A youth perspective on suicide prevention
Authors: Bliss Croton, Cleo Brocius, Sheherazade Weyland, Jarid Rother, Lydia Lutsyshyna, Morgan Leets, Elissa Schuler Adair, Kahae Rikeman, Emily Moser
Journal: The Lancet Psychiatry (2020)

Holmes and colleagues1Holmes EA O'Connor RC Perry VH et al.Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science.Lancet Psychiatry. 2020; (published online April 15.)https://doi.org/10.1016/S2215-0366(20)30168-1Summary Full Text Full Text PDF PubMed Scopus (3685) Google Scholar have summarised psychological and social effects of COVID-19. The health-care system response needed to address these effects, up to and including suicide risk, provides an opportunity to align direct services (eg, crisis lines), individual providers, and universal population interventions to protect and promote mental health.2Gunnell D Appleby L Arensman E et al.Suicide risk and prevention during the COVID-19 pandemic.Lancet Psychiatry. 2020; (published online April 21.)https://doi.org/10.1016/S2215-0366(20)30171-1Summary Full Text Full Text PDF Scopus (958) Google Scholar Therefore, it is useful to consider how alignment might look in practice. Effective youth suicide prevention requires collective action and values3Caine ED Building the foundation for comprehensive suicide prevention − based on intention and planning in a social–ecological context.Epidemiol Psychiatr Sci. 2020; 29: e69Crossref Scopus (11) Google Scholar at all levels.4Hong JS Espelage DL Kral ML Understanding suicide among sexual minority youth in America: an ecological systems analysis.J Adolesc. 2011; 34: 885-894Crossref PubMed Scopus (55) Google Scholar YouthLine, based in Portland, OR, USA, is one of the few teen support and crisis lines in the USA that uses youth volunteers (appendix p 1). Many considerations arise when supporting a young person in crisis. These considerations exist for youth and adult helpers, on crisis calls or in a community. Using a youth-adult codesign process,5Donetto S Pierri P Tsianakas V Robert G Experience-based co-design and healthcare improvement: realizing participatory design in the public sector.Design J. 2015; 18: 227-248Crossref Scopus (361) Google Scholar the YouthLine wrote this Correspondence. Working through mental health concerns is hard for those experiencing them and those helping, which is why it is important for young people in crisis and their peer supporters to have adults on their side. As a team, we can help each other and connect people to the resources they need. Young people should never feel like the sole supporter of a friend or loved one. Those providing peer-support are not professionals (even in the mental health field responsibility never exists to fix another person's problems). If the safety of someone you know is at risk, adults need to know. There are four main actions we recommend, as follows. First, setting boundaries. A boundary is a limit we set for ourselves. Boundaries are part of taking time and space to address your own needs. Although we wish everyone had the space to communicate their needs and receive validation, it is important to acknowledge that many experience pushback related to others' experience. Developing strong boundaries is vital in spaces where your wellbeing is not prioritised. Since creating boundaries can be exhausting work, it is crucial to pair these efforts with effective self-care. Second, asking for help. Asking for help when you need it is a way to take care of your own mental health. Reaching out and communicating with a peer, parent, or counsellor can better allow you to cope with your own challenges. Seeking help can include advocating for others who are not in a place to get care for themselves, whether they lack the words, supportive adults, resources, or security. Third, being a role model. Being open about your own mental health issues and how you address them can help you feel better and might also support and encourage others who feel isolated, hopeless, or in crisis. By having your own boundaries, self-care routines, and avenues for fighting stigma, you can be an ally and show others what to do for themselves. Finally, self-care—not putting too much on yourself. Setting boundaries and knowing when to ask for help are the first step to self-care. Beyond setting boundaries and asking for help, self-care might include activities you enjoy, taking care of tasks necessary for your physical health, and giving yourself space for your emotions. By practicing self-care, you not only help yourself, but you also better support for those around you. There are times when, despite our efforts, the outcome of the situation is not what we would have hoped. Holding compassion for ourselves is as important as having empathy for the youth we support. To contact YouthLine (USA only) call 877-968-8491 or text "teen2teen" to 839863, or access chat from anywhere globally via https://www.oregonyouthline.orgThis online publication has been corrected. The corrected version first appeared at thelancet.com/psychiatry on August 28, 2020 To contact YouthLine (USA only) call 877-968-8491 or text "teen2teen" to 839863, or access chat from anywhere globally via https://www.oregonyouthline.org This online publication has been corrected. The corrected version first appeared at thelancet.com/psychiatry on August 28, 2020 We declare no competing interests. YouthLine thanks the many youth volunteers, leads, and coaches who contributed by providing feedback on earlier drafts of the manuscript. Youthline is a service of LinesforLife.org. Download .pdf (3.7 MB) Help with pdf files Supplementary appendix Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health scienceThe coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. Full-Text PDF Correction to Lancet Psychiatry 2020; 7: 736–37Croton B, Brocius C, Weyland S, et al. A youth perspective on suicide prevention. Lancet Psychiatry 2020; 7: 736–37—In this Correspondence, some of the hyperlinks were incorrect. These corrections have been made as of Aug 28, 2020. Full-Text PDF