Adolescent Suicide: Detection, Intervention, and Prevention

Although 5,000 to 6,000 adolescents (ages 13 to 21) take their lives each year and another 500,000 teens make unsuccessful attempts, suicide continues to be a relatively taboo topic of discussion within our society (Cantor, 1991; Gordon, 1985; Hipple, 1991). Jacobs (1980) found suicide to be "the fifth leading cause of death among adolescents in the 15- to 19-year-old age group, exceeded only by accidents, malignant neoplasms, cardiovascular-renal disease, and homicides:" Today, suicide ranks as the second or third leading cause of death among adolescents. Suicide ranks below accidents and is nearly tied with homicides (Clark,1993; Conrad,1991; Godwin,1986; Ryland & Kruesi, 1992, 1993; Schepp & Biocca, 1991; Smaby, Peterson, Bergmann, Bacig, & Swearingen,1990). In 1988, it was found that 11.3 adolescents (age 15 to 24) per 100,000 took their own lives compared with 2.7 per 100,000 (ages 15 tol9) in 1950 (Ryland & Kruesi,1992, p. 185). For most, suicide is a permanent solution to a temporary problem. In 1985, Shneidman defined suicide in the western world as: "a conscious act of self-induced annihilation, best understood as a multidimensional malaise in a needful individual who defines an issue for which suicide is perceived as the best solution" (as cited in Leenaars,1991, p. 96). This definition was revised by Pfeffer (1986) in 1986 to encompass adolescents as well. It is not necessary for a child to have an understanding of the finality of death but it is necessary to have a concept of death, regardless of how idiosyncratic it may be. Therefore, suicidal behavior in children can be defined as a selfdestructive behavior that has the intent to seriously damage oneself or cause death (as cited in Leenaars, 1991, p. 96). Suicidal adolescents are usually in great pain, and their only desire is to be rid of it (Hicks, 1990;Joan, 1986; Slaby & Garfinkel, 1994). Shneidman (1965) found ironically that those who are intent upon committing suicide still want to live. For the average individual, everyday problems may seem trivial, but to the teenager seriously contemplating death, they are insurmountable. Many feel shame, guilt, and loss. These emotions, coupled with the adolescent's already low self-esteem, may prove to be disastrous. "The pain was too much. I couldn't stand it anymore. No one loved me anymore, my grades stunk, and I was sick and tired of living- after all, why bother? Life would be so much better without me. And best of all, the pain would finally go away and I could be in peace" (Anonymous adolescent male, personal communication, May 1992). Some adolescents are just confused and do not know what to do, as is apparent in the following journal entry written by 18-year-old Todd Robinson, just 2 days before he shot himself in the head and died. "Lately the thought of suicide has crossed my mind. I don't know why. I have wonderful family and friends. I have an excellent future ahead of me. But I think I'm going to do it. Mom, Dad, don't fall apart" (Robinson, 1991, p. 30). Some teens may not even realize that death is final. "I only wanted to die for a little while . " (Anonymous adolescent female, personal communication, April 1991). UNDERSTANDING THE BEHAVIOR Understanding the behavior of suicidal adolescents and trying to prevent them from completing their intentions begin with dispelling some of the many myths that surround suicide. An examination of the risk factors, of the methods of detection of suicidal behavior, of the intervention techniques, and of prevention aspects of suicidal adolescents follows. Common And Dangerous Myths There are many myths surrounding adolescent suicide, which can be very dangerous if used to understand suicide. The myths listed below are the most common and the most dangerous (Hicks, 1990). The work of several researchers has been instrumental in dispelling these myths. Those who talk about suicide really never do it. …