Risk Factors Include Abuse, Bullying, Being LGBT - Firearms Are the Second Leading Method of Suicide
Editor's note: This article is being published to help our readers become more aware of the risk factors associated with suicide in the hope of helping reduce and prevent it. See the list of resources at the bottom for more.
Suicide is now the second leading cause of death among teenagers, according to a new report from the American Academy of Pediatrics (AAP) released Monday, which updates guidelines to pediatricians for helping teens manage risk factors for suicide. In 2007, suicide was the third leading cause of death among teens.
A USA Today article also published Monday, "Pediatricians urged to screen for suicide risks among teens," notes, "Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, the nation's largest suicide prevention network, commends the report for shining light on the pediatricians' role in having the right conversations with patients about mental health and providing practical examples of how to ask the right questions that keep adolescents engaged."
Suicide risk factors listed include a history of physical or sexual abuse, mood disorders, drug and alcohol use, self-harm, being LGBT, and bullying, including cyberbullying.
Firearms in the home may also increase risk of suicide, and the AAP recommends that the families of at-risk teenagers remove any guns stored in the house. Firearms were the second leading method of suicide, increasing risk of completed suicide attempts no matter how they are stored.
USA Today adds, "Ben Shain, author of the report and head of the Division of Child and Adolescent Psychiatry at NorthShore University HealthSystem, says suicide rates may have increased due to the stresses and anger levels induced by electronic media and a reluctance to use antidepressant medication."
In fact, frequent internet use was also strongly associated with a higher risk of suicide. Staying online more than five hours per day correlates with an increased risk for depression and suicidal thoughts and actions, although social networking sites mitigate this risk by providing greater social support.
Pediatricians should be looking for other health concerns, including typical symptoms of mental health issues like negative feelings, fatigue, and insomnia, as well as behavioral problems and physical symptoms like chest pain, headaches, weight loss, and lack of energy.
Additionally, learning about another person's suicide can be a risk factor for people already at risk.
Adolescent girls have a higher rate of attempted suicide than boys, but boys have a success rate nearly three times as high as girls. According to the AAP, this is because girls choose less lethal methods than boys do.
The report also gives guidelines for doctors to help struggling teens. Suicide screening should include questions about symptoms of depression, as well as asking about risk factors and past attempts. Screening was not found to correlate with suicidal thoughts; in other words, asking teenagers about suicidal thoughts does not cause them to have suicidal thoughts, even if they are already at risk. Screening should also be done without a parent present, although parents should be given information to help their child if they are at risk.
The AAP also addresses the black box warning associated with antidepressant medications. The FDA requires labels on medications that were found to lead to an increased risk in suicidal thoughts and behavior through clinical trials. Although, as the AAP report says, "Subsequent studies have addressed the validity of the black-box warning and suggest that, for appropriate youth, the risk of not prescribing antidepressant medication is significantly higher than the risk of prescribing." The FDA has not changed its guidelines on the black box warning, and the AAP guidelines say that the warning should be discussed when medication is prescribed.
If you or someone you know is considering suicide, there are many people available to help. Call 911 if there is an immediate risk.
You can contact the National Suicide Prevention Lifeline, or call them at 1-800-273-TALK (8255).
States offer federally-funded free or low-cost mental health services. Use the SAMSHA locator or call 1-800-662-4357.
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