Suicide and Suicidal Behavior Health Article

Definition

Suicide is the act of ending one's own life. Suicidal behavior are thoughts or tendencies that put a person at risk for committing suicide.

Description

Suicide, attempted suicide, and thoughts of committing suicide are, as of the early 2000s, growing problems among adolescents in the United States and much of the world. It is the third leading cause of death among 15 to 19 year olds in the United States and the sixth leading cause of death among 10 to 14 year olds. About 2 percent of adolescent girls and 1 percent of adolescent boys attempt suicide each year in the United States. Another 5 to 10 percent of children and teens each year come up with a plan to commit suicide.

Psychologists have identified the teenage years as one of the most difficult phases of human life. Although they are often seen as a time in which to enjoy life, hang out with friends, and perform other activities that adults would not usually do, the teenage period can be difficult. Many changes in the human mind take place during puberty. Apart from facing the onset of sexual maturity, teenagers must also make key decisions about their future, develop their identities, change schools, and meet new friends. They may have to cope with a wide range of personal and social challenges. Many young people have difficulty dealing with stress these experiences may elicit.

The most common reasons for suicide or suicidal behavior among children and adolescents involve personal conflict or loss, most frequently with parents or romantic attachments. Family discord, physical or sexual abuse, and an upcoming legal or disciplinary crisis are also commonly associated with completed and attempted suicide. Adolescents who complete suicide show relatively high suicidal intent, and many are intoxicated at the time of death. The most serious suicide attempters leave suicide notes, show evidence of planning, and use an irreversible method, such as a gunshot to the head. Most adolescent suicide attempts, though, are of relatively low intent and lethality, and only a small number of these individuals actually want to die. Usually, suicide attempters want to escape psychological pain or unbearable circumstances, gain attention, influence others, or communicate strong feelings, such as anger or love.

Suicidal behavior is rare in children prior to puberty, probably because of their relative inability to plan and execute a suicide attempt. Psychiatric risk factors, such as depression and substance abuse, become more frequent in adolescence, contributing to the increase in the frequency of suicidal behavior in older children. Some view the transition from primary to middle school as particularly stressful, especially for girls. Also, parental monitoring and supervision decrease with increasing age, so that adolescents may be more likely to experience emotional difficulties without their parents' knowledge.

Repeated suicide attempts are common, but rates vary. Follow-up studies ranging from one to 12 years found a re-attempt rate among adolescents of 5 to 6 percent per year, with the greatest risk within the first three months after the initial attempt. Factors associated with a higher re-attempt rate included chronic and severe psychiatric disorders, such as depression and substance abuse; hostility and aggression; non-compliance with treatment; poor levels of social skills; family discord, neglect, or abuse; and parental psychiatric disorders.

Highest risk

Four out of five teenagers who successfully commit suicide are male, but the average female teenager is prone to attempt suicide four more times during her teen years than the average male. White teenage males are more likely to commit suicide than other ethnic groups, but as of the early 2000s teenage suicide among blacks is also increasing. Teenagers who have unsuccessfully tried to commit suicide in the past are more likely to attempt suicide in the future. The odds increase after each failed attempt. There are two groups of teens that are at a particularly high risk for committing suicide: Native Americans, and gay, lesbian, bisexual, and transgendered teens.

In Native American, including Native Alaskan, youth ages 15 to 24 years, suicide is the second leading cause of death, according to a 2001 survey by the Bureau of Indian Affairs. The survey also showed that 16 percent of Native American youth attempted suicide in the preceding year. Among Native American high school students, suicide attempts were most associated with poor school performance, poor physical health, a history of family or friends who committed or attempted suicide, family problems, and physical and sexual abuse.

Gay and bisexual male teens, which represent about 10 percent of the male teen population, are six to seven times more at risk for attempting suicide than their heterosexual peers. Several surveys show gay and lesbian youth account for 30 percent of all suicides among teens, according to the U.S. Department of Health and Human Services. Yet most studies of teen suicide have not been concerned with identifying sexual orientation.

A 1997 study by the Massachusetts Department of Education found that 46 percent of high school students who identified themselves as gay, lesbian, or bisexual, had attempted suicide in the past year compared to 8.8 percent of their heterosexual peers. Of the gay, lesbian, and bisexual teens, 23.5 percent required medical care as a result of their suicide attempt compared to 3.3 percent of heterosexual students who attempted suicide.