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Suicide: A Primary Prevention Recipe.
Stop the Problem Before It Goes Too Far.
Suicide is the eighth leading cause of death for all people regardless of age, sex, or race. It is the third leading cause of death for young people age 15-24, and the fourth leading cause of death for persons between the ages of 10 and 14. It is a far more common form of violence involving students than is school homicide. Why then is there a lack of comprehensive services devoted to primary, secondary and tertiary intervention for this form of violence that takes so many children's lives? The following document addresses primary prevention strategies for children who have not yet attempted to commit suicide. This type of prevention focuses on reducing the likelihood that children will get to the at-risk stage where they are contemplating suicide as a solution to their problems.
So what can we do to protect children from getting to the point where they are contemplating suicide as a solution to their current situation?
There are three main areas that can be the focus when attempting to prevent suicide at the primary level. They are:
Increasing the protective factors within and around the child. Protective factors are those factors that increase the child's chances for success.
Reduce the risk factors within and around the child. Risk factors are those factors that reduce the child's likelihood for success.
Create a positive and supportive climate that affirms life and provides outlets for students who are experiencing difficulties.
Increasing Protective Factors and Reducing Risk Factors Within the Child and Within Their Environment:
Suicide of young children under the age of 10 is rare. The explanation that has been given for the lowered rates of suicide among young children is that compared to adolescents these children are (1) less depressed, alienated, and lonely, (2) more involved with parents (3) less involved with alcohol and drugs and (4) have less access to firearms.
Students who experience prolonged depression, are substance abusers, are estranged from their parents and from their peers and community, who have access to firearms, and who are at risk for running away are found to be at an increased risk for committing suicide. All of these factors are risk factors within the child and within their environment that produce an increased chance of committing suicide. These factors can be addressed through strategies that help reduce risk factors and help to increase protective factors. The following are some strategies that can be used to reduce risk and enhance protective factors in children and in their environment:
Implement programs that help to develop children's coping, problem-solving, and stress management skills. Children who resort to suicide in order to solve their problems may be lacking the stress management skills that would allow them to reduce their personal stress, the coping skills which would help them to develop strategies to deal with their current situation, and the problem-solving skills which would help them to develop alternative solutions to their problems other than the solution of suicide.
General suicide education programs that center around the development of these skills are a positive means for teaching children about the realities of suicide, and for training them in the skills that can help to prevent either themselves or others from selecting suicide as a solution to their problems. General suicide education programs are typically school-based programs that teach the facts and myths about suicide, alert students to warning signs, and provide information about how to seek help for oneself and for others. Additionally, some programs also encourage students to share their feelings and develop their interpersonal coping skills. They also provide alternatives for solving problems, and training in stress management and coping skills to help students deal with their problems. Some programs also promote the development of listening and interpersonal skills to help students improve their relationships with peers, parents, and others.
It is the programs that contain the additional components, where stress management, coping skills, and problem solving skills are a focus, that help to increase the protective factors that students can use when dealing with their problems. There has often been concern about these programs and the role that they might play in increasing the rates of suicide. Some feel that increased awareness of suicide may lead children to use suicide as a problem solving technique. Research results, however, have shown that there is NO evidence of increased suicidal behavior, and that the highest risk is that students may react negatively to the program, and school officials must be ready to assist students who find the program upsetting.
Peer support programs are other programs that can be used to enhance the interpersonal and coping skills of students. These programs allow students to increase their use of natural social support networks for dealing with problems. These groups, while typically used with at risk youth, can be beneficial to all youth.
Problem-solving, stress management, coping, and interpersonal skills are skills and abilities that are useful to develop in all children so that when problems do present themselves, children have the artillery to fight back.
Develop an awareness of the signs of depression so that adults and peers within the school system can detect and address these symptoms before they reach the point where the student is considering suicide as an alternative to the pain that they are feeling. Teachers, students, and all staff members of the school community should be taught how to identify signs of depression, and who to contact if they are concerned for a student or peer. Counseling and other treatments can be provided for children to help alleviate that pain that they are experiencing from depression.
Make sure that children have access to drug and alcohol abuse treatment programs, as well as programs that provide help and services to runaways, pregnant teens, and school dropouts. These programs help to address some of the variables that have been found to be present in at-risk youth for suicide.
Restrict access to firearms. Official 1998 statistics provided by the American Association of Suicidology stated that 60.7% of youth suicide is carried out by firearms and explosives. Impulsiveness appears to play an important role in suicide, especially youth suicide. Ambivalence is also a prominent characteristic of suicide, where those who are contemplating suicide are not really sure if they want to follow through with the act. It has been argued that if lethal means, such as firearms, are not readily available when a person decides to attempt suicide, he or she might either delay the attempt, allowing for the possibility of later deciding against suicide, or use a less lethal means, allowing for a greater possibility of medical rescue. Growing research demonstrates that handgun control plays a role in reducing the youth suicide rate. While this prevention effort falls into the category of secondary prevention, it should be brought to the awareness of all parents as part of any prevention effort against suicide.
Creating a positive and supportive climate that affirms life and that provides outlets for students who are experiencing difficulties.
Many of the strategies mentioned above for reducing risk factors and increasing protective factors in students help to create an environment where students know that they have supports that they can turn to when they are experiencing difficulties. There are several things that can be done to help create a positive and supportive climate that provides outlets for students who are experiencing difficulties:
Develop support networks for children that can help to reduce feelings of alienation, depression, and loneliness. These networks can include peer support programs and mentor programs within the school. It is important to develop an awareness of signs of student stress among adult individuals who are working within the school community. All individuals who are trained in recognizing signs of student distress, and in reporting distressed students to individuals who are trained to help serve as a support system for the child, are part of a support network that should be available for every child within the school system.
Assist parents in identifying signs of stress within their own children and in developing strategies to approach and talk with their child. Information should be shared with parents about how to detect when their child is experiencing difficulty and about how they can be a support during those times.
Implement programs that provide a safe environment where students can learn to deal with their problems. General suicide education programs and peer support programs, if implemented correctly, are examples of means through which students can, share their feelings and develop their interpersonal coping skills.
Develop a school climate policy where it is part of the school's mission to create a school atmosphere where children feel physically and psychologically safe, and where adult members of the community provide both academic and emotional support for children as they develop and grow into adulthood.
As children grow and develop they will be faced with many challenges. By working with children to develop protective factors both within themselves and within their environment, including the creation of a positive and supportive environment, we are helping to prevent the possibility that a child will turn to suicide as a means for dealing with their problems. Through developing protective factors and reducing risk factors within the child and his/her environment, we are providing him/her with the roadmap they need to navigate that many challenges and feelings they will face while growing and developing.
If you are interested in reading more about suicide prevention the following resources are a good place to start.