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Ask The Therapist: Suicide

Q. “I keep hearing about teenage suicide and I’m scared. Is there anything I should be looking out for as a parent or that my children’s  schools should be doing?”

A. Just as no community is immune to mental health challenges, suicide is a heartbreaking reality that touches Jewish communities all over the world. A full discussion of issues relevant to parents, families, and teachers requires much more space.  However, this short article provides a few ideas that can provide an introduction for thinking about core issues. Readers are encouraged to read more on the topic from reputable sources; many resources are available online, such as from the Suicide Prevention Resource Center (SPRC).

Suicide Prevention

As with other psychological or behavioral challenges, there is no simple rule for prevention of suicide. Nevertheless, as parents or educators, there are a number of guiding principles that can play a role in prevention.

Suicide prevention in Schools

In schools, combating bullying and fostering inclusive environments can provide a strong foundation for healthy psychological, emotional, and social development.  A healthy environment contributes to healthy adolescents and lowers risk for self-harm. School guidance counselors play an important, proactive role in addressing developing concerns among students.  They are an important address for students who are struggling.

Suicide prevention in the Family Home.

A healthy home environment that contributes to positive development, should include emotional warmth, positive communication, encouragement, and a good balance of structure vs. independence. These features can also serve to prevent self-harm behaviors as kids grow up.

In both school and home settings, ensuring that the children are safe from abusive situations is also a crucial role for both teachers and parents.

Early Detection of potential Issues

Another aspect of prevention is detecting signs of potential issues.  Addressing issues early may prevent them from escalating into more severe problems. In such circumstances, the optimal ways to address these challenges may not involve direct intervention with the child. Instead, schools may need to work with teachers or parents to adjust the student’s environment. Parents may need to adjust elements of their home environment to match their child’s needs. Other times, children may require direct psychiatric or psycho-therapeutic interventions.

Both educators and parents may benefit from speaking with mental health professionals, or seeing online resources to determine the best ways to identify early warning signs, and to prevent escalation.

Although there is no definitive way to predict a person’s level of risk, experts identify a number of signs in speech, actions, and mood, that may point to higher risk for self-harm.

Speech signs may include: – making direct comments about feeling hopeless or trapped, -feeling like a burden to others, -thoughts of killing themselves or having no reason to live, -statements of unbearable pain. Actions signs may include: -changes in alcohol or substance abuse, -social isolation, -giving away valued belongings or tying up loose-ends. Mood signs may include: -high levels of depression, anxiety, or other intense emotions; -notably, people may actually experience a positive spike in emotional state shortly before a suicide attempt.

This list is not comprehensive, and if you are unsure whether you are observing signs of risk, it can be helpful to ask a professional who can provide guidance.

Crisis management

Schools need to be prepared for what to do in the event of an emergent mental health crisis, just as they prepare for other types of emergencies (e.g. fire, earthquake, terrorist). Particularly for school administrators, many questions can arise:

  1. Is this student in crisis and a risk to himself or someone else?

  2. How do we keep him safe?

  3. Whom do we call?

  4. When is the student fit to return to school?

  5. Who makes the decisions?

For schools, where basic statistics suggest that this type of crisis can occur periodically, it is particularly important to develop and disseminate to the staff a crisis management plan. Under the duress of an emergency, the decision-making skills of the teachers and administrators is often reduced. Which means that what seem like obvious steps to protect the student may not be taken. Mental health professionals can help guide schools regarding how to develop a plan.  They can provide a clear plan of action for teachers and administrators to allow for safely addressing emergency mental health issues in the school.

Postvention

It is a painful reality that despite our best efforts, we cannot always prevent suicide. In addition to the grief we as adults experience, parents and teachers often search for ways to provide some answers and guidance to their children and students. These conversations with kids can be uniquely challenging, as we balance our own fears and grief with a desire to provide some level of comfort and security. Kids, just like adults, may have many questions: What happened? Why did the person do this? How do I know it won’t happen to me or someone else in my family or social circle?

Reaching out to Mental Health Professionals

As parents or teachers, we will not have all of the answers to all of the questions. We also may not know what thoughts or information to share and how to share it in a way that serves our children’s needs. There is not one right way, as each circumstance, and each relationship with the child, is different, and as such may necessitate individualized responses. In this case, it can be important to reach out to mental health professionals who can provide guidance and reading materials specific to the unique circumstances.

Additionally, online resources can be extremely helpful to provide general guidelines for teacher and parent responses in light of a student’s suicide.

The most important role we have as teachers and parents is to ensure, as best we can, the safety of the children in our care. There are times when acceptance of a tragic outcome is the only option we have.  But it is also important for us to consider how we can prevent suicide. In addition,  providing support to our community and children should such a tragedy occur is crucial.  If we can all work together, we hope and pray that we can prevent suicides, and foster the positive development of all the youngsters in our communities.

Israel Suicide Prevention Hotline Phone Number, operated by ERAN: 1201. U.S. National Suicide Prevention Lifeline Phone Number operated by the Suicide Prevention Resource Center: 1 (800) 273 TALK (8255)

Dr. Ethan Eisen

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