“There’s no treatment for suicide behaviors, there’s only treatment for the things that cause suicide behaviors.”
— Lawrence Amsel, MD, MPH
Our adolescent girls are facing an array of challenges, from the ramifications of COVID-induced social isolation to the escalating prevalence of online harassment and the alarming rise in incidents of sexual violence. In fact, according to a report released by the CDC, 1 in 3 (30%) of adolescent females considered suicide in 2021. Over half (57%) of teen girls were weighed down with persistent feelings of sadness and hopelessness.
Hearing these statistics is hard. Knowing what to do is necessary. Lawrence Amsel, MD, MPH, a REACH faculty member and Associate Professor of Clinical Psychiatry at Columbia University, shares his thoughts on slowing the trend, “prevention involves screening for and addressing the risk factors for suicidal ideation.”
The reasons adolescent girls, as well as boys, are feeling this way are multifaceted. According to a report from the National Survey on Drug Use and Health, there has been a significant increase in major depressive episodes among adolescents and young adults in recent years, a trend that can be linked to an increase in suicidal thoughts.
Various elements contribute to this rise in depression, including excessive use of social media, mounting academic pressure, an increase in sexual violence, and, notably, the ongoing COVID-19 pandemic. The pandemic has disrupted the lives of young people in numerous ways, from school closures to social isolation. This disruption has led to increased anxiety and depression among adolescents and may be contributing to the rise in suicidal behaviors, a category that includes suicidal ideation, suicide attempts, and completed suicides.
Parents and educators must be vigilant about identifying behaviors in young individuals that may indicate a heightened risk of suicide. Some crucial warning signs to be aware of include:
REACH teaches primary care providers what to do when hearing or seeing symptoms that could lead to suicide. Here’s a refresher of the protocol taught during REACH’s Patient-Centered Mental Health in Pediatric Primary Care (PPP) course.
After screening with the ASQ toolkit, you can decide whether the patient needs extra mental health support or if they need to go straight to the emergency room. (See last November’s blog, “When and how to send kids to the emergency room.”)
“You can’t treat suicidality, you can only treat the causes of suicidality. Maybe you take them off the internet. Maybe you have to put them on medication or give them CBT for their depression. So, you treat the underlying risk factor,” explains Dr. Amsel. Addressing issues such as bullying, depression, anxiety, or other mental health concerns is crucial to effect positive change. Suicide behaviors can be viewed as symptoms of a stressful environment, untreated mental health conditions, or both, which underscores the significance of early detection and effective intervention.
Tuning in to patients’ personal lives and mental health can make a world of difference—so can a single conversation. “How do you tell the difference between a cry for help and somebody that needs to go to the emergency room? You always treat it seriously,” adds Dr. Amsel.
If you or anyone you know is thinking about suicide, know that the Lifeline network is available across the United States, 24/7 by dialing 988 or by chat at 988lifeline.org.
Screening toolkit: ASQ (Ask Suicide Screening Questions)
“The opportunity to learn information to help me manage psychiatric conditions in my patients in this time where demand clearly outweighs supply of services, is going to be excellent for me as a PCP in my community.”