Suicide as a Health Risk Among Adolescents

Background

Suicide refers to a fatal or lethal self-injurious action linked to some proof of the intent to die. It is a severe public health issue, which disproportionately impacts young individuals within the U.S and globally (Breux & Boccio, 2019). Suicide among the youthful populace, including adolescents aged between 15- and 29-years, accounts for approximately a third of all suicide incidents worldwide (Björkenstam et al., 2017; Miranda-mendizabal et al., 2019). Suicidal deportment integrates aspects such as completed suicide, attempting or attempted suicide, planning suicide, and suicidal ideation (Campisi et al., 2020). The analysis of suicidal behavior determinants within this populace segment is crucial to the initiation of early intervention approaches and their prevention. This paper provides:

  • An overview of suicide, a risk factor among youths.
  • Its contributing factors, prevalence within the community.
  • The role of healthcare practitioners in addressing the issue.
  • Ways of distinguishing and resolving this problem.
  • Support resources and an activity related to the issue.

Overview

Various terms are used to characterize this mental condition; they include suicidal ideation, suicide attempt, and suicide death. Robin et al. (2018) identify suicidal ideation as the desire to or consideration of terminating one’s life; it usually ranges from active to passive thoughts. Research integrating actual-time monitoring and self-report techniques demonstrates that adolescents within the community who experience suicidal thoughts do so at a moderate frequency with varying severities of between mild and moderate ideations. Perry et al. (2016) distinguish suicide death as a deadly act to intentionally end one’s life, as routinely ascertained by a proxy informant, coroner, or medical examiner.

The most typical suicide approaches used by adolescents include the use of firearms, ingestion or overdose, and suffocation or hanging. On the other hand, a suicide attempt refers to a premeditated act to purposefully end one’s own life. Suicidal behaviors and thoughts among this population segment demand significant concern levels due to several reasons.

First, there is a substantial surge in the incidence of suicide demises across the lifespan, which, according to Miranda-Mendizabal et al. (2019), occurs between young adulthood and early adolescence. Second, suicide is among the dominant causes of death within this particular age group compared to other growth stages. As indicated earlier, it ranks second amid the leading causes of demise during adolescence and childhood, and according to Campisi et al. (2020), it is the tenth major death cause amid all age groups. Third, several individuals who attempted or considered suicide in their lifetime did so in their youthful phase.

This viewpoint is supported by Campisi et al. (2020), who identify the young adulthood phase as the lifespan stage linked to the onset of suicidal attempts and ideation. Ultimately, suicide-related demises are preventable – the adolescence phase presents a primary opportunity for prevention.

Contributing Factors

The description of the term youth, with regard to specific age ranges, is relatively arbitrary and differs through time and by country. Suicide among children aged five years is rare. Most studies on suicide among youths or adolescents refer to the following population: adolescents aged between 13 and 20 years and school-aged children aged between 7 and 12.

Mental conditions

Studies by different researchers highlight the interconnection between suicide and mental health conditions. According to Campisi et al. (2020), around 90% of the individuals who commit suicide have a history of at least one psychological disorder. Campisi et al. (2020) further argue that psychiatric conditions account for approximately 47%-to-74% of risks linked to suicide.

Depression is responsible for around 51%–66% of suicide incidents and is typical among women than males (Robin et al., 2018). Substance abuse, especially alcohol misuse, is positively linked to suicide risks, particularly among males and older adolescents. Approximately 30 to 40 % of individuals who succumb to suicide death had been diagnosed with a personality disorder (Robin et al., 2018). Suicide has also been ascribed to demises among adolescents with eating disorders, especially anorexia nervosa, anxiety disorders, and schizophrenia patients.

History of Suicide Attempts

A strong connection exists between suicide and self-harm history or initial suicide attempts. Around 25-33% of all suicide cases are preceded by a previous suicide attempt, an observation whose incidence was statistically significant among men than females (Perry et al., 2016). According to Perry et al. (2016), adolescent males and females with a history of initial suicide attempts have been linked with a thirty-fold and threefold increased susceptibility to suicide risks, respectively.

Personality Characteristics

There is a relationship between suicide and impulsivity. The fatal move or transformation from suicidal thoughts and attempts to actual suicide occurs impulsively, unexpectedly, and suddenly, particularly amid adolescents. Challenges in managing the varying mixed but strong emotions and fluctuations in mood, accompanied by the burden of the ever-changing and new confrontations in different domains, contribute to youthful suicide. Korczack et al. (2020) associate this phenomenon with the bio-neurological aspects. Studies also associate young individuals who commit suicide with inadequate problem-solving proficiencies when compared to their peers. These factors typically trigger low self-esteem and self-efficacy, as well as insecurity. According to Korczack et al. (2020), they may prompt perfectionist personalities, aggressive deportments, anger, and suicidal and emotional crises.

Family Factors

The family context in which one grew up or lived is among the most crucial support sources when addressing youths’ multiple issues. According to Campisi et al. (2020), numerous risk factors linked to family processes and structure have been associated with suicidal behavior. Campisi et al. (2020) support this viewpoint by arguing that approximately 50% of suicide cases among youths are connected to family factors, including immediate family members’ mental disorder history, particularly substance abuse and depression. Suicidal behavior’s augmented presence exists amid the family members of self-destructive adolescents. Poor communication, violence, parents’ divorce, and direct conflicts among family members have also been implicated in the increased suicide prevalence among youths.

Specific Life Events

In the midst of developing self-confidence, establishing one’s identity, and addressing upcoming challenges, many adolescents typically attach significance to being involved in specific peer groups, creating intimate relations, as well as developing security and confidence. Interpersonal losses, including peer rejection, friends’ demise, and relationship break-ups, may generate substantial impacts in a youth’s life.

School-related issues and academic distress have also been linked to around 14% of suicide instances among youths (Perry et al., 2016). Severe conflicts with guardians or parental figures account for 40% of these cases (Perry et al., 2016). Other prominent contributing factors include disciplinary issues, sexual, physical, and mental abuse, and bullying, including cyberbullying.

Availability of Means

Individuals contemplating suicide are typically ambivalent regarding this decision. As indicated earlier, the transformation from suicidal thoughts to actual suicide usually occurs impulsively due to severe psychosocial stressors, particularly among youths. Accessibility to means of committing suicide can enhance this progression during that moment and under that particular circumstance. The chosen suicide method may also ascertain the fatality of the act. For instance, children typically commit this action by drug poisoning using prescription medications, running into traffic, jumping from high places, and hanging. On the other hand, adolescents use firearms, poison, and hanging. Robin et al. (2018) endorse the restriction of physical availability suicide means and cognitive availability as preventive strategies for suicide.

The Prevalence of Suicide Among Adolescents

Suicide among the youthful populace, including adolescents aged between 15- and 29-years, accounts for approximately a third of all suicide incidents worldwide (Miranda-Mendizabal et al., 2019; Björkenstam et al. 2017). Furthermore, according to Campisi et al. (2020), it ranks second among the significant demise causes within this population segment. Although the above-mentioned risk factor accounted for less than 2.3% demises in the U.S in 2016, it was responsible for around 20.2% of deaths among youths between 15 and 24 years old (Campisi et al., 2020).

The global incidence for suicide deaths among early adolescents (children aged 10 to 14 y/o) is 0.94 in every 100,000 females and 1.52 in every 100,000 boys, which, according to Campisi et al. (2020), increase significantly to 10 in every 100,000 individuals in late adolescence, i.e., 15 to 19 y/o. A meta-analysis consisting of twenty-four pieces of research revealed that females have a considerably high suicide attempt risk than their counterparts (Campisi et al., 2020). Furthermore, according to Breux and Boccio (2019), a significant number of minority youths experience some suicidality level compared to adolescents from other ethnic groups.

My Role as a Healthcare Provider

My role as a healthcare provider in preventing suicide and promoting better mental health outcomes incorporates patient and system level approaches. At the systems level, my duty involves taking part in training pertinent to suicide prevention and developing appropriate practices, policies, and protocols that improve mental health. On the other hand, my responsibilities at the patient level include supervising and monitoring at-risk patients, offering suicide-centered psychotherapeutic interventions, and analyzing all initiated interventions’ outcomes.

Furthermore, as a care practitioner, I am tasked with documenting suicide risks accurately and comprehensively. To execute this duty effectively, healthcare providers are required to report risk levels during the initial assessment, hospitalization, and at discharge. I will also conduct continuous evaluations of the environment to ascertain its safety levels and initiate modifications accordingly. This can be done by distinguishing environmental risks at the individual and unit levels, identifying conditions likely to indicate higher patient suicide threats. Potentially dangerous items around patients should be removed, mainly if they are at risk of self-harm, and ascertaining the needed patient supervision level.

Ways of Identifying the Problem and Addressing the Issue

Devising a stepwise approach for developing a strategy for suicide prevention can aid in distinguishing and addressing this issue at the state and local level. The above-mentioned approach consists of several phases which will be discussed below:

Identifying stakeholders

This phase is crucial in developing an appropriate prevention approach. Suicide prevention, according to Perry et al. (2016), require a multisectoral strategy which integrates healthcare practitioners and representatives from different sectors. These stakeholders include

  1. Governmental sectors, including the health ministry as well as the social and education welfare ministry.
  2. Healthcare professionals such as public health managers, nurses, physicians, and emergency care experts.
  3. Mental health practitioners, including psychiatrists, social workers, mental health nurses, and service managers.
  4. Professionals in the education sector, including administrators, school counselors, and teachers.
  5. Legal experts, including the medico-legal professionals.
  6. Policy makers.
  7. Nongovernmental organizations, families and survivors, and youths.

Conducting a situational evaluation

This analysis will help to distinguish the issue’s extent in a specific geographical region. The assessment should assess the yearly incidence of suicide attempts and suicide, clinical, structural, and socio-demographic factors, the typical methodologies and potential reasons for suicide, as well as the availability of these methods.

Evaluation of the required resources and their availability

According to Robin et al. (2018), the access and availability of both fiscal and human resources is central to the comparative public health intervention’s success.

Attaining political commitment

Political commitment is crucial in ensuring that the initiative acquires the resources it needs and the attention from state and national leaders. This can be done by increasing awareness, frequent publication, and continuous lobbying with government representatives.

Addressing stigma

Stigma linked to suicide is still a primary barrier to efforts related to suicide prevention. Stigma can hinder individuals from seeking assistance and can become an obstacle to accessing services that promote suicide prevention, including postvention support and counselling.

Increasing awareness

Involving the media can be instrumental in the strategy development procedure. Stakeholders should be informed of the achieved progress. Communication advocacy, and awareness raising can influence public opinion and policy makers; this consequently helps in mobilizing resources and political commitment. Awareness can also trigger sustained and increased stakeholder involvement, and increase community buy-in.

Proposed Activity

The audience will be requested to

  • Share three learned concepts with three individuals in the audience.
  • Write down four activities they intend to implement in their routine activities to promote their mental health status.
  • Share whatever they wrote down with three or four individuals within the audience.

Help and Support Resources

Suicide prevention resources according to the SAMHSA (Substance Abuse and Mental Health Services Administration) include

  • Crisis lines which offer support to individuals in crisis 24/7. They include Crisis Text Line (Text 741741), National Suicide Prevention Lifeline (call 1-800-273-TALK (8255) or chat), Trevor Lifeline (1-866-488-7386 or text “START” to 678678), Trans Lifeline (call 877-565-8860). (“Resources for suicide prevention,” 2020).
  • SAMHSA resources for prevention located on the institution’s website (https://www.samhsa.gov/childrens-awareness-day/event/resources-suicide-prevention). These resources include the resource center for suicide prevention, a detailed approach for preventing suicide, and the appropriate mode for suicide prevention (“Resources for suicide prevention,” 2020).
  • Professional, as well as family and youth resources, such as Chatsafe available on the SAMHSA website (“Resources for suicide prevention,” 2020).

Other resources include

  • Online support and forums such as BetterHelp, IMAlive, and Self-Injury Outreach and Support, and Society for the Prevention of Teen Suicide (Robin et al., 2018).

References

  1. Björkenstam, C., Kosidou, K., & Björkenstam, E. (2017). Childhood adversity and risk of suicide: Cohort study of 548721 adolescents and young adults in Sweden. BMJ, 357, 1–7. Web.
  2. Breux, P., & Boccio, D. E. (2019). Improving schools’ readiness for involvement in suicide prevention: An evaluation of the creating suicide safety in schools (CSSS) workshop. International Journal of Environmental and Public Health Research, 16, 1–15. Web.
  3. Campisi, S. C., Carducci, B., Akseer, N., Zasowski, C., Szatmari P., & Bhutta, Z. A. (2020). Suicidal behaviours among adolescents from 90 countries: A pooled analysis of the global school-based student health survey. BMC Public Health, 20, 1–11. Web.
  4. Korczak, D. J., Finkelstein, Y., Barwick, M., Chaim, G., Cleverley, K., Henderson, J., Monga, S., Moretti, M. E., Willan, A., & Szatmari, P. (2020). A suicide prevention strategy for youth presenting to the emergency department with suicide related behaviour: Protocol for a randomized controlled trial. BMC Psychiatry, 20, 1–11. Web.
  5. Miranda-Mendizabal, A., Castellvı, P., Pare´ s-Badell, O., Alayo, I., Almenara, J., Alonso, I., Blasco, M., Cebria, A., Gabilondo, A., Gili, M., Vilagut, G., & Alonso, J. (2019). Gender differences in suicidal behavior in adolescents and young adults: Systematic review and meta-analysis of longitudinal studies. International Journal of Public Health, 64, 265–283. Web.
  6. Perry, Y, Werner-Seidler A, Calear, A. L, & Christense, H. (2016). Web-based and mobile suicide prevention interventions for young people: A systematic review. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 25(2), 73-79. Web.
  7. Resources for suicide prevention (2020). the SAMHSA. Web.
  8. Robinson, J., Bailey, E., Witt, K., Stefanac, N., Milner, A., Currier, D., Pirkis, J., Condron, P., & Hetrick, S. (2018). What works in youth suicide prevention? A systematic review and meta-analysis. LANCET, 4, 52–91. Web.

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