Troubled Waters — Stemming the Rising Tide of Youth Suicides

A new report from the Centers for Disease Control and Prevention (CDC) chronicles three alarming trends in youth suicide (Sullivan et al, 2015).

• More teens are dying by suicide through suffocation and strangulation.
• Suicide rates for boys and young men, which decreased from 1994 to 2007, are on the rise.
• Suicides among girls and young women are increasing.

Overall, suicide in the United States represents the second leading cause of death among young people ages 10-24, according to the new CDC report. It was number three just over six months ago (CDC, 2014). This increase is particularly disturbing given that such self-destruction is widely viewed as preventable.

Last month’s manslaughter indictment of 18-year-old Michelle Carter, a high school senior in Massachusetts, for allegedly encouraging the July 2014 suicide of 18-year-old Conrad Roy (Tedesco, 2015) brought new and troubling perspectives on what can only be called an epidemic. Yet, it may be the growing lethality of means to the end that best underscores this public health crisis in America.

And that is only part of the problem.

Behind the finality of successful suicides lurks a remarkable number of youth thinking about it. The CDC notes that 17 percent of high school students have seriously considered suicide and 8 percent have attempted to end their lives more than once (McSpadden, 2014). It also reports that, “Each year, approximately 157,000 youth between the ages of 10 and 24 receive medical care for self-inflicted injuries” (CDC, 2014).

Also afoot are new calls for “means restrictions” to augment traditional suicide prevention strategies. This approach recognizes that there isn’t always a fact pattern to suicide attempts, perhaps especially among the young and impulsive (Watson Seupel, 2015).

In some ways, the sudden surge in female suicides maps—and may be related to—other rising rates of risk behavior among girls and young women. Data from the Center for Adolescent Research and Education (CARE) and the national SADD organization (Students Against Destructive Decisions) reveals that females have shed their historically lower risk profile, catching up to—and in some cases surpassing—their male peers when it comes to making potentially dangerous choices (Wallace, 2013).

For example, among 16-year-olds, girls outpaced boys in reporting alcohol use (26 percent versus 20 percent). By age 17, girls also pulled ahead of boys on other drug use (13 percent versus 7 percent) and by age 19 in each of the areas studied:

• drinking (52 percent versus 40 percent);
• using other drugs (19 percent versus 15 percent); and
• driving under the influence (10 percent versus 7 percent).

Similar differences exist for intimate sexual behavior and intercourse (Wallace, 2013).

So, what’s going on with girls?

Potential etiologies of problematic behavior include a push for gender equality that may be ratcheting up the pressure for girls to compete with boys on multiple fronts, including socially.

Professor Scott Poland, Ed. D., a co-director of the Suicide and Violence Prevention Office at Nova Southeastern University and a CARE National Advisory Board member, keys in on that social landscape, saying, “Female adolescents have a lot of difficulty when they have friends who are not friends with each other. These situations can lend themselves to bullying behaviors and stress.”

On the connection to substance use, Poland offers, “Of course, when you add alcohol or other drugs to the mix, inhibition goes down and risk goes up.”

Charlie, a student at Tulane University, weighs in on the topic, saying, “Girls here feel like they’re being judged all the time. It’s tough for them to get by without making risky decisions. They feel like they need to stand out to be known.”

Risk ingredients aside, it is clear that young people of both sexes and all backgrounds face significant stressors related to social-emotional change during the increasingly elongated phase of development known as adolescence. Each of these can serve as a trigger for self-harm.

So, what to do?

• Make them aware of warning signs, which include thoughts of suicide, talk of hopelessness, increased substance use, anxiety, changes in sleep and extreme mood swings (Farley Steele, 2015).
• Encourage them to seek help from a mental health professional who can assess risk and plan treatment, possibly including medication.
• Educate them about the often transitory nature of distress because many, if not most, young people lack sufficient longevity to know that how they feel at a certain point in time is not how they will feel forever (Wallace, 2014).
• Facilitate their connectedness to adults with whom they can disclose their feelings and to other (healthy) adolescents who model appropriate relationships and coping behaviors.

On this last point, Dr. Poland says, “One of the best protective factors for young people is connectedness to peers, parents and other caring adults who can keep them on solid ground.”

These important cohorts of youth influencers can also, when necessary, provide a safe, sturdy bridge over increasingly troubled waters.

*The name of the non-professional referenced has been changed for privacy reasons.

This contribution is from Stephen’s March 2015 column for Psychology Today.

Stephen Gray Wallace is president and director of the Center for Adolescent Research and Education (CARE), a national collaborative of institutions and organizations committed to increasing positive youth outcomes and reducing risk. He has broad experience as a school psychologist and adolescent/family counselor and serves as senior advisor to SADD, director of counseling and counselor training at Cape Cod Sea Camps, a member of the professional development faculty at the American Academy of Family Physicians and American Camp Association and a parenting expert at kidsinthehouse.com and NBCUniversal’s parenttoolkit.com. For more information about Stephen’s work, please visit StephenGrayWallace.com.

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REFERENCES

Centers for Disease Control and Prevention. (2014). Youth suicide. Suicide Prevention. September 26, 2014. Injury Prevention & Control: Division of Violence Prevention. http://www.cdc.gov/violenceprevention/pub/youth_suicide.html (link is external) (9 March 2015).

Farley Steele, M. (2015). Teen suicides by hanging on the rise across U.S.. Medline Plus. U.S. National Library of Medicine. March 5, 2015. National Institutes of Health. http://www.nlm.nih.gov/medlineplus/news/fullstory_151302.html (link is external) (8 March 2015).

McSpadden, K. (2015). Suicide rate for young women rises in U.S.. TIME. March 6, 2015. http://time.com/3734888/suicide-mental-health-suffocation-center-for-dis… (link is external) (8 March 2015).

Sullivan, E., Annest, J., Simon, T., Luo, F. and L. Dahlberg. (2015). Suicide trends among persons aged 10-24 years – United States, 1994-2012. Morbidity and Mortality Weekly Report. March 6, 2015. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6408a1.htm (link is external) (8 March 2015).

Tedesco, A. (2015). Plainville student charged with manslaughter after allegedly encouraging friend to commit suicide. Boston.com. February 27, 2015. http://www.boston.com/news/local/massachusetts/2015/02/27/plainville-stu… (link is external) (8 March 2015).

Wallace, S. (2014). Better days. The Huffington Post. September 22, 2014. http://www.huffingtonpost.com/stephen-gray-wallace/better-days_b_5860354… (link is external) (8 March 2015).

Wallace, S. (2013). Flip: changing gender roles in youth risk behavior. May 3, 2013. Psychology Today. http://www.psychologytoday.com/blog/decisions-teens-make/201305/flip (8 March 2015).

Watson Seupel, C. (2015). Blocking the paths to suicide. Health. March 9, 2015. The New York Times. http://www.nytimes.com/2015/03/10/health/blocking-the-paths-to-suicide.h… (link is external) (10 March 2015).