Risk, Assessment and Youth Mental Health

Unfortunately, we have all heard the stories.  You know, the ones where someone’s son or daughter is hospitalized because of some type of self harm or worse yet the report that they took their own life.  There are very few people that I’ve met in my professional career that have not been touched by the impact of suicide.  Maybe not a family member, but an acquaintance, a co-worker, or an old high school friend. Most of us have experienced this to some degree, that surreal feeling of finality, maybe even the struggle to comprehend what they must have been feeling or thinking or even how they got to the place where this could happen.

Youth self-harm, suicidal ideation, and suicide are more common than most people realize.  Too common in fact.  Consider the following:

  • Over the past 20 years, emergency room visits for self-harm have increased by 88% for adolescents 10-19.
  • Over the past 10 years, 44% of high school students surveyed said they feel “persistent feelings of sadness or hopelessness” according to the Center for Disease Control.
  • After seeing a plateauing of suicide rates from 2000-2007, by 2018 this number jumped by nearly 60% for those in the 10-24 age group.
While these numbers are heartbreaking, what is even harder to digest is the fact that there are risk factors that can be observed and assessed along with protocols that can be followed in an effort to support those who are feeling helpless and hopeless. Let’s call these the 3 “R’s”: Recognize, Respond, and Refer:

Recognize:

Some signs that a person may be struggling with self-harm or suicidal thoughts include: persistant sadness, hopelessness, and/or helplessness; low energy, family history or previous suicide attempts; changes in mood to include increased impulsiveness or aggressiveness; sudden drug or alcohol use or overuse.

Respond:

Once you recognize someone may be struggling, your responses are critical.  It’s important to be supportive and not judge.  Refrain from being critical, cynical, or dismissive.  Recognize that you likely don’t have an understanding of everything they are being impacted by nor how they are processing this information.  Listen and be available and most importantly let them know they aren’t alone and don’t have to figure things out all by themselves.

Refer:

By knowing the signs and how to provide immediate support, you have put yourself in a great position to help.  However, just because someone appears to be “feeling” better doesn’t mean they are “thinking” better. Knowing who else to get involved, especially for someone who has been, or is, actively suicidal could be the difference between life and death for that individual. For students, get an administrator or counselor involved or contact your local emergency department if no one else is available.  Most importantly, don’t leave them alone, even for short periods of time.  Be present and supportive until additional support arrives or offer to take them somewhere where help is available.

Suicide has been described as a permanent solution to a temporary problem.  Others have described it as not necessarily wanting to die but not being able to continue living the life that is in front of them. We, as a society, must place more emphasis on our ability to Recognize, Respond, and Refer when we encounter someone who doesn’t see a path forward.  We can each be a difference-maker in situations that may literally be life or death.  

Free and confidential Hotlines in the US include:

National Suicide Prevention Lifeline: 800-273-TALK (8255)

Samaritans Helpline: 877-870-HOPE (4673); Call or Text

The Trevor Project: 866-488-7386 – hotline for LGBT youth

Trans Lifeline: US – 877-565-8860; Canada – 877-330-6366 – Designed for transgender people, hotline staff are themselves transgender

Copline: 800-267-5463 – Designed for police officers, hotline staff are retired police officers