In 2021, suicide was the 11th leading cause of death in the United States, according to the Centers for Disease Control and Prevention. More than 48,100 Americans died by suicide that year.
Suicide is the 2nd leading cause of death for those aged 10-14 and 25-34 and the 3rd leading cause for those aged 15-24. Nearly 20% of high school students report having serious thoughts of suicide.
September is Suicide Prevention Month, so we’re spreading the word about the importance of mental health, particularly for youth, and how we can help prevent youth suicide.
Suicide is a public health crisis, and together, we can increase understanding and awareness of this critical issue, break the stigma, and spread hope.
We sat down with Courtney Armstrong, the Community Health Programs Specialist and Certified QPR (Question, Persuade, and Refer) Instructor at Kadlec Regional Medical Center, to learn more about suicide prevention.
What are the clues and warning signs that a youth might be contemplating suicide?
Courtney Armstrong: There are 3 types of warning signs to watch out for—behavioral clues, verbal clues, and situational clues.
Behavioral Clues
Behavioral clues refer to any changes in behavior or mood. Be on the lookout for changes in social interactions, like withdrawing from families or not spending as much time with friends; changes in hygiene, like not showering or brushing hair; changes in eating or sleeping habits; and substance use.
It’s important to pay attention to kids and be knowledgeable of their baseline behavior so you can tell when there’s a change. For example, if a particular child doesn’t mind being dirty, then it probably wouldn’t be a warning sign for them not to shower, but if a child usually likes to be very neat and clean, then a sudden lack of hygiene would be more notable.
Verbal Clues
Verbal clues can be either direct or indirect, and both should be taken seriously. Direct verbal clues are when someone directly says they want to kill themselves or they wish they were dead. Indirect verbal clues can be anything like, “I can’t go on,” “My family would be better off without me,” or, “I just want out.” Verbal clues also refer to posts on social media.
Situational Clues
Situational clues are any situations that may be upsetting to youth. These might be disappointing experiences or future plans not working out, like not making a sports team, not getting into their first-choice college, or not getting a job they wanted.
Situational clues can also be family issues or the loss of a relationship, either due to a breakup or the death of a loved one. Getting into some kind of trouble or experiencing an embarrassing situation can also be a cause for concern, especially if the situation gets spread around online.
What should you do if you suspect a youth is depressed or contemplating suicide?
CA: Always follow your gut feeling. If you suspect there’s a problem, then act. The 3 steps to help prevent suicide are QPR—Question, Persuade, and Refer.
Question
Check in, and ask the child how they’re doing. If they don’t answer, or they just say, “Fine,” without elaborating, be persistent. Ask deeper questions, and try to get more information. You can ask them to name some specific things that happened that day or how they felt about different experiences.
Provide a safe place for kids to talk to you. Listen to them, give them your full attention, and allow them to speak freely. You may be tempted to jump in and try to solve their problems, assure them it’s not a big deal, or tell them about a similar experience you went through. However, you should hold off on a response like that because it may come across like you’re not taking their problems seriously. Just be there for them, and listen to what they have to say.
Persuade
Persuade the child to seek help and stay safe. This will look different depending on the severity of the situation. If you think they are in immediate danger, call 911 or take them to the emergency room right away. Otherwise, if the risk is non-imminent, ask if they will let you help them. Offer them hope in any form.
Refer
Get the child the help they need. Find a local professional who can help, like a counselor or a medical provider, or you can use the Suicide & Crisis Lifeline: 988. If you or someone you know is having a mental health crisis, call or text 988, and you will be connected to trained counselors who will listen, provide support, and put you in contact with the necessary resources.
What can we do to promote mental wellness for youth every day?
CA: Build a support system that makes kids feel comfortable coming to you for help. Show you care by asking them questions and listening to their answers. Validate their feelings. Even if a problem doesn’t seem like a big deal to you, remember that if it feels like a big deal to the child, then you should treat it like a big deal.
Cultivate a space where talking about feelings and mental health is normalized. Talk about your own mental health to let kids know it’s okay.
If a child is having trouble understanding or talking about their mental health, try comparing it to physical health. Go over symptoms of physical illnesses with them. For example, you can explain how you might throw up when you have the flu. Then you can use that to teach them about how mental illnesses have symptoms as well. When you have depression, you might feel sad, and just like throwing up is a symptom of a physical illness, that feeling is a symptom of a mental illness.
One way to start a conversation about feelings is to make a routine of each person naming one good thing and one bad thing that happened to them each day. While it may be tempting to ignore the bad things and only focus on the good, talking about bad experiences gets all the feelings out in the open and lets kids know that having these feelings and experiences is normal. It also teaches kids that we can be there for each other and eventually move past these bad feelings.
*This interview was slightly edited and paraphrased for readers with permission from Courtney Armstrong. We hope this interview and information helped you understand youth mental health and suicide prevention. For more information and resources, contact Courtney at [email protected].
