collaborative and the host of focus on health thank you so much for joining me today i am with diane were in who is a social worker who has extensive background in grief counseling and crisis intervention and we're going to explore issues related to teen suicide diane thank you so much for joining me today to dive into this very important topic tell us st a little bit about yourself certainly i run a program called grief education resources so i do presentations and workshops on grief and trauma and loss throughout the united states and i am also the clinician for the cambridge  department so that when st responders have horrific call so the team that i am part of in cambridge will go in and assist the firefighters so kind of after aftermath yes absolutely absolutely  to another whole show that is another show i guess help out helping the helpers yeah yeah ok that sounds very interesting but let's dive into teen suicide the numbers are staggering yes let's talk a little bit about  we have a public health issue you know sometimes who will use the word epidemic i don't like that word and neither does the c d c but we do have a public health issue in the united states the figures continue to rise in fifteen to twenty four so in the united states there are presently it's hovering around five thousand dollars suicide deaths of teenagers in the st category of fifteen  dollars and then there are additional five hundred and twenty five dollars suicides of children aged ten to fourteen wow yeah those numbers are certainly concerning yeah how help us understand a little bit and  i ask these questions with fully understanding that there are sometimes more questions than answers on this topic but try to help our audience understand how does a teenager get to the place where suicide becomes an option i think what we do know is that upwards of ninety percent of people all people adults and children who take their own lives are struggling with a mental illness oftentimes undiagnosed at the time of their death so you're already dealing with an undercurrent of an existing issue whether that major depressive disorder and there are different kinds of depression whether it's bipolar or paranoid schizophrenia there are mental health issues that are usually the underlying cause and then we look at what are some risk factors that could add to the mental illness that would bring somebody to the decision that either i'm a burden i don't matter i don't count people would be better off without me i can't tolerate the pain so some of the some of the factors that we would certainly look at would be if there's a history of alcohol abuse or substance abuse we look if there have been prior suicides so if there's a family history did your dad take his own life your grandfather so it's not that we're looking at it as a coping mechanism but we do see somewhat of a familial pattern that sustains and teens certainly look to that we look  at their perception of themselves so and this comes in the form of kids who have disabilities you know when you're an adolescent you do not want to be different and yet if something happens to a child disfigurement a change in the same n'est ce you know that they that they long for it truly can disassemble how they see themselves and how they place themselves in the world that they live in whether that school their outside jobs organisations that they may belong to it's also a time of gender identification and sexual orientation we do know  that in the l g b t q community among children and i was able to pull this from there's a wonderful website called the trevor project and they indicate and along with other very good sources know just because i think it's a really important point and i don't want to get lost in all of the data almost up to ninety percent of people are teens who go down this suicide path have mental illness so if i'm a parent and my child does not have a clear diagnosis is not in therapy but is exhibiting what could be typical teen mood teen anger how do i as a st place to pause how do i get a sense of what's normal for teens versus what my require some therapy or perhaps a medication how do i get a handle on that i cannot emphasize strongly enough two points of parents one is you need to educate yourself about teen suicide whether you think your child is suicidal or not you need to educate yourself you need to understand warning signs because i do agree with you that you look at your teenage child and i raised three teens so i do remember fondly of thinking is this hormonal right is it age appropriate or is this something deeper that's going on here a struggle within my child that that i can't access and the nd thing is we have to learn to communicate with their children and listen i get it i know that asking anybody do you have any intention of taking your life is an incredibly difficult question and you know the anxiety goes through the roof and parents when they ask the question expressed that you know that really monitor at the child so that is it teenage angst as you say or is it something more and so what you really need to look at are what are the degrees of some of the risk factors so one of the ricks risk factors would certainly be withdrawing withdrawing socially withdrawing academically you know is it i don't feel like going to church this week or is it i don't believe in god there's no point in church i hate this i hate that i'm not going out anymore is it i don't want to go out on a friday night or is it a complete despair banding of the friendships that they know ok so you really you know for a parent they really want to look at you know what are the degrees that are going on and you want to look at alcohol use you want to look at your child's drug use if in fact there is a history there so you  know you parents really need to monitor situations and if you have any any hesitation at all around thinking that your child may not be safe you know the st thing is call your pediatrician get some clinical guidance with this and the nd thing is if you have any lethal means in the house get rid of them if you have a gun get rid of the gun because we know that access to means absolutely is a problem so lovely just to kind of summarize some of the highlights there because there's a lot of really valuable information for parents there is something that is normal among teenagers there's normal teen anx there's there's a little bit of withdrawal there sullenness there's mood swings but what i hear you saying diane is as a parent who is monitoring their children their teens if you see it really going to an extreme where they have withdrawn from not only the family but friends social endeavors if the mood swings are very low if the lows are just you know remark staying so then you get help talk to your child  seek mental health call the pediatrician try to get some help right for your child and then if it seems incredibly scary what i heard you say if you think your child is at risk for hurting him or herself ask the question yes are you safe do you have an intention of of suicide right to just to ask the hard question i think we know from data that you're not going to introduce the concept of suicide and that is a myth that i believe is out there that if i bring it up i will it'll be a subtle suggestion and we know that's not true it took it out a little it's not true and in fact for some people it's a release that the jig is up ok perhaps i can come clean because somebody has found meow and i think it's always so important to remember that the suicidal person does not want to end their life they want to end the pain it's just becomes in tal an intolerable situation the other thing i think is that parents need to speak to each other you know we have become much more isolated and we don't like to air our dirty laundry but the reality is if i come to you as a friend and we have children in the same grade and i say this is what i notice about my child what do you see right and then we can kind of go back and forth that camaraderie when you are in the throes o child who is struggling can make all the difference in the world for yourself care right or it's parental support you are absolute there is a program in needham i believe where they encourage parents to meet on a regular basis to discuss not only basic parenting things like curfews and is there liquor in the house are their guns in the house will you be home but also to touch base with  doing how stressed are they are you know is there anything that we should know about so i think you bring the community in as as extra eyes and a word to parents who are thinking about having this discussion is choose the right time we live incredibly busy lives our children are our stressed i mean our kids have way too much going on and so you need to pick and choose the time that you're going to ask this question and it's got to be the right time it should not be right before bed it should not be right before they're going out or going to school it i wouldn't do it alone if you have the support of a partner or spouse and i think it should be phrased in the light of this is what i'm saying ok that's good you know so i'm worried this is this is what i've noticed about you that you were sullenness is not just listing a weekend or a couple of days that now we're looking at a month of just disengagement from from academics or from you know social events i'm i'm worried about you right you know the person of touching the vulnerability in a way that that's it's uncomfortable kind of like i did like i said earlier it's also an opening yes i mean we know from the risk behavior survey here in belmont when we compare our data to the state results we know that belmont teens are incredibly stressed that jumps out we know that there is a there is a alarming  response regarding ideation regarding thoughts ideas getting thoughts about suicide so i think as a community to acknowledge the stress and to hopefully put mitigate some of the stress i know with my own kids i have tried to make it very clear that you know they don't need to take a p courses if that's going to be a stressor they don't need to i'm not expecting perfect s a t s scores they get the scores they get they'll find a great school but i think  everybody or something for everybody but i think what happens in some of these communities is they do put a lot regardless of what's happening at home they themselves put a lot of stress absolutely they want to do well and do a lot and have a good college application so i think acknowledging what the youth risk behavior survey helped me as a parent to do is acknowledge and really come face to face with the stress and understand that when you see those numbers so you know one in six kids nationally tell us that they have had strong thoughts not just around ideation but planning so they've given themselves a method and i think we need to address that you know so so there are some wonderful programs out there and i mean certainly we've talked previously there's a program called q p r question persuade and refer and it's how do we ask the question you know and are we ready for the answer right so if your child says no no i would never hurt myself you know don't even think that and you're still hesitant about the truthfulness of your child's response you know not judge mentally except what they're saying but keep yourself on high alert or you could say listen you know i'm just wondering you have your pediatrician check up you  know i do want to encourage him to kind of bring this up you know and you make it some push and pull that's ok who cares of the day to keep our kids safe it's like i don't want to wear a helmet when i'm riding a bicycle yeah i don't care about that as what we're going to err on the side of caution absolutely and i know that there comes that point when your children are physically larger than you so that may pose an issue they're louder than you there may be some anger management issues so the parent may be placed in a position of i don't want to say fear but certainly intimidation this is the time i cannot encourage strongly enough to say you've got to stand strong you know you've got to go toe to toe and say i'm doing this because i love you if i didn't love you and i didn't see that this has potential for disaster i wouldn't say anything right that you know the most important thing that we could do to do for children whether they it's pretty an attempt or after the st attempt is to encourage engaging them back into the family into whatever organizations they were involved in at a pace that is certainly conducive to the well being for the child and not stressful things so rather than the french immersion and soccer and being captain of the team and getting into this school and that's when the other school hey how about if we just go for a hike you know or go to the movies or whatever your family likes to do play a board game but it's that you know everybody nowadays goes to his or her room and they have everything that they need in that room in the form of their handheld computers we call now the telephone right right and i actually a good segue mean we can jump right into we know that there has been an impact around social media let's talk for a minute about how impactful that has bee bend to the lives of our teenage  writers so where we once had the luxury of eavesdropping on our children's conversations because they were talking to each other on the telephone we don't have that luxury anymore because unless you've got very good vision children now have the luxury of that few former generations did not have as a result parents are oftentimes kept out of the loop i can tell you most assuredly it is critical for parents to understand social media to understand twitter accounts to understand facebook i don't have a problem with that because what we have learned is that kids will wri i'm going to kill myself and the next thing you know they're crossing the street and they're on a train track so we know that they are revealing parts of their souls on social media plans are revealed on facebook plans revealed on accounts it's it's at and then the aftermath ok before we go to the aftermath and i just want to mark this point for parents who might be listening if you're if what i hear you saying is if your teens instagram or snap chat or facebook or texting you have to understand these programs you have to understand what tools that they are engaging in on a day to day basis because there are things that are revealed there that may not be revealed at home over dinner conversation and i think that's an important point because i hear parents all the time kind of alluding to snap chat or instagram but not really being fully steeped in what that is and i am guilty as well however in our house the rule is we pay for the phone we pay for the monthly communications bill and therefore we have said to our kids if we have any concerns we will be taking the phone and reading and getting caught up and getting data because if we're concerned we'll we will need data to either confirm what we're concerned about or to assuage are concerned that without data you know where we're kind of in a bit lost that we're limply i think the other piece to recognize is that other teams have told us that they knew of the child who took his or her own life they knew of their plans before he and facebook has now done a wonderful job where you can anonymously report somebody that you think has posted something on facebook that would lead someone to think that they're going to take their own life and if you go if you're on facebook and you are going to the section it's on the right upper corner it allows you to look at whether you want to block  post facebook has now design choices as to why you would want to block that post and under that is do you feel there's a health risk to the person or to somebody else if you check that facebook will then notify a crisis line and they they use their discretion but they also have the ability to then send a post send a message to the person so not the person reporting but the person who's expressed suicidal ideation to say this is what we've seen and these are some crisis hotline numbers in your area that you may want to avail yourself to so that teenagers oftentimes don't want to come forward they don't think that it's real or they think they could stop it but this is a way that you can report it in get it out there on the open that sounds like a real  sense from when i was a kid and i'm sure you as well we didn't have in our health classes the topic of mental health right we did not discuss depression anxiety and other other mental health issues and now kids that is a part of the curriculum so i think kids have a better language to at least talk with each other about what's going on whether or not they take it to the next step if they're concerned and tell an adult tell a teacher at least they encouraged to do so so it sounds like there are some some changes in not only in curriculum but in social media which are having hopefully will have a positive one i agree because we do not want to attach any stigma with reaching out and trying to get help there's nothing wrong with reaching out and hopefully before a crisis and for absolutely absolutely you know to tell me what you're thinking or even the child who has attempted and is still struggling still has so let's talk a little bit about that because that's a question that i've heard in the community if a teen does attempts but is unsuccessful and hopefully from that point forward i wasn't under the care of a professional prior is in the care of a professional but is there is there is the child out of the woods or not the child still at risk you know the child is still at risk i think the national figures are prevention so that you know it's it's a constant i don't want to say battle but effort on the part of anybody who is in the child's life so whether that's coaches teachers the school nurse you know these kinds of things suicide attempts cannot be kept a secret right and i understand hipaa fully however i think it's important that when you have a child who's attempted that the clinician and the parent have a discussion with the child to say you know what we need to keep you safe we want to keep you safe and and you know do you want to keep yourself safe you know you need to ask the child where are you at so they're you know the child the ship best barometer and the only way you're going to really know that is to keep that dialogue engage your child in the conversation and as we said earlier it's not going to persuade the child to a test just as much as it wouldn't dissuade the child not to make an attempt if you bring it up you're asking the quits like if you're a death when we say well we don't want to talk about the dead person because we don't want to make them sad or that  that's exactly right now i think that's a really good point for people in the community to know that it's better to err on the side of talking and engaging and expressing concern and and knowing that we're not going to be planting seeds  and the child you know we want to empower the child and give the child some tools that they can use so if in fact we now know that the telephone is their primary source of connection  oftentimes to themselves there's an application out there it's called my three app dot org m y the the number three and what this does is it is helpful for the child who is either contemplating or has made an attempt to write down right in their phone what their safety plan is so if i feel like i want to hurt myself i can call my mother i can call my coach i can call my boss i can call my aunt and what you want to do is you want to get people who are nonjudgmental right so you don't want anybody to say don't do that it's a sin it's against this you know don't that's ridiculous we don't do that in our family i mean you wouldn't believe the people the things people come up with in an effort to protect the child but what this app does is it gives the child control over his or her own safety plan so i mean one of the things is you know what are the resources how can i distract myself so when i am feeling very depressed what make kind of help me through this episode or kind of remove myself from this so it could be exercising taking a run or calling up a friend you know again communication and reengagement but there are resources out there that empower correlated with mental illness you would know more judge or stigmatize a child with type one diabetes or a teenager with leukemia than why would we judge or stigmatize a child who is suffering from mental attempts and suicide rates well dayin we're up against the clock but i thank you so much for taking time out of your schedule to engage in this conversation i hope we were able to impart some helpful too to parents i think the media center for hosting focus on health there are lots of resources out there talk to your pediatrician if you're concerned about your child talk to the school guidance department there are professionals who are available to help you navigate what is sometimes a very scary terrain so i thank you diane for joining me and until next time on focus on