Director's note

INCREASE OF NUMBER OF SUICIDES IN CHILDREN AND YOUTH: How to recognise the problem and help

Suicide is a very difficult issue for most people, including professionals, especially when children and youth are involved. Most people find it almost impossible to accept and understand that a young person would take his/her own life. However, suicide is the second most prevalent cause of death in persons aged 10 to 24. Almost one fifth of deaths at that age is due to suicide.

The fact is that in recent years the number of suicides among persons aged 15 to 24 has increased by 65%. It warns us that suicide is a phenomenon which is present in our society and that it certainly deserves attention, regardless of how difficult it is. There are many things we can do in order to recognise the signs and influence those around us who possibly have suicidal thoughts. The World Suicide Prevention Day is on 10 September.

Studies show that there are some characteristics and life circumstances which are more frequent in the lives of suicidal persons. Their childhood is often marked with conflict, abuse, a lack of warm relationships, love and support. During adolescence, they often experience stressful situations in which they feel insecure and worthless. Some problems which trigger young person’s suicide can seem small and not difficult enough for such an act. They may include poor grades at school, problems in their love life, some “shameful” event, peer-bullying and similar. Young people are often impulsive and find it difficult to think about long-term consequences of their behaviour. Sometimes, suicide may seem the only solution to their problem.

The most frequent reasons for suicidal thoughts or attempted suicide in young people:

- psychological pain

- loneliness

- being ostracized

- abuse – physical/psychological/sexual

- deep grief

- guilt – frequent in those suffering from PTSD

- depression

- helplessness

- all of the above combined

Some of the myths related to suicide:

1. People talking about suicide will not commit it.

People who decide to commit suicide often give some sign that they will do it. Their behaviour can be explained as a cry for help. Possible words they tell others are: “You will be sorry when I am not here any more” or “Life does not make sense any more, there is no way to get out of this situation”. All such signs need to be taken seriously and talked about with the person who sends them.

2. A person who attempts or commits suicide is mentally ill.

In most cases, suicidal persons are not mentally ill. Sometimes they are depressed, hopeless and cannot see how they can get out of some situation which is bothering them, and suicide seems like the only solution to their problems.

3. If someone has decided to commit suicide, nothing can stop him/her.

It is possible that some people cannot be stopped. However, in the majority of cases, suicidal people do not really want to die, they just want the pain to stop and they want a relief. That is the reason why some people may be indecisive whether to take their life or not, till the last moment.

4. People who committed suicide did not want to be helped or nobody cared.

Most people who committed suicide asked for help at some time, but it is possible they did not do it in a way which was recognised by people around them. We should not blame anybody.

5. People get the idea to commit suicide by talking about it.

Sometimes, by talking about suicide, people do not get the idea to commit it, but it has an exactly opposite effect. Talking helps become conscious of what suicide means and of its consequences. This especially applies to children and youth who do not easily anticipate long-term consequences and do not clearly understand the concept of the finality of death. They can get an insight that suicide is final and impossible to reverse once it has been committed. By talking, a suicidal person can get a feeling of being understood, taken seriously and supported.

When we see that a young person has suddenly changed behaviour, it is necessary to give that person attention. Young people sometimes say more by their behaviour that by words. Young suicidal people most often show withdrawal and isolation from other people. We can see that the young person has also lost interest in his/her favourite activities, school and learning, that s/he has been floating the theme of death in school essays and conversations, that there are a reduced concentration, sleeping problems, neglect of personal hygiene, a lack of interest in personal appearance, inability to deal with praise, a sort of “saying goodbye” to close persons, loss of a sense of humour, risk behaviours and similar. Suicidal people may say that they are bad, that they are bothering others in their environment, that soon everything will be resolved and they will not be a burden to anybody any more.

What we can do when we know someone who is planning suicide:

1. Take that person seriously.

If you notice the above described signs or if somebody tells you s/he has suicidal thoughts, take it seriously. Under no circumstances should you accuse the person for attracting attention or say that his/her problems are not serious enough for suicide.

2. Listen.

It is important to listen about how the person is feeling, what preoccupies his/her mind and which problems s/he is coping with. If s/he feels uncomfortable talking about it, encourage him/her to talk to you or to somebody close whom s/he trusts.

3. Be honest.

A common reaction when we hear that someone is thinking about suicide is fear. It is natural that it scares us and that we are concerned about someone thinking about suicide. It is good to share our feelings with that person because it is how we show that we are concerned and that we care.

4. Find help.

When you suspect that someone is suicidal, it is necessary to find professional help. The person who confided his/her suicidal thoughts or showed troubling signs, may resist asking a mental health professional for help, but it is absolutely necessary to find help for him/her.

5. Take good care of yourself.

It is difficult to deal with the knowledge that someone wants to take his/her life or is thinking about it. We can feel responsible for what that person does, especially if it is our child or a close person. However, it is important to know that nobody should bear responsibility for that. We need to focus our efforts into providing what we can – be there for that person, listen, support, provide acceptance and understanding, find professional help. There is always a part of responsibility on the part of that person. Talk to someone about your feelings and concerns.

6. Try not to see the person exclusively as someone who tried to commit suicide.

It is a fact that every suicidal attempt increases the probability that the person will attempt it again. The most dangerous period is the following three months, because the person’s condition is improved with abundant energy to undertake something. Although it is important to bear in mind, it is even more important not to take suicidal intentions as the main feature characterising of that person.

Advice for those who have suicidal thoughts and feelings:

• Find professional help as soon as possible.

• Talk to someone every day, in person, if possible. Socialising sometimes has therapeutic effects.

• Make a safety plan in case you wish to commit suicide. That plan can contain contacts of important persons who you can ask for help, like some family members, your physician, help-lines and similar.

• Create a written plan of your activities for every day. Sticking to your schedule and performing daily routines can give you a feeling of control over your life.

• Go out into the sun and nature. Nature is relaxing and improves your physical and mental health.

• Exercise. It produces endorphins which are responsible for feeling good, reducing stress and improving emotional status.

• Find time for activities which make you happy. That way you will think about things you like.

• Remember your personal aims. Write them on paper and strive to realise them. It can be about travelling to some specific place, searching for some new free activity, buying a new book, going to a performance or a concert, etc.

You should avoid:

• Terminating professional support. Suicidal persons sometimes terminate their treatment with a mental health professional, because they are reluctant to visit them, they believe their condition is improving and do not feel that visiting their psychiatrist/psychologist is purposeful. That is something you can talk about with your therapist, it is just important not to give up at the first obstacle.

• Being alone. Loneliness can further motivate suicidal thoughts. It is important to be around close people as much as possible.

• Using alcohol or drugs. They can worsen depression, increase impulsiveness and reduce your problem solving ability.

• Doing things which make you feel bad. Many things may increase negative feelings, like listening to sad music, watching movies with tragic endings, reading old messages, etc.

• Thinking about suicide and other negative things. It is important to try not to be preoccupied with negative thoughts and to find something as distraction.

In order to recover from suicidal thoughts and feelings faster, it is important to be aware of your condition. The following behaviours can help you with that:

1. Identify situations and events which cause your feelings of hopelessness and suicidal thoughts.

2. Take good care of yourself, eat regularly, sleep sufficiently and do physical exercise.

3. Surround yourself with people who positively influence you and make you feel good.

4. Find new activities which give you a feeling of purpose. Doing things which give you fulfilling experience makes people feel better about themselves and then it is less probable that bad feelings will return.

5. Learn how to appropriately cope with stress. For some people it is daily physical exercise, while other meditate or practice relaxing and breathing techniques, or something else.

Remember: Suicide is a permanent “solution” for a temporary problem. We need to give ourselves sufficient time for change, for the pain to subside and for the problem to be solved.