American children are taking their own lives at an alarming rate. Over 7 percent of high school students say they engaged in non-fatal suicidal behavior, while 17 percent say they seriously considered suicide within the previous year, according to a nationwide survey. For children under 15, the prevalence of death by suicide nearly doubled from 2016 to 2017. Considering these sobering statistics, it’s no surprise that suicide has become the second leading cause of death for youth between the ages of 12 and 18.
Sadly, many parents don’t recognize the signs of depression in their children until a crisis occurs. It can be difficult to determine the difference between normal adolescent behavior and something far more serious. For National Children’s Mental Health Awareness Day I want to use this opportunity to share strategies that have been proven to decrease suicidality in children and teens.
A few years ago a teenage girl named Alyssa* came to me for therapy, along with her family. She described feeling disconnected from her parents, who didn’t understand her interests. She spent a lot of time in her room watching anime, playing video games, and chatting with her friends online. Like many young girls, she had negative experiences with peers at school and felt acute academic pressure.
Her parents saw no cause for alarm until they were contacted by a concerned school counselor, in whom their daughter had confided. When they learned Alyssa had thoughts about harming herself, they decided it would be safest to place her in a hospital while they made a plan to address her challenges, which included anxiety and depression.
Prevention Is Key
Fortunately, Alyssa turned to a trusted counselor for help. For individuals concerned about child suicide, a number of protective factors have been shown to help reduce the risk of suicidal behavior. These include community connectedness, abstinence from drugs and alcohol, close family relationships, strong peer support systems, and regular involvement in hobbies or activities. Joining activities that promote positive self-expression (music, art or drama) or self-efficacy (such as sports or skill-based activities), and continuing them through adolescence, can support building a positive and stable identity, the primary task and stress of teenage years.
Other protective factors are more difficult to cultivate. People with a positive self-image, strong problem-solving skills, and the ability to regulate their emotions tend to be more able to cope in times of increased stress. If a child is struggling in these areas, especially while distancing themself from family or friends, it may be time to think about family therapy. Engaging teenagers in therapy isn’t easy, so building a trusting relationship with a mental health professional early for youth with heightened risk factors is instrumental in suicide prevention.
Working with youth also comes with a unique set of challenges. They can be more impulsive, have trouble seeing a long-term perspective, and be heavily influenced by their friends and online relationships. These are just a few reasons why it’s important to find a therapist with extensive experience treating youth. The right professional can advise parents on what’s typical versus when to access other services, and how to keep channels of communication open.
Trust Evidence-Based Therapies
When a child is in therapy for suicidal thoughts or actions, it’s critical to use an evidence-based treatment approach. As a career therapist and Director of Youth Shelter Services at Grafton Integrated Health Network, my team and I rely on the CAMS model. Short for Collaborative Assessment and Management of Suicidality, CAMS was developed over 30 years ago to specifically assess and treat suicidal risk.
This method uses a highly individualized approach that allows patients to be actively involved in the development of their own treatment plans. Rather than shaming youth for their suicidal behavior, our therapists take an empathetic and non-judgmental approach, which helps us identify and treat the root causes of the client’s suffering. In randomized controlled trials, the CAMS model has been shown to more accurately assess the need for acute hospitalization and reduce suicidal thoughts.
We know this approach works. With the help of a psychiatrist, music therapist, and individual and family therapy using mindfulness and cognitive-behavioral interventions, Alyssa was able to feel more hopeful and connected, while reducing her thoughts of suicide. Her therapy included identifying and working towards positive future goals, improving problematic communication patterns, increasing connection in activities with supportive peers, and following a safety plan.
There is no quick fix for youth suicide, but promoting good mental health and seeking professional help early is the best prevention we have. It’s also never too late for a child and family to seek the right supports to build resiliency and move towards recovery.
* Patient name has been changed to protect privacy.
If you are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.