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Self-Harm: Signs a Child or Adolescent May be Considering Self-Harm or Suicide.

Recently, I have been asked by many teachers, to share some links on suicide in children and adolescents. Please note that if you are concerned that a young person you know might be at risk of a suicide attempt, it is important to act immediately. Call a doctor, mental health professional, mental health crisis service (such as LIFELINE), or go with them to your local hospital’s emergency department. In the case of an emergency, call triple zero (000).

Suicide rates in teenagers have risen drastically over the past decade. In fact, in Australia, suicide is the leading cause of death among young people. According to Beyond Blue, roughly 350 Australian youth’s took their own lives in 2013. Australian data by the ABS (Causes of Death, 2015) reports deaths due to suicide in 2015 to have been a total of 3027 lives lost. Furthermore, for every death by suicide, it is estimated that as many as 30 people attempt to end their lives. This amounts to approximately 65,300 suicide attempts each year within Australia.

Risk factors for suicide include:

Previous suicide attempts (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).

History of substance abuse and/or alcoholism.

History of mental health conditions – depression, anxiety, bipolar, PTSD.

Relationship problems – conflict with parents and/or romantic partners.

Legal or disciplinary problems.

Access to harmful means such as medication or weapons.

Recent death of a family member or a close friend.

Ongoing exposure to bullying behaviour such as cyberbullying.

Losing a friend or family member to suicide.

Physical illness or disability.

Protective factors for suicide include:

Strong, positive relationships with parents and guardians. A secure attachment style creates feelings of security and support.

Connections to other non-parental adults.

Closeness to caring friends.

Academic achievement.

School safety.

Feeling a sense of belonging to something bigger than themselves – community, culture, religion, sports team.

Awareness of and access to local health services overall resilience.

Warning signs that a child or young person might be considering suicide include:

Talking about suicide – i.e., ‘I wish I was dead’, ‘I wish I hadn’t been born’, ‘I feel like giving up’, ‘People would be better off if I wasn’t here.’

Talking about feeling hopeless or despairing, either in person or online. For example, in blogs or social media status updates, talking a lot about death or dying, or drawing or writing poetry, songs or stories about death or dying.

Saying goodbye to people as if expecting not to see them again.

Collecting things that could be used to commit suicide. For example, drugs or lethal weapons, putting affairs in order or giving away stuff for no reason.

May not be interested in social activities, and might spend less time with friends and more time alone.

May show a rapid drop in school performance.

May have a lot of trouble sleeping or wake up later than usual.

Might run away.

May get into trouble with the police.

May start using alcohol and/or other drugs, or may increase their regular usage.

May show signs of losing touch with reality (psychosis), for example, hearing voices or hallucinating.

May seem very anxious, angry, confused or agitated.

May have mood swings, rages or periods of aggression that are out of character, or be suddenly cheerful after a period of depression.

May seem not to care about other people, or have little or no reaction to happy or unpleasant events.

Some teenagers don’t show any signs and might attempt suicide without any warning. Even highly experienced mental health workers cannot always know with certainty that a person is experiencing suicidal thoughts. It is however extremely rare for a person who is asked sensitively about symptoms, to completely deny being suicidal.

By asking questions, you may prevent suicide by showing care and compassion towards the young person. It is however, extremely important to never promise to keep these thoughts or feelings about suicide a secret. As a therapist, if a client asks me to keep the information confidential, I may say something like ‘remember when you first started coming here and I told you that I would keep things we discuss confidential unless I am worried that you or someone you know is in harms way? I think this counts as a situation in which you are in harms way. I am not going to go behind your back and tell anyone anything, but I really do feel like you and I should tell someone together.’

I have attached two links to this article. The first link is to the Suicide Risk Screener (computerised version), which I would recommend using with older adolescents and adults. The second link, is a power point presentation I found online from the University of New Mexico, which outlines protocols people should take if they are concerned about the safety of a young person. I found this presentation to contain some useful information, guidelines, and questions to guide a risk assessment.

Suicide Risk Screener:

Power point Presentation:

Please use both links with caution. Please also note that the screening tool should be used by a mental health professional. If you are unsure about whether or not to report a young person who you believe is at risk of suicide, please call LIFELINE on 13 11 14.

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