A Guide to help Youth with Suicide Thoughts, Tendencies and Threats
Sixteen-year-old Trisha had been enrolled to junior college just a month before. Her whole family was anticipating that she will do well and enjoy her college days. Her teachers were fond of her and would keep in touch with beyond studies.
Trisha dropped out of the college not long afterwards, however. The teachers and friends visited her several times, but they failed to persuade Trisha to return to college. Her parents, teachers and friends were concerned for her, but no one suspected the real reason of her absence. Trisha was pregnant.
About few months after she got to news about her pregnancy, Trisha tided her room, emptied her cupboard, and wrote a note to her mother:
“You kept asking me if I was OK and I kept telling you I was, but I wasn’t OK. I am sorry, Mom. I’ve got too many problems. I am taking the easy way out.”
Trisha left that day before her mother arrived home from work. She walked to the railway tracks near her house, knelt between the rails, and folded her hands over her little rounded belly as Rajdhani Express ran down upon her.
The train driver, a man who had a sixteen-year-old daughter of his own, later said that when he saw Trisha, it was too late to stop the train, He watched her cross herself before she died.
Problem of Suicide
Suicide is the leading cause of death among teenagers.
According to Lancet Commission on Adolescent Health and Well-being, suicide was leading cause of death among youngsters aged 10-24 in our country (reported in 2013). 62960 deaths by suicide followed by 41168 by road accident and 32171 by tuberculosis.
The recent National Crime Records Bureau (NCRB) report stated that 13,000 students took their own lives in India last year. In fact, over the five years from 2016 to 2021, the number of student suicides in India has risen by 27%. The total number of suicide cases rose by 20% over the same period, from 1,31,008 in 2016 to 1,64,033 in 2021.
Another Indian study showed that the suicide rate was highest in the 15-29 years age group (38 per 100,000 population) followed by the 30-44 years group (34 per 100,000 population). The rates of suicide were 18 per 100,000 in those aged 45-59 years and 7 per 100,000 in those aged >60 years.
Reliable sources now say that over a thousand teenagers try unsuccessfully to kill themselves every day! Almost one teen per minute tries to commit suicide.
The statistics do not tell nearly the whole story, however. Many suicides are not even counted in the above statistics due to several factors. Dr. G. Keith Olson points out:
There are more successful suicides each year that are counted as other forms of death because of lack of knowledge of the victim’s intent or motivation. A significant percentage of one car accidents are actually suicide. . . Some people who are medically ill die only because they stop taking their medication. And others “flirt with death” by their involvement in high-risk occupations and sports (e.g. sky diving. . .) and life-endangering habits (e.g. smoking, heavy drinking and drug anise). And finally, Marvin E. Wolfgang has studied a form of suicide that is mainly peculiar to adolescents and young adults. “Victim percipitatal homicide” occurs when one person provokes or sets up another to kill him or her.
More importantly, perhaps, statistics alone do not convey the tragedy of teen suicide, nor its epidemic proportions. The human tragedy of promising lives lost in moment, of parents, siblings, and friends enduring unspeakable grief and sorrow, of families and communities torn apart, cannot be measured.
David Elkind points out that it is often difficult to identify teens who are contemplating suicide partly because “teenagers in particular are often reluctant to reveal the problems they are experiencing or their inner thoughts. Unfortunately, many teens conceal their inner pains and fears so that even their parents and closest friends have no idea that they are suffering and considering suicide.
“Nonetheless,” Elkind says, “while many young people often give no implications of impending suicide attempts, other do.” Some of the signs that may alert a parent, teacher, youth leader or friend to a possible suicide attempt include:
- Previous suicide attempt
- Threats of suicide
- Talking about death
- Preparation for death (clearing out cupboard, giving away possessions, etc)
- Sudden change in behavior (acting out, violent behavior, etc)
- Somatic complaints (sleeplessness, sleeping all the time)
- Increased risk-taking
- Drafting a suicide note
While it is not always possible to recognize the signs of suicidal tendencies or to prevent a teen from contemplating or committing suicide, a familiarity with the causes and precipitating factors of adolescent suicide can make a crucial difference.
Causes of Suicide
“There is growing consensus,” says Bill Blackburn, author of What You Should Know about Suicide, about the broader causes of teen suicide, “towards identifying the following influences:
- the changing moral climate,
- the high mobility of our society,
- the increasing divorce rate,
- the frequent abuse of alcohol and other drugs,
- the glorification of violence in the mass media,
- the already high suicide rates.”
He goes on, what remains solid and dependable for young person in the potentially difficult years of adolescence? Two sources of support are a society where moral guidelines are firm and a family that you can depend on even though you are breaking away from it. But what happens if the rules of the society keep changing and the morals are objects of debate rather than reliable guideposts? What if the family moves hundreds or thousands of kilometers from any relatives or mother and father separated and you see one of them regularly? The sources of support become shaky foundations.
When the foundation becomes shaky, some young people turn to alcohol and other drugs for solace. These agents, when mixed with a teenager’s romantic notions of death, a society that glorifies violence and easy access to the means of suicide, combine into a powerfully lethal mixture that spells death for more and more adolescents. Finally, suicide begets suicide. Suicide attempted or completed plants the idea of self-generated death in the minds of others [, and] suicide in the family especially pulls other family members closer to that option.
But beyond the societal factors are personal factors. Why do teens try to kill themselves? the following are among the reasons.
Many researchers have attempted to trace the relationship between family disruption – separation, divorce, moving, etc. – teen depression and suicide. Although the results are sometimes contradictory, insomuch as family disruption increases a young person’s stress, sense of alienation, and perhaps parental rejection, it may be a contributing factor not only to depression but to suicide as well.
A clinically depressed youth may become suicidal,
writes author Marion Duckworth, and experts agree. (See also Depression – Bijoyful).
She cites her own experience:
I remember writing my own dairy when I was a teenager and angry at my mother, “She’d be sorry if I was dead.” But for a seriously depressed youth, the thought of suicide is ongoing and if help is not forthcoming, he may become convinced it’s the only way out.
Most suicidal persons want to escape from what they consider an intolerable situation. The shape of that situation varies with each person, and many other persons in similar situations do not consider suicide an option. Two important ingredients for those who begin to ponder taking their lives are hopelessness and faulty reasoning. These two are linked: there seems to be no hope of resolving the situation, but the reason hope does not appear is that the suicidal person is not thinking carefully or clearly. Sometimes this is because of mental illness.
The suicidal person may be intent on escaping a terminal or painful illness, or punishment, or humiliation, or simply the weight of his or her mental and emotional burdens.
“For some,” writes Olson, “the death of a parent, close friend or loved one seems too painful to bear.” At such times, the grieving young person will often entertain thoughts of suicide – some-times simply in an effort to end the seemingly unbearable sorrow and grief, (see also Grief – Bijoyful) and other times, as Blackburn points out, to rejoin the friend or loved one in death.
Guilt feeling often contribute to suicide tendencies as well. (See also Guilt – Bijoyful). Olson writes,
Suicide is often the individual’s own attempt to take control of punishment for faults or misdeeds of which he or she feels guilty. When no punishment has been received from society, friends or family, the individual chooses to be the victim of his or her own self punishment. Too often suicide becomes the ultimate punishment.
A suicide attempt grabs attention like few other things. People are startled, guilty, concerned, puzzled. Where people previously ignored a person now, they lavish attention on him.
In such an instance, the attempt is often a desperate cry, not only for attention, but for help as well. It may be a teen’s way of saying,
I’m hurting, I’m desperate, I don’t know how to cope, and I need help. Please someone pay attention to me!
Tragically, of course, the cry for help sometimes go too far and becomes fatal.
Blackburn offers insight into this motivation as well:
Although akin to the attempts to gain attention, this reason for attempting suicide is designed to get more than attention. There is a specific object or action that person is seeking. The desire is to elicit a response that seems otherwise unobtainable. A suicide attempt can be the trump card played after all the other cards have been played.
Manipulation by attempting suicide is used by children against parents, husbands against wives, girlfriends against boyfriends, worker against co-workers.
Olson points out:
People, often young people, feel so overwhelmed by being hurt by another, that their wish to hurt back overrides their wish to live. The suicide revenge is usually directed towards a lover, parent or parent figure.
The teen years are often characterized by experimentation and impulsiveness. Adolescents often display a casual disregard for their life and safety, and also sometimes exhibit a fascination with the unknown, including death. The volatile blend of curiosity, impulsiveness, and feelings of invincibility that exist in the adolescent heart and mind can create a dangerous propensity for suicidal acts.
Expression of Love
Both Olson and Blackburn, among many others, attribute some teen suicide to a desire to express love. Says Olson:
Loving emotions in adolescents and young adults are often extremely intense and loyal. The break-up of a romantic relationship, a divorce and the death of a loved one deal the rejected or surviving individuals a shattering blow. Their emotions are numbed, their perceptions distorted and their hopes for the future destroyed. Their total focus is on the object of their lost love. Their last self-expression is a twisted proclamation of their love – the ultimate sacrifice of their lives.
Effects of Suicide
Obviously, the primary, overwhelming effect of a teen suicide is the loss of a young life, with all its promise and potential. But few young people contemplating suicide realize the traumatic effects an act of suicide can have on those around them, principally, grief and the planting of seeds of destruction.
The suicide of a friend or family member invariably causes a depth of grief and questioning that surrounds few – if any – other experiences in life. Parents reprimand themselves endlessly over their inability to prevent the tragedy, friends feel deserted and sometimes betrayed, youth leaders question whether they could have or should have done or said something differently and futilely wish they had recognized the signs- if, indeed, any were present to recognize.
Don Baker writes:
Hundreds of times I’ve watched different degrees of marital disintegration and numerous times I’ve seen the aftermath of a crushing suicide experience. Inevitably the living never blame the dead – they blame the living – they blame themselves.
The emotional fallout of suicide among the survivors is both deep – the emotional and psychological equivalent of Hiroshima
Perhaps – enduring, affecting people’s lives for years, decades, even -in the case of those closest to the victim – lifetimes. (See also Grief – Bijoyful)
Seeds of Destruction
Suicide not only destroys the person who takes his or her life, but it plants seeds of destruction in the lives of those around him or her – parents, siblings, friends, and classmates. The Journal of the American Medical Association reports “an increased rate of suicide attempters.” In other words, those closest to a suicide victim are at a higher risk of attempted suicide than others. Some researchers believe this may be due to genetic factors (and it may), but it may also indicate a greater willingness among those whose loved ones have committed suicide to look at suicide as a viable option.
As Blackburn says,
Suicide has a ripple effect. Sometimes these ripples become tidal waves that drown the family and other close by.
Response to the Problem of Suicide
If a youth has attempted suicide (or is seriously contemplating or threatening an attempt), your responsibility is both urgent and simple: get the young person immediately to a mental health hospital or emergency room; a professional evaluation is absolutely necessary.
The following response is designed to help a youth worker, teacher, or parent offer counsel to a young person who has admitted having passing thoughts of suicide (in contrast to someone who has attempted or threatened suicide). If at any time during the counseling process, you infer or suspect that the youth may be contemplating suicide, do not leave the youth alone until he or she is in the care of a mental health professional.
If at any time you have reason to believe that a young person has given even passing thought to suicide (but has not attempted or threatened suicide), you must still proceed to intervene with extreme care and thoughtful prayer. Blackburn advises not to try to shock or shame the person, nor to get into an argument or philosophical discussion or attempt to “mind-read or psychoanalyze” the youth.
Instead, the wise youth worker or parent can help by employing a strategy such as the following:
Always take every indication seriously that an individual is thinking about suicide.
Never dismiss, mock, or challenge a youth’s statements about contemplating or attempting suicide. “The more concrete their plans,” Duckworth continues, “the more dangerous the situation and the more the need for immediate action. Do they have a weapon concealed somewhere? Have they experimented with fashioning a loop with running knot? Even if their plans aren’t concrete, [keep in mind that] youth are notoriously impulsive.” Listen carefully, sensitively, patiently — and take no chances.
The primary power you have in dealing with a suicidal person is your relationship with him and the way you show interest and concern. . . . Wisely use this power to avert the potential suicide.
Ways to make the most of your relationship may include:
- Making every effort to be available, especially at crisis moments
- Calling periodically to “keep in touch” with the youth’s moods and progress
- Praying for the young person (letting him or her hear your prayers)
It may be tempting to try to contradict a young person’s estimation of how bad things are, how rotten his lot is etc. While the youth’s hopelessness and faulty reasoning should be addressed, it is of primary importance that everything that is said and done by the adult be presented in a way that strongly affirms his or her worth as a person, as a child of God, as a valued and loved family member or friend, and as an individual with capabilities, gifts, and immeasurable potential.
The following imperatives, drawn from the work of Marion Duckworth, Jay Adams, and Bill Blackburn, may present a helpful direction for guiding a teen with suicidal tendencies:
- Work on relationship. The best resource any parent or other adult has for helping a suicidal youth is a healthy relationship. Work on building your relationship with the youth and on helping him or her to build strong, open relationships with others.
- Build self-worth. Duckworth writes, “Parents and [other] can ease the struggle for self-acceptance by consistently using every method available to teach children. . . . two things: Who they are; How to cultivate a personhood in which they can feel at home.” She suggests accomplishing that by reinforcing the child’s successes, offering loving reminders that he or she is loved and accepted, and keeping an open dialogue about the things the child faces.
- Instill hope. “Suicidal persons. . . need hope,” writes Adams. “They are preeminently persons with no hope.” Duckworth suggests instilling hope by exposing youth to the God of hope (and a hopeful way of looking at Creation, natural laws, etc.), cultivating a sense of wonder that they are children of God, responding to the young person as an individual with a unique personality and unique gifts, working out differences between parents, involving the positive influences of extended family in the life of the young person.
- Foster communication. A disturbing percentage of youth say that they can’t talk to their parents about the really important things in life. Duckworth quotes Cathy Benitez’s advice to let teens know “they can say whatever they want, and they won’t be condemned for it. Respect their opinions no matter what they are.”
- Teach coping skills. It’s hard to believe in yourself — or in the future — when your world is falling apart, Duckworth says. Many teens lack the skills to cope with the myriad of pressures and problems they face at home, at school, and in their circle of friends. Among her suggestions: majoring in relationships, setting clear boundaries, modeling appropriate ways of solving problems, communicating wisdom wisely and tactfully, entering into the teen’s world, and allowing him or her to experience the real world without illusions.
- Focus on the available resources. “Most suicidal persons fail to see resources available to help them cope,” say Blackburn. “Not in an argumentative way, but in a vein of gentle exploring, help the person begin to identify clearly the nature of the problems he faces and the alternatives. . . With some persistence. . . you may be able to spark a flame of hope.”
- Develop a plan of action. Devise a set of practical, concrete steps that will help the youth and his or her circumstances. Foremost among these steps should be the development of a regular, honest habit of relationship with God, both private and public. A helpful plan of action may also include negotiating changes in home and family routines, avoiding environments or companions, engaging in some new or favorite hobby or form of recreation, joining a youth group, entering a mentoring relationship, etc.
Make every effort to enlist the young person’s own participant in preventing a suicide attempt. Perhaps the most effective way to do so is to encourage him or her to enter into a contract with you. This can be a verbal or written contract that states:
- The youth agrees to contact you or another person (named in the contract) if her or she begins to think of suicide.
- The youth agrees not to stop trying, even if he or she has trouble reaching you, until the two of you have talked about his or her thoughts of suicide.
- The adult agrees to respond to any call or message immediately upon receiving it and to take time to talk without annoyance or impatience.
- The adult agrees not to leave the young person alone until both parties are confident that the crisis has passed.
Olson states emphatically,
Once it has been assessed that a teenage counselee is a potential suicide risk, definitive counseling intervention is a must.
In other words, consult the young person’s parents and get professional help immediately.
The American Association of Suicidology advises:
The cardinal rule of suicide prevention is this: Do Something. If someone you know has attempted suicide and has not received professional care: Get Help. If someone you know threatens to end his life: Get Help. If someone you know has undergone a drastic change in his life and begins preparing wills or giving away personal possession: Get Help. Don’t wait to see if other signs develop. Don’t decide to consider it for a while. Do it today. Tomorrow may be too late.”
Getting help may involve contacting a family physician or taking the young person to a local hospital, calling a suicide crisis center or hotline (like iCall 9152987821, Samaritans Mumbai 8422984528) involving the local mental health or consulting a professional psychologist or psychiatrist. Whatever it takes: Get Help.
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Bijo Joseph is the founder of Bijoyful Foundation, a faith-based NGO (reg. 357152/sec. 8 co.) that aims to deliver positive changes in the lives of young people troubled with adverse mental health, addiction or other life challenges through range of strength-based, recovery and livelihood programs and support offered by counsellors, social workers and volunteers. He has the youth leadership experience of 17 years and with educational foundation from TISS, Mumbai & IIM Calcutta. He is also a certified QPR Suicide Prevention Gatekeeper.