Saving Lives in New York: Suicide Prevention and Public Health Challenge, Strategy and Policy Recommendations

The New York State Office of Mental Health report establishes suicide as a statewide problem and calls for an integrated strategy to address it. In May, 2004, OMH unveiled SPEAK, a public education and awareness campaign to highlight the threat suicide poses to public health, and ways to combat it. A second model suicide prevention initiative is the Teen Screen program at Columbia University which operates in 250 locations in 42 states. This 64 page report includes 88 action steps, most of them targeted to a specific set of risk factors and populations.  Downloadable pdf file.

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The Choice of Life

This article from The Washington Post is a parent's account of a teen who attempted suicide, the depression that brought him to attempt suicide, medications, the importance of family and the challenge of handling a troubled adolescent. The section on teenage depression is particularly good.

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Evidence-based Practices in Suicide Prevention Programs

The Suicide Prevention Resource Center and the American Foundation for Suicide Prevention have completed development of an online registry of evidence-based suicide prevention programs. The registry of 14 programs represents an initial step in the collection and promotion of evidence-based suicide prevention programs. The link above will take you directly to the registry contents.

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Death by Gunfire in Rural America

Fox Butterfield reports in the New York Times that Americans in small towns and rural areas are just as likely to die from gunfire as Americans in major cities. The difference is that gun deaths in rural America are primarily suicides. Suicides occur at a higher rate in rural areas than in cities or suburbs, and rise steadily the more rural the community.

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New Suicide Hotline

The SAMHSA National Suicide Prevention Lifeline’s mission is to provide immediate assistance to individuals in suicidal crisis by connecting them to the nearest available suicide prevention and mental health service provider through a toll-free telephone number: 800.273.TALK (8255). The network currently numbers over 100 local crisis centers around the country. Click on the link above to visit the website.

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Teen Suicide in Maine

The Portland Press Herald has just published a series of articles about the high rate of teen suicide in that state – 49% higher than the national rate for teens 15-19. In spite of the creation of a statewide suicide prevention program seven years ago to raise awareness the rates have remained high. Maine is a rural state and rural states tend to have the highest rates for suicide. The stigma that keeps teenagers and adults from receiving mental health treatment is another. Lack of services is a third. About 40% of Maine’s residents own guns. The series features sidebar articles that include FAQs abut youth suicide, warning signs, and where to get help.

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Juvenile Suicide in Confinement: A National Survey

A new study of suicidal behaviors among juveniles indicates that young offenders are more likely to commit suicide than is commonly thought, and they do so for different reasons than adults. The study, the first large-scale, systematic look at juvenile suicide in confinement, identified 110 juvenile suicides between 1995 and 1999 and analyzed all 79 cases for which records were available. At the time of their deaths 13 of the 79 offenders were on suicide precaution status at the time of their deaths. 60 pages plus appendices. Pdf file

The PbS web site (Performance-Based Standards for Juvenile Correction and Detention Facilities) has a report online. Suicide Prevention in Juvenile Correction and Detention Facilities includes a chapter on critical components for a suicide prevention plan. Click on "Resources" and go to Resource Guides.

News articles:

A Closer Look at Juvenile Suicide - reviews the study above. Good synopsis of a long report. 

Law aims at curbing suicides by youths – A new law signed by President Bush authorizes $82 million in grants aimed at preventing suicide among young people. The Garrett Lee Smith Memorial Act authorizes $82 million over three years for grants to states, Indian tribes, colleges and universities to develop youth suicide prevention and intervention programs. Funding for the grants has not been fully appropriated.

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FDA Public Health Advisory on Suicidality in Children and Adolescents Being Treated With Antidepressant Medications

October 15^th the Food and Drug Administration (FDA) directed manufacturers of all antidepressant drugs to revise the labeling for their products to include a boxed warning and expanded warning statements that alert health care providers to an increased risk of suicidality (suicidal thinking and behavior) in children and adolescents being treated with these agents. Click on this link for more details.

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Bullying Settlement Reached in Teen Suicide Attempt

The Anchorage, Alaska School District paid out one million dollars as part of a four and a half million dollar settlement in a case that stemmed from bullying. The boy who was bullied attempted suicide and is severely brain damaged. He was a very bright middle school student with a promising future.  Marlene, thanks for sending this on to me.

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Suicide Attempts and Physical Fighting Among High School Students – United States, 2001

The CDC’s Mortality and Morbidity Weekly Report (MMWR) for June 11, 2004 examines the connections between suicide attempts and physical fighting among high school students.   According to the report:

	homicide and suicide are the second and third leading causes of death for persons ages 13+ years.
	Research suggests a link among adolescents between violent behaviors directed at oneself (suicidal behaviors) and violent behaviors directed at others, such as school shooters.
	One in 20 high school students reported both suicide attempts and participation in physical fighting in the preceding year.

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	For the young, people between ages 15 and 24, suicide is among the three leading causes of death.
	In 1998, more teenagers and young adults died of suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia and influenza, and chronic lung disease COMBINED.
	Over the last several decades the suicide rate in young people has increased dramatically. From 1952-1994, the incidence of suicide among adolescents and young adults nearly tripled.
	Males under the age of 25 are much more likely to commit suicide than their female counterparts.

You can also check the Suicide page in the Subject Library for more information.

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	Between 1981 and 1998 20,775 juveniles ages 7-17 committed suicide in the United States . Nearly as many as were homicide or cancer victims.
	Males were the victim in 78% of these juvenile suicides.
	Over the same period, the suicide rate for American Indian juveniles was far higher than for any other race, and almost twice the rate for white juveniles.

High School Suicide Prevention Program

 

 

The SOS (Signs of Suicide) Suicide Prevention program provides school health professionals with all the educational materials necessary to replicate this program in a variety of school settings. SOS helps teens to understand the connection between suicide and undiagnosed, untreated mental illness – usually depression – and empowers them to ACT:

 

	Acknowledge that their friend has a problem, and that the symptoms are serious
	Care – let that friend know that they are there for them, and want to help,
	Tell a trusted adult about their concerns.

An evaluation of SOS found that schools using the SOS program reported a significant increase in help seeking by depressed students. No high schools reported any adverse reactions among students exposed to the SOS program.   

 

SOS is produced by Screening for Mental Health, Inc., a non-profit organization developed to coordinate nationwide mental health screening programs. SOS has been designated as a “promising program” by SAMHSA and is the only suicide prevention program selected for its National Registry of Effective Programs.

 

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Losing Joshua

 

 

A feature article from the Village VOICE about a 17-year-old’s suicide. Joshua had been diagnosed with ADHD when very young and re-diagnosed as bi-polar four months before his death. He suffered from severe chronic depression. This article is a very thorough treatment of a complex and difficult subject.

 

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Teen Suicide – Who is at Risk?

 

 

Two articles from the February 25 issue of the Washington Post discuss screening teenagers for suicide and depression and the Columbia TeenScreen Program at Columbia University . TeenScreen uses a sequence of tests and interviews designed to sift through a large group of teens and identify the few kids at high risk for depression and suicide. The second article looks at characteristics of teens with an elevated risk of suicide.

 

Suicide Mission

 

Who Is At Risk for Suicide?

 

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TeenScreen Tool-kit – Suicide Prevention

 

 

Columbia University ’s Division of Adolescent Psychiatry developed a program to screen adolescents that utilizes technology and other methods to detect warning signs for suicide in the young and provides intensive treatment and follow-up services for teens with a range of disorders. At this site you can look at the TeenScreen Tool-kit and read a monograph about the program. Helping Troubled Youth, a booklet that describes the nature and scope of the Columbia TeenScreen program can be ordered at the site.

 

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From 1952-1995, the incidence of suicide among adolescents and young adults nearly tripled. From 1980-1995 the rate of suicide among persons aged 15-19 years increased by 23% From 1980-1995 the rate of suicide among persons aged 10-14 years increased by 112%. Although suicide among young children is a rare event, the dramatic increase in the rate among 10-14 year-olds underscores the urgent need to intensifying efforts to prevent suicide among persons in this age group. For African American males aged 15-19, the rate increased 146%. Among persons aged 15-19 years, firearm-related suicides accounted for 96% of the increase in the overall rate of suicide from 1980-1995. Males under the age of 25 are much more likely to commit suicide than their female counterparts. The 1996 gender ratio for people aged15-19 for 5:1 (males to females), while among those aged 20-24 it was 7:1. At a Glance: Suicide Among the Young, The Surgeon General’s Call to Action to Prevent Suicide, 1999

Suicide is now the eighth-leading cause of death in the United States Among the young, people 15 to 24 years old, suicide is the third leading cause of death, behind unintentional injury and homicide.

The U.S. Surgeon General has just published the first national guide for implementing suicide-prevention programs in schools, colleges, workplaces and jails. A National Strategy for Suicide Prevention is the result of a 1998 national suicide-prevention conference.

Internet resources on youth suicide:

Youth Suicide Prevention Programs - A series of prevention guidelines  published by the Center for Disease Control. The reports are downloadable.  Probably the most complete resource on teen suicide prevention on the net.

Depression and Suicide in Children and Adolescents - From the Surgeon General’s report on Mental Health, this subsection to Chapter 3, Children and Mental Health,  discusses depression and mood disorders in detail. One of the most useful portions of the chapter describes how childhood depression differs from adult depression, both in terms of the nature of the illness and how it shows up, i.e., children who are depressed may not look or act depressed.

Teen Suicide, An Epidemic of the 90's - Written by teens. Includes statistics, warning signs, facts about suicide, a bibliography, and information on suicide among First Nation teens (This is a Canadian site. In U.S. terms, Native American kids.)

Juvenile Justice Evaluation Center Online -- Another resource from OJJDP/NCJRS. Resources, programs, state information, national initiatives.  Evaluation instruments, applications, and links too.

Teen Suicide - From the American Academy of Child & Adolescent Psychiatry, a fact sheet about symptoms of suicidal feelings, warning signals for parents and others.

Preventing Suicide – CDC site presenting help on suicide prevention for individuals, families and friends, and communities. Includes extensive list of resource organizations.

Youth Suicide - Causes for stress and depression in the young, signs of depression and suicide, and a set of guidelines for anyone who potentially may be dealing with a young person who is suicidal. From The Befrienders, a volunteer organization dedicated to befriending those who are suicidal, despairing and lonely.

If you are thinking about suicide...read this first – Internet help for anyone considering suicide.