Zur Institute
Clinical Update, June 1, 2007

Teen Suicide: The Preventable Tragedy

It is estimated that every minute of every single day, one young person under the age of 18 will attempt to end his or her own life. In the United States and throughout the world adolescent suicide remains an alarming problem. 

Our latest online course on Teen Suicide for 4 CE Credits (http://www.drzur.com/teensuicidecourse.html) presents the facts and myths of teen suicide, as well as assessment and treatment techniques to prevent teen suicide. 

Facts About Teen Suicide
* Suicide is the third leading cause of death for adolescents and young adults.
* Young males are much more likely to commit suicide than their female peers.
* Female adolescents are more likely to attempt suicide than their male peers.
* Female Hispanic students are more likely to attempt suicide than all other students.
* American Indian/Alaskan Native male adolescents have the highest suicide rate.

Myths and Faulty Beliefs about Suicidal Teens
* Once a teenager decides to kill himself, nothing can stop him.
* Young people talk about suicide mostly to get attention, therefore the best thing to do is to ignore the person.
* If we ask a young person if they are thinking about suicide, we run the danger of putting the idea of suicide in their mind.
* When a person tries to commit suicide and fails, the pain and shame will deter another attempt.
* Since depression is often a common sign of suicidal behavior, once the depression has subsided,  the suicidal teen is out of danger.
* Because suicide may "run" in families it cannot be prevented.

What to Do:
* Do find out if the individual has suicide ideation, a plan and means, and if so, what does it entail? Remember, the more specific the plan, the higher the degree of risk.
* Do acknowledge that suicide is one solution to the problem, but it is not the only nor the best solution to the problem.
* Do state that you will do whatever you can to prevent this suicide.
* Do accept that in some cases you may not be able to keep the individual from committing suicide.
* Do remember ambivalence. Most people do not want to die, and individuals who want to kill themselves are suicidal for a limited time only.
* Do make sure that someone removes any guns or potentially lethal medication from the person.  The police department will accept any lethal means that people do not want to keep at home.  (If other alternatives are available, do not keep it in your office.)
* Do tell the person that he/she does not have to solve this problem alone.
* Do recognize the warning signs.  This is a key to preventing teen suicide. While there is no single warning sign indicating that a person will attempt suicide, there are warning signs that teenagers give that may alert us to their danger.
* Do remind them that death is final and emphasize that suicide is a permanent solution to a temporary problem.
* Do respond to a student's suicide by following up and utilizing multiple approaches to prevent future suicides or cluster suicides.
* As a professional, weigh all your options, consider the clinical, ethical and legal aspects of the case, conduct a thorough suicide and level of risk assessment and risk-benefits analysis, and when appropriate, consult.  Always document your ethical decision-making, what you did and why.

What Not to Do!
* Don't debate the merits of living or dying with an actively suicidal person.
* Don't ask why the person would commit suicide. Suicidal people may not know why. Determine how serious the person is and ask if the individual has a plan and means.
* Don't belittle the person for having these thoughts.
* Don't offer platitudes. They don't help.
* Don't try to win arguments about suicide.  Your client will always win.
* Don't keep silent, stay passive or ignore the threat and danger.
* Don't leave the person alone if you think there is immediate danger.
* Don't engage in a physical struggle with a person who is armed.
* Don't challenge the person by telling them to go ahead and do it.
* Don't give false reassurances that "everything will be fine."
* Don't be misled if a teen tells you that things are OK and that the emotional crisis has ended.
* Don't assume that the aggressive child is more likely to commit suicide than the "good," "quiet" or "obedient" child.

Online course on Teen Suicide (at http://www.drzur.com/teensuicidecourse.html) will help clinicians explore:
* Their attitudes and beliefs about teen suicide
* Profiles of the suicide attempter
* Facts about teenage suicide
* Specific assessment tools
* Techniques for better evaluating potential and risk of suicide
* The do's and don'ts of responding to suicidal teens
* Postvention techniques and protocols
* Referral resources

Zur Institute: Innovative Resources and Continuing Education

Ofer Zur, Ph.D.
clinicalupdates@drzur.com
http://www.drzur.com
Phone: 707-935-0655, FAX: 707-935-3918
Sonoma Medical Plaza, 181 Andrieux St., #212, Sonoma, CA 95476