Philadelphia Community Services for Children and Adolescents

VIII. Suicide

Suicides of young people nationwide have increased dramatically in recent years. Depression and suicidal feelings are treatable. The child or adolescent needs to have his or her condition recognized and diagnosed, and appropriate treatment plans should be made. When parents are in doubt about whether their child has a serious problem, a psychiatric examination or psychological evaluation may be performed with no harm to the youngster.

A. Myths And Facts About Suicide

MYTH: If you ask a person about his or her suicidal intentions, you will encourage the person to kill him or herself.

FACT: Asking someone about their suicidal feelings may make the person feel relieved that someone finally recognized their emotional pain.

MYTH: People who talk about killing themselves rarely commit suicide.

FACT: Studies reveal that the suicidal person gives many clues and warnings regarding his or her suicidal intentions.

MYTH: There is a "typical" type of person who commits suicide.

FACT: The potential for suicide exists in all of us. There is no "typical" type of suicidal person.

MYTH: All suicidal individuals are mentally ill, and suicide is always the act of a psychotic person.

FACT: Studies of hundreds of suicide notes indicate that although the suicidal person is extremely unhappy, he or she is not necessarily mentally ill.

B. Why Do People Commit Suicide?

The suicidal person feels a tremendous sense of loneliness, isolation, helplessness, and hopelessness. There is a feeling of no longer being able to cope with problems, and suicide may seem to be the only way out. Most people think about suicide at some point in their lives. They find these thoughts to be temporary as, gradually, things do get better.

Many teenagers experience strong feelings of stress, confusion, and self-doubt in the process of growing up. It is easy to see why self-doubts could intensify.

For some teenagers, divorce, the formation of a new family with step-parents and step-siblings, or moving to a new community can be very unsettling and can intensify self-doubts. In some cases suicide appears to be a "solution."

For teenagers who have had a persistent pattern of school failure and/or trouble with the law, their feelings of discouragement and hopelessness can lead them to commit suicide.

For other teenagers, anxiety and guilt over their sexual orientation can lead to suicidal thoughts. According to recent studies, gay and lesbian teens account for a significant number of deaths by suicide.

C. Warning Signs

Many of the symptoms of suicidal feelings are similar to those of depression. Parents should be aware of the following warning signs of adolescents who may try to kill themselves. One sign alone does not mean that a person is suicidal. However, several signs at the same time may indicate that the child needs help. Mental health professionals recommend that if several of the following signs occur, parents should talk to their child about their concerns and seek professional help if the concerns persist. The signs include:

Statement of a wish to die.
Loss of friends, rejection and isolation from peers.
Accident - proneness, risk - taking.
Sudden changes in behavior: withdrawal, apathy, moodiness, aggression.
Changes in eating and sleeping habits.
Withdrawal from friends, family, and from regular activities.
After one person commits suicide, his or her friends at school may also be at risk for suicide.
Violent or rebellious behavior, or running away.
Drug and alcohol abuse.
Unusual neglect of personal appearance.
Radical personality change.
Persistent boredom, difficulty concentrating, or a decline in the quality of school work.
Frequent complaints about physical symptoms, often related to emotions, such as stomach aches, headaches, fatigue, etc.
Loss of interest in pleasurable activities.
No tolerance of praise or rewards.
Depression: crying, hostility.
Anxiety.
Nervousness.
Fixation on death.

A teenager who is planning to commit suicide may also:

Complain of being "rotten inside."
Give verbal hints with statements such as: "I won't be a problem for you much longer," "Nothing matters," "It's no use," "I won't see you again."
Put his or her affairs in order by, for example, giving away favorite possessions, cleaning his or her room, throwing things away, etc.
Become suddenly cheerful after a period of depression.

D. What To Do

People often feel uncomfortable talking about death. However, it can be helpful to ask the child or adolescent whether he or she is depressed or thinking about suicide. Rather than "putting thoughts into the child's head," such a question will provide assurance that somebody cares and will give the young person the chance to talk about his or her problems.

Stay with the child at all times. Offer assistance in solving problems.
Take seriously every complaint and feeling that the child expresses. Do not dismiss or undervalue what the child is saying.
Listen without judging.

E. What Not To Do

Do not allow yourself to be sworn to secrecy by the suicidal child. You may lose the confidence of the child, but you may save a life.
Do not leave the child alone.
Do not act shocked at what the child tells you.
Do not debate whether suicide is right or wrong. This may make the child feel guiltier.

F. Where To Get Help

For immediate help, contact:
Counseling/Crisis/Suicide Hotline
215-686-4420 (24 hours a day/seven days a week)

For more information in a crisis, see on Psychiatric Emergencies.

If you are not in an emergency, refer to Resources for Evaluation and Treatment.

Many schools have Student Assistance Programs (SAP). These programs are similar to Employee Assistance Programs for adults. They are designed to provide evaluation and support services for students who have been identified by peers, teachers, and families as being at risk for suicide. Ask at your school counselor's office whether your child's school has a SAP.

For more information about sexual orientation and suicide.