Suicide among young people

It can be frightening and distressing when someone you care about is considering taking their own life. Suicide prevention starts with recognising the warning signs and taking them seriously, talking to your young person about what’s going on, and helping them seek professional support.

Feelings of despair and hopelessness are not uncommon in a young person with anxiety and depression. But while many young people have thoughts of suicide, only some of them begin to think about it as a real option – the only alternative to the overwhelming distress or unbearable pain they’re feeling. It’s important to realise that most suicidal young people don’t want to die. Rather, they’ve run out of ways to cope with their pain and all they can see ahead of them is despair. With support, they can find better ways to manage their distress and get through the crisis.

Youth suicide – the issues

One major threat posed by mental illness is that it may eventually lead to suicide. Most commonly associated with depression, suicide is a major cause for concern, especially in Nepal, where action against mental illnesses is very rarely taken. Suicide among youth is increasing in an alarming rate in Nepal. According to Nepal police the 7,144 suicides were reported in 2018 and half of the them were among youth below the age of 18.
Although these are startling numbers, what is even more concerning is what we don’t know enough about it in Nepal. Research elsewhere shows that in this age group, for every one suicide there are approximately 100-200 suicide attempts. While suicide can affect anyone regardless of age, gender, race, income and family background, some young people are at greater risk of self-harm and suicidal behaviour.
Although these numbers are alarming, the good news is that youth suicide is mostly preventable.

Risk factors for suicide
The reasons behind a youth’s suicide or attempted suicide can be quite complex. Although young children also commit suicide, the rate of suicides and suicide attempts increase greatly during adolescence. Science suggests that suicide does not occur for just one reason. There is a confluence of factors that lead to a tipping point. Mostly, suicide is the result of mental disorders, such as bipolar disorder, schizophrenia, social anxiety, dysthymia (persistent mild depression) and major depression. The risk factors for suicide increase due to family genetic vulnerabilities, a family history of suicide, mental illness among parents, substance abuse and family violence. These factors are excavated by traumatic experiences such as bullying, childhood sexual abuse, natural disasters, war, family violence, pressure of education, and break-ups. These factors also often act as “trigger points”.

While warning signs are more immediate such as sudden changes in behaviour, risk factors are often longer-term challenges that a young person may deal with over a period of time. The more challenges a young person has in their life, the greater their risk of suicide

Young people who have attempted suicide are 18 times more likely to try it again and are 40 times more likely to die by suicide in the future.

Warning signs for suicide

It’s quite common for young people to go through the ups and downs of adolescence and to feel strong emotions. But for some young people, the downs can be so intense and extreme that they think about taking their own life.

So how do you figure out what’s within a ‘normal range’ and when you should be concerned?

Research shows that there are some key suicide warning signs to be aware of. Warning signs are behavioural changes, thoughts or feelings that can provide 'clues' or 'red flags' about your young person’s risk of suicide.

Some warning signs may be relatively easy to pick up, such as when a young person talks about death or says they want to die.

Other signs are harder to spot – if your young person is trying to hide their feelings and emotions from family or friends, you’ll need to watch out for changes in their behaviour.

You’re really looking for dramatic changes in behaviour and mood over a relatively short period of time:

1. Watch for dramatic changes in behaviour
2. Monitor changes
3. Ask questions

Common warning signs

• A sense of hopelessness or no hope for the future.
• Isolation or feeling alone – “No one understands me”.
• Aggressiveness and irritability – “Leave me alone”.
• Possessing lethal means – e.g. medication, sharp objects, weapons.
• Negative view of self – “I am worthless”.
• Drastic changes in mood and behaviour.
• Frequently talking or writing about death – “If I died, would you miss me?”
• Self-harming behaviour like cutting.
• Engaging in 'risky' behaviour – “I’ll try anything, I’m not afraid to die".
• Making funeral arrangements.
• Giving things away like clothes or expensive gifts – “When I am gone, I want you to have this”.
• Substance abuse.
• Feeling like a burden to others – “You would be better off without me”.
• Making suicide threats – “Sometimes I feel like I just want to die”.

How you can help

If you’re worried that a young person you care about is thinking about suicide, don't ignore it. Talk with them about how they’re feeling.

Sometimes people worry that talking about suicide may put ideas in a young person’s head, but the opposite is true. Talking openly lets them know that you care, you’re listening and you want to help them through this tough time.

Talking about suicide

Don’t be afraid to ask direct questions about suicide. You can’t ‘put the idea of suicide’ in someone’s head by talking about it.

In fact, by asking questions, you may prevent suicide by showing your young person that you care and are there to help. Asking direct questions can also help you to determine if they’re in immediate danger and in need of assistance.

Here are some ways to ask a young person if they are considering suicide:

• "Are you feeling so bad that you’re thinking about ending your life?"
• "Are you having thoughts about suicide?"
• "Do you ever wish you were dead?"

You should never promise to keep thoughts or feelings about suicide a secret. Keeping the secret may be extremely harmful, if not fatal. Be sure to tell the young person that you are unable to keep their secret. Even if they seem upset with you now, they will thank you later.

If you suspect that a young person you care about is in danger, get help immediately. Don't wait for things to blow over or calm down.

TALK ABOUT THEIR THOUGHTS AND FEELINGS

Encourage your young person to talk about how they feel, even if you find it hard to hear. Giving them a chance to talk things through can be really helpful. It will also make them feel supported.

GET SUPPORT

Encourage your young person to get support. You might suggest a health professional (link to the champions) . Let them know that they don’t have to face this on their own – there are specialist services to help them.

STAY SAFE

Remove or lock away anything that could be used to cause harm (e.g. weapons, medications, drugs, alcohol).

When a young person confides that they are feeling suicidal, don’t promise to keep it a secret. Be clear about the limits of confidentiality – if they are at risk of suicide you have a duty of care to let someone know and get them support. Try to do this in collaboration with the young person.

If you or someone you know is having symptoms of Depression, immediately seek health care. You can find MHA Champions Care Providers below: