING OF SUICIDE • Suicide describes the voluntary and intentional act of taking one’s own life. • Two Latin words: • sui (self) • Caedere (to kill) • FACTS from 2007-2009 • Approximately once every eighty seconds a teenager attempts to take his or her own life and approximately once every one hundred minutes a teen actually completes a suicide. • Suicide is the third leading cause of death for 15-24 yr. olds in U.S. • Car accidents and murder are first two leading causes

3. From: Teens and Suicide by Hal Marcovitz (page 10)

4. MYTHS ABOUT SUICIDE • People who talk about suicide don’t commit suicide • Suicide happens without warning • Suicidal people want to die • Suicide is related to socioeconomic status • People who want to commit suicide are mentally ill, crazy, or insane • People who threaten suicide are just seeking attention • Talking about suicide or asking someone if he or she is suicidal will encourage the person to attempt suicide • TAKEN from Suicide: An Essential Guide for Helping Professionals and Educators (page 9-10)

5. CLASSICAL GREECE AND ROME: VIEWS OF SUICIDE • Aristotle: • Considered the act to be unwise since the state would lose a useful citizen • “an offense against the state” • Plato • Reasonable option if life became unbearable

6. CLASSICAL GREECE AND ROME • Greek government supplied poison to people who requested it • Whoever no longer wishes to live shall state his reasons to the Senate, and after having received permission shall abandon life. If your existence is hateful to you, die; if you are overwhelmed by fate, drink the hemlock. If you are bowed with grief, abandon life. Let the unhappy man recount his misfortune, let the magistrate supply him with the remedy, and his wretchedness will come to an end (Alvarez, 29) • Romans viewed it as bravery and virtue

7. STATISTICS ON TEEN SUICIDE IN U.S. • 3rd leading cause of death for youth between 15-24 • 4600 teens commit suicide every year, 20% of all deaths annually between 15-24 year olds • For every completed suicide there are 100-200 attempts • 1 in 12 teens attempt suicide, 1 in 6 seriously consider it • More likely during 9-10th grade than 11-12th

8. CHANGING SUICIDE TRENDS • Suicide rate had declined 1990-2003 by 28.5% • In 2003-2004 study by CDC, rate jumped by 8% for teens of all ages • 2009 Teen Suicide rate was 6:3%, 2011 rate was 7.8%

9. GENDER FACTORS Male complete suicides 4:1 compared to females Females attempt suicide 3:1 compared to males Firearms most commonly used method by young males (56%) Poisoning most commonly used method among young females (37.4%)

10. GENDER FACTORS Rate among 10-14 year old girls increased by 76% 2003-2004(overall rate still low, fewer than 1/100,000) Rate among 15-19 year old girls increased by 32% Rate among 15-19 year old boys increased by 9%

11. RACIAL/ETHNIC DISPARITIES Suicide rate among American Indians/Alaska Natives (ages 15-34) is 2.5 times higher than national average (Suicide Facts at a Glance, CDC 2012)

12. RACIAL FACTORSYOUTH RISK BEHAVIOR SURVEY, US 2011 • “Felt sad or hopeless every day for 2 weeks or more” Females: Hispanic 41.4%, White 34.3%, Black 31.4% Males: Hispanic 24.4%, White 20.7%, Black 18% • Suicide Plan in last 12 months: Hispanic 14.3%, White 12.1%, Black 11.1% • Suicide Attempt 1 or more times in last 12 months: Hispanic 10.2%, Black 8.3%, White 6.2%

13. METHODS OF SUICIDE Current CDC Statistics Change in Method 1990 guns used in approximately 50% of suicides among young females 2004 death by hanging/suffocation 71% of girls aged 10-14, 50% females aged 15-19 • Firearms 45% • Suffocation 40%, • Poisoning 8%

14. RISK FACTORS FOR TEEN SUICIDE • Depression/Psychiatric Condition • Low Self-Esteem • Bullying • School pressure • Family Dysfunction/History of Suicide • Substance Abuse/Aggressive behaviors • Sexual Orientation/Sexual Minority

15. DEPRESSION • Main cause of suicide • People with mood disorder (depression, anxiety disorder, bipolar disorder)12 to 20 times as likely to commit suicide • 15-24 year olds suffer higher rate of depression and suicidal thoughts and also least likely to seek outside help of any age group

16. SIGNS OF DEPRESSION • Losing interest in hobbies, school, friends • Sleeping too much or too little • Frequent Crying/ uncontrollable • No energy/constant fatigue • Trouble concentrating • Weight gain or loss

17. SELF- ESTEEM ISSUES • Body image • Super-skinny models and the media • A survey of 2000 teenage girls revealed that 19% were overweight and yet 67% thought they were too heavy • Teenage girls feel the need to lose weight and thus turn to bulimia, anorexia, • Feeling rejected or not good enough • Think they have no place or purpose in the world

18. From: Youth and Suicide by Brent Q. Hafen and Kathryn J. Frandsen (page 93).

19. BULLYING / LONELINESS • The internet has created a new world of communication where a new method of bullying is also created. • Studies show that 50% of students claim to be alone most of the time online • 16% talk to their parents about what they do online • Many teens take photos, put them on the internet and send through text messages • National Crime Prevention Council study: 43% of teens state they had been bullied online • http://www.youtube.com/watch?v=vmQ8nM7b6XQ

20. BULLYING • Feeling not accepted by others • Teens who are bullied at home tend to become bullies at school • http://www.nydailynews.com/news/crime/teen-commits-suicide-rape-endless-bullying-family-article-1.1314786

21. SCHOOL STRESS Problems at school • Stress of passing tests, homework, getting into college (students’ choice or parents’?) • Fitting in, popularity • Setting high standards and not achieving them • Pressure to succeed

22. FAMILY DYSFUNCTION/HISTORY OF SUICIDE • Family situation • Two working parents—children and teens don’t get as much attention • Children put into day care and grow up feeling lonely • Kids born to parents who didn’t plan or expect them • Families constantly moving—teens constantly have to adjust to new houses and loss of friends = loneliness • Problems in house—divorced or fighting parents, custody battles • Alcoholic parents • History of family suicide • Suicidal parents

23. SUBSTANCE ABUSE • 25% of all people committing suicides (adult and teen) are dependent on alcohol • 50% of all people committing suicide have alcohol in their system

24. SUBSTANCE ABUSE IN TEENS • Substance abuse in teens may mask depression—aggressive behaviors hide underlying symptoms • People with both depression and substance abuse issues are at greatly increased risk of committing suicide than either factor individually

25. SUBSTANCE ABUSE IN TEENS • Alcohol most common substance abused, followed by marijuana • Students’ opinions on marijuana as risky dropped from 50% to 25% since 1987, even more so for alcohol • 38.7% of high school students used alcohol at least once in last 30 days (before survey) • 20% of high school students used prescription drugs without a prescription • Low use for other opiates, sedatives, cocaine, hallucinogens, inhalants, heroin

26. EASY AVAILABILITY OF DRUGS TO TEENS • Marijuana—84% • Amphetamines—50% • Crack—37.5% • Tranquilizers 23.6%

27. SEXUAL ORIENTATION • Center for Disease Control and Prevention: Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9–12 — Youth Risk Behavior Surveillance, Selected Sites, United States, 2001–2009 • Measured risk behaviors in all teens (health risk behaviors—everything from not wearing bike helmet to alcohol and drug abuse and violence)

28. SEXUAL ORIENTATION • Students identifying as homosexual or bisexual at higher risk for all health-risk behaviors than those identifying as heterosexual

29. STUDENTS FORCED TO HAVE SEXUAL INTERCOURSE • 7.2% Heterosexual • 23.7% Gay/Lesbian • 22.6% Bisexual • 19.8% Unsure orientation • 2-3 times more likely

30. STUDENTS WHO FELT “SAD OR HELPLESS” EVERY DAY FOR 2 WEEKS OR MORE • 24.8% Heterosexual • 41.3% Gay/Lesbian • 56.3% Bisexual • 37.6% Unsure orientation • Almost 2 times more likely

31. STUDENTS WHO ATTEMPTED SUICIDE 1 OR MORE TIMES IN 12 MONTHS BEFORE SURVEY • 6.4% Heterosexual • 25.8% Gay/Lesbian • 28% Bisexual • 18.5% Unsure orientation • 4 times more likely

32. SEXUAL ORIENTATION &BULLYINGCDC 2009 SURVEY LGBT AGES 13-21 • 8 out of 10 verbally harassed • 4 out of 10 physically harassed • 6 out of 10 felt unsafe at school • 1 out of 5 was victim of physical assault at school • Those in grades 7-12 were more than twice as likely to attempt suicide than their heterosexual counterparts

33. LGBT FAMILY ACCEPTANCE FACTOR • Those LGBT youth with severe family rejection more than 8 times more likely to report having attempted suicide than peers with little to no family rejection.

34. SUICIDE SIGNALS FROM AMERICAN PSYCHIATRIC ASSOCIATION TEEN SUICIDE BROCHURE • Depressed mood • Substance use • Frequent episodes of running away/incarceration • Family loss or instability, significant problems with parents • Expression of suicidal thoughts/talk of death or afterlife

35. SUICIDE SIGNALS • Withdrawal from friends or family • Difficulties in dealing with sexual orientation • Loss of interest in pleasurable activities • Unplanned pregnancy • Impulsive, aggressive behavior or frequent expressions of rage

36. INTERVENTION: WHAT TO DO? From American Psychiatric Association website, Teens page http://www.psychiatry.org/mental-health/people/teens AT HOME: 
Parents are more likely to see some signs of mental health problems in their teenage children than anyone else.

37. “LET’S TALK ABOUT TEEN SUICIDE” AT SCHOOL: 
Teachers, coaches and other school personnel who interact with students every day, are in an excellent position to notice when students may be showing signs of mental health problems. IN THE COMMUNITY: 
Neighbors or other adults in the community interact with teens in different settings than their parents or teachers do — at stores,  places of worship or recreation centers — and can notice behaviors that parents and teachers might not see.

38. “LET’S TALK ABOUT TEEN SUICIDE” TAKE THESE STEPS: • NOTICE   Notice the warning signs (see below) of mental health problems.  The signs usually aren’t one-time occurrences; they persist over several weeks. • TALK     If you see any of the warning signs, you can talk to the teen.  Ask how he or she is doing, and be compassionate as you listen and respond.

39. “LET’S TALK ABOUT TEEN SUICIDE” • SHARE    Make sure to share what you’ve seen and heard with someone who can.  Make sure the teen gets help:  
              • The teen’s parents 
                • A mental health professional at school or in the community 
                • A health professional (doctor, nurse) at school or in the community

40. “WHAT SCHOOLS CAN DO”, LGBT HEALTH, CDC.GOV • Identify safe spaces for LGBT teens and teens of any sexual orientation to receive support from teachers, administration, other students • Found/support student organizations that promote acceptance and respect

41. SAFE SPACES • Advocate for policies to prevent violence/bullying • Encourage training for staff on gender identification issues, encourage staff to attend • Facilitate access to community-based providers: health, social, and psychological services

42. PREVENTION RESOURCES • National Suicide Prevention Lifeline: http://wuicidepreventionlifeline.org/ • Substance Abuse and Mental Health Services Administration (SAMHSA) Preventing Suicide: Toolkit for High Schools • Stop A Suicide resources, anonymous mental health screening quiz, http://www.stopasuicide.org/ • Online mental health screening: http://www.helpyourselfhelpothers.org/ • The Trevor Project: suicide prevention services to LGBT http://www.thetrevorproject.org 1-866-4U-TREVOR(1-866-488-7368)

43. SUPPORT OF FAMILIES AND FRIENDS OF SUICIDE VICTIMS • Those left behind “The who are left behind in the wake of suicide are left to deal with the guilt and the anger, to sift the good memories from the bad, and try to understand an unexplainable act” (Jamison, 291) • Seeking professional help • Often those who know the person who committed suicide feel a sense of guilt • “The two most common negative feelings that differentiate the bereavement of suicide and other kinds of death are shame and guilt” (Granello, 12) • Can lead to depression and anxiety

44. HAVE A FRIEND WHO IS THINKING ABOUT SUICIDE? • According to American Association of Suicidology • Be direct, don’t just remain silent • Be willing to listen • Don’t debate whether suicide is right or wrong • Don’t offer false reassurances that everything will work itself out • Don’t act shocked • Seek professional help

45. NONFICTION RESOURCES • Crook, Marion. Out of the Darkness: Teens Talk about Suicide. Vancouver. Canada: Arsenal Pulp Press, 2004. • Esherick, Joan. The Silent Cry: A Teen’s Guide to Escaping Self-Injury and Suicide. Pennsylvania: Mason Crest, 2004. • Granello, Darcy and Granello Paul. Suicide: An Essential Guide For Helping Professionals and Educators. New York: Pearson, 2007. Jones, Jami. Helping Teens Cope: Resources for School Library Media Specialists and other Youth Workers. Worthington: Linworth Publishing, Inc, 2003. • Powell, Jillian. Self-Harm and Suicide. Pleasantville, NY: Gareth Stevens, 2009. • Preventing Suicide: A Toolkit for High Schools (free toolkit) http://store.samhsa.gov/product/Preventing-Suicide-A-Toolkit-for-High-Schools/SMA12-4669 • Sperekas, Nicole B. Suicide Wise: Taking Steps Against Teen Suicide (Teen issues). Berkeley Heights, N.J.: Enslow Publishers, 2000.

46. YOUNG ADULTFICTION: ABOUT SUICIDE • Asher, Jay. Thirteen Reasons Why. New York: Penguin, 2007. • Fine, Anne. Up on Cloud Nine. New York: Delacorte, 2002. • Ford, Michael T. Suicide Notes: A Novel. New York: Harper Collins, 2008. • Green, John. Looking for Alaska. New York: Dutton Books, 2005. • Jay’s Journal. New York: Simon Pulse, 1979.  • Lacour, Nina. Hold Still. New York: Dutton Books, 2009.

47. YOUNG ADULTFICTION: ABOUT SUICIDE • Olsen, Gregg. Envy. New York: Splinter, 2007. • Peters, Julie. By the Time You Read this, I’ll be Dead. New York: Disney, 2010. • Wilson, Martin. What They Always Tell Us. New York: Delcorte Press, 2008. • Wolf, Allan. Zane’s Trace. Massachusetts: Candlewick Press, 2010.

48. WEBSITERESOURCES American Association of Suicidology (www.suicidology.org) National Alliance on Mental Illness (www.nami.org) Suicide Awareness Voices of Education (www.save.org) National Suicide Prevention Lifeline: (suicidepreventionlifeline.org/) Online mental health screening:(www.helpyourselfhelpothers.org) Stop A Suicide(www.stopasuicide.org) Teen Drug Addiction. www.teendrugaddiction.com American Psychological Association. www.apa.org/topics/teens/

49. WORKS CITED/MORE RESOURCES • Alvarez, A. Early Views of Suicide. New York: Greenhaven Press, 2006. • Ayer, Eleanor. Teen Suicide: Is it Too Painful to Grow Up? New York: Twenty-First Century Books, 1993. • "Facts and Figures.” Stop a Suicide Today. Screening for Mental Health, Inc,  2013. Web. 24 September 2013. • Giddens, Sandra. Frequently Asked About Suicide. New York: Rosen Publishing, 2009. • "Girls’ Suicide Rates Rise Dramatically.” CBS News.com. CBS News.com. February 11, 2009. Web. 24 September 2013.

50. WORKS CITED, CONT. • Hafen, Brent Q and Kathryn J. Frandsen Youth and Suicide. Cordillera Press, 1986. • “Injury Center: Violence Prevention, Suicide Prevention.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, August 15, 2012.  Web. September 21, 2013. • Jamison, Kay R. Night Falls Fast: Understanding Suicide. New York: Alfred A. Knopf, 1999. • Johnson, Wanda Y. Youth Suicide: The School’s Role in Prevention and Response. Bloomington: Phi Delta Kappa Educational Foundation, 1999.