Content warning – suicide.
Each year in Australia more than 3,000 people die by suicide, and another 65,000 Australians make a suicide attempt. Researchers estimate that for every person who suicides, another 135 lives are impacted (the friends, family and colleagues they leave behind). I’ve spoken to many families and schools who are worried about the risk of youth suicide within their communities.
Contrary to popular belief, we thankfully have not yet seen a marked increase in suicides over the past 18 months since this pandemic began ( here’s the data on this – https://everymind.org.au/…/data-on-ambulance…). However, the stressful circumstances people are being placed under (businesses imploding, social isolation and the loss of connection to safety nets like schools and sporting clubs) are providing a deeply troubling perfect storm. We are right to be cautious and highly concerned.
While the research clearly shows it’s important to have open, honest conversations with young people about suicide, these must be managed very carefully. And some of the best practice advice on suicide can seem counter intuitive, I know. I thought I’d compile a quick summary of the best practice.
Positive — that’s the key. There are positive things we can all do to help our kids cope when they are feeling overwhelmed. We can listen and look for the signs that all may not be well in their world, and we can offer our support.
What many people who try to take their lives share is a sense of being trapped in a stressful or painful situation, a situation that they are powerless to change. Having depression or a mental illness raises a person’s risk of suicide. Stressful life events or ongoing stressful situations may fuel feelings of desperation or depression that can lead to suicide attempts. Examples of these stresses include the death of a loved one, divorce or a relationship breakup, a child custody dispute, settling in to a blended family, financial trouble, or a serious illness or accident. Any kind of abuse – physical, verbal or sexual – increases the risk. Substance abuse by any member of a family affects the other members of the family and can lead to suicidal feelings either directly or indirectly, through the loss of income and social networks or trouble with the law.
Bullying needs to be taken seriously as it has been known to trigger suicidal thoughts (although we must be careful never to attribute suicide to one cause. The reality is that the underlying reasons for why someone may have taken their own life are complex – regardless of what a letter left behind may say, or what families might initially suspect). Attributing the death to one cause may also trigger suicidal thoughts in other young people (“She was bullied and took her life. I’m being bullied too. Maybe that is the only solution…”).
Also, teens are right in the middle of forming their own individual identities and a major component of that is their sexuality. For a teenager who is questioning their sexual preference or gender, the pressure to be like everyone else, the taunting they receive because they clearly are not, or their own guilt and confusion can become unbearable. A relationship breakup can be a trigger for suicide in some teens. As adults, we have the ability to look at the bigger picture and know that in years to come, a teenage breakup will not seem anywhere near as important as it does at the time. A teenager, on the other hand, may not yet have the maturity to see beyond the immediate pain. If they seems unduly distressed about a breakup, pay attention.
Another trigger for teen suicide is the recent suicide of someone close to them, or the anniversary of a suicide or death of someone close to them, so these are times when our young people may need extra support. This is known as the contagion effect – more on this in a moment.
Suicide is hard to talk about. It is almost taboo, simply too painful to touch on. But silence can be deadly. Often the parents of a teen at risk of suicide do not ask them the tough question of whether they are planning to take her own life. In part they may be in a state of denial, which is only human – after all, no parent wants to imagine that their child feels suicidal. They may also have a fear that seems to be ingrained in our culture: that if they mention suicide to their depressed or distressed person, they will be putting the idea in their head. But experts in adolescent mental health agree that it is more than okay to speak directly to your child about suicide.
Another unhelpful myth about suicide is that a teen who talks about suicide is simply seeking attention and won’t actually take her life. In fact, four out of five young people who suicide tell someone of their intentions beforehand. Besides, I have never understood the point of making a distinction between attention seeking, a cry for help or a genuine intention to suicide. Even if a teen is not actually going to go through with a plan to take their own life, if they are distressed enough to cry out for help, their voice needs to be heard and they need our support.
What you can do
Number one: if anyone – child, adolescent or adult – says something like ‘I want to kill myself’ or ‘I’m going to kill myself’, seek help straightaway. Remove anything they might be tempted to use to kill themselves with and stay with them. Dial 000 in Australia or 111 in New Zealand or a crisis line. I’m amending to add (as a lot of people don’t know this) if you call for an ambulance as you fear someone is suicidal or they have attempted to take their own life, the police will also be sent as well.
The following phone counselling services are available 24 hours a day:
Lifeline: 13 11 14
Kids Help Line: 1800 55 1800
Salvation Army 24-hour Care Line: 1300 36 36 22
– New Zealand
Lifeline: 0800 543 354
Another valuable thing you can do to help someone you fear is having suicidal thoughts is to listen. These pointers are adapted from the Victorian Government’s excellent ‘Youth suicide prevention – the warning signs’ on www.betterhealth.vic.gov.au:
Listen and encourage them to talk
Tell them you care
Acknowledge their feelings
Gently point out the consequences of their suicide, for them and the people they leave behind
Stay calm; try not to panic or get angry
Try not to interrupt them
Try not to judge them
Don’t overwhelm them with too much advice or stories about your own experiences
I highly recommend the suicide prevention training courses delivered by Living Works Australia – these are exceptional. I have completed both their half-day SAFE Talk, and two full day ASSIST suicide intervention course. You may enquire about attending one here: https://www.livingworks.com.au/
Suicide warning signs
Loss of interest in activities they used to enjoy
Giving away prized possessions
Thoroughly cleaning their room and throwing out important things
Violent or rebellious behaviour
Running away from home
Taking no interest in their clothes or appearance
A sudden, marked personality change
Withdrawal from friends, family and usual activities
A seeming increase in accident proneness, or signs of self-harm
A change in eating and sleeping patterns
A drop in school performance, due to decreased concentration and feelings of boredom
Frequent complaints about stomach aches, headaches, tiredness and other symptoms that may be linked to emotional upsets
Rejection of praise or rewards
Verbal hints such as ‘I won’t be a problem for you much longer’ or ‘Nothing matters anyway’
Suddenly becoming cheerful after a period of being down, which may indicate they have made a resolution to take their life.
The contagion effect
Between 2011-2012, there were a horrific 12 youth suicides in South-East Melbourne. We know that adolescents are particularly vulnerable to what is known as a contagion effect. Suicide contagion refers to the process whereby one suicide or suicidal act within a school, community or geographic area increases the likelihood that others will attempt or die by suicide. This is why any conversations we have must be managed sensitively.
Things that may be risky to say include:
– Any discussion of how or where the person died (this is one of the reasons why the TV series 13 Reasons Why was so problematic. It did show where, and how, the main character Hannah took her own life).
– Any attempt to attribute the death to one cause e.g.: bullying, HSC stress, a relationship break up.
– Using phrases such as “now the person is at peace” or “now they can rest.” This idealises suicide and a highly distressed person may view peace and rest as appealing. Headspace explain this as follows: “the glamourising or romanticising of suicide that can occur in the process of communicating about a suicide death. This refers to actions or messages that may inadvertently make suicide seem desirable to other vulnerable young people.It’s common for people to remember the positive things about someone who has recently died and to focus less on the difficulties they may have been having prior to their death. While this may be well meaning, it has the potential to encourage suicidal thoughts and behaviour in other vulnerable young people. Care needs to be taken not to give the impression that suicide was a positive outcome for the young person.”
– Setting up shrines or events in the person’s honour ( by all means honour them privately. Families must grieve however they feel they need to. But the rest of us should, and must, be mindful).
- Reports and discussion of suicides should not be repetitive, as prolonged exposure can increase the likelihood of suicide contagion.
There was an excellent podcast on the contagion effect on ABC recently, I highly recommend it: https://www.abc.net.au/…/contagious-behaviour/12046090
Caring enough to get our friends professional care
Finally, there are a lot of kids who hold heavy stuff for their mates. I teach teens that we should never keep dark secrets for people. When a young person begins talking to me and says something to the effect, “I want to tell you something but you must promise not to tell anyone.” I respond with the following; “You may tell me anything. And I will listen with my whole heart. But if you have been hurt, or could be hurt, I want you to know that I care too much about you not to do something about that.”
All young people need to know that reporting concerns to trusted adults is not a betrayal. Rather, it shows the depth of their compassion and bravery.