Youth Suicide Prevention

1. Youth Suicide Prevention Information for parents, caregivers, and friends of suicidal youth From the Youth Suicide Prevention Website http://www.youthsuicide.ca/friends/friends.htm

2. Why do youth attempt suicide? Unlike adults, youth do not have the ability to think about life and life events in terms of the broader perspective or "big picture". They tend to believe that all of the unhappiness they are feeling and experiencing will go on forever. Everything that is happening to them is in the "here and now" and they can't begin to think that there might be a brighter future just around the corner. They often don't believe that anyone can help them, and they feel helpless and hopeless within their situation. They believe that they can either choose to live with the pain, or end it by ending their life. Unfortunately their ultimate decision could be fatal.

3. Suicide is a permanent solution to a temporary problem The reasons for suicide are deep and long standing. The teen that attempted suicide right after his girlfriend broke up with him or the teen that contemplated suicide after losing her job probably had a history of low self-worth that was magnified by the upsetting event.

4. Canadian Statistics • Suicide is the second leading cause of death among youth 10-24 after motor vehicle accidents • Between 70% and 80% of youth consider suicide before graduation • Over 25,000 youth attempt suicide annually and over 250 complete • Adolescent males complete suicide 3 to 5 times more often than adolescent females • Males typically use more lethal methods such as hanging and firearms • Adolescent females are 4 to 7 times more likely to attempt suicide than adolescent males • Females typically use drugs, poisons, or gases, slower methods which increase the opportunity for the youth to be found and intervention is more likely - recently however, females have been choosing more lethal methods

5. What is so stressful about being a youth? • Trouble at home • Change in family dynamics • Balancing relationships with divorced/separated parents • Change of schools • Difficulties at school (may include bullying) • Relationship breakup • Social struggles • Balancing school, work, social life, and family • Environment that encourages drugs, alcohol, and sex • The natural separation from parents • Dating • Learning to accept themselves, their talents/abilities • Getting good grades for college/university • Getting a part-time job • Choosing a college/university or career

6. While there is no stereotypical "suicidal type" the following risk factors may increase the risk for suicide in some youth...

7. Who’s at risk? • Diagnosis of depression or other psychiatric disorder • Chronic or terminal illness • Previous suicide attempt • Family history of suicide • Recent suicide of family member, friend, classmate • History of sexual, physical, or verbal abuse • History of self injury • Engaged in risky or self-destructive behaviour (i.e. smoking, dangerous driving, substance abuse, unprotected sex) • Perfectionist • Low self-image, low self-esteem • Gay/lesbian youth - confusion around sexual orientation • Youth living on the street • Social isolation or neglect from family • A traumatic or recent loss (includes divorce) • First Nations

8. What do suicidal youth feel? Youth who are contemplating suicide often feel worthless, alone, unloved, unlovable, and they may actually believe that they are a burden on their parents. They feel misunderstood and judged by their peers and by adults. They are often ultra sensitive to criticism, scared to make mistakes, and feel unable to cope. They believe that these feelings will last forever and that nobody can help them.

9. Warning Signs Youth suicide and suicidal thoughts or behaviour might seem like it appears out of the blue, but in reality, youth almost always present prior warning signs. The following signs could be clues that a youth might be considering suicide.

10. Warning signs you might see: • Signs of depression or feelings of hopelessness • Lack of interest or energy (or wild variations) • Changes in eating habits or sleep patterns • Loss of concern about personal appearance • Increase in anxiety or anxiety related illnesses (head aches, stomach aches) • Any dramatic changes in behaviour, actions, or attitude • Being unusually quiet or unusually aggressive/angry • Dropping out of hobbies, sports, school, or job • Talking about death or cult figures who died by suicide • Preoccupation with death, dying, or suicide * • Expressing a preoccupation with death or suicide *(creative writing, poetry, artwork)

11. Warning signs you might see continued … • Making jokes about death or suicide * • A sudden elated mood following a time of depression * • A previous suicide attempt * • Serious talk of suicide or making a plan * • Engaging in risk taking behaviour (driving recklessly, unsafe sex) * • Increase in alcohol or drug use * • Giving away prize possessions, saying good-bye, writing a will, writing farewell letters * (* Indicates the more serious warning signs)

12. Warning signs you might hear: • Often a youth who is considering suicide will give clues through their comments. If you hear a youth make statements like these take them seriously. • "Nothing ever goes right for me." • "It'll all be over soon." • "Whatever, nothing matters anyway." • "I might as well kill myself" • "I hate life" * • "Everyone would be better off without me" * • "I just can't take it anymore." * • "I wish I was dead." * * Indicates the more serious warning signs)

13. Tips for providing support: Do: • LISTEN - don't give advice, make judgements, or attempt to solve the problem - just listen • Comment on the changes that you have noticed ("Lately I've noticed that you have been spending a lot of time alone in your room, is something bothering you?" - this shows that you are concerned • Take their problems seriously • Send them the message that they are important to you, you care about them, and you want to help.

14. Tips for providing support continued … Don't say: • "Oh come on, things aren't that bad." • "You have it good compared to ..." • "Aren't you exaggerating a bit?" • "Suicide. That's a stupid way to solve your problem." • "Hang in there things will blow over."

15. Providing support: Ask Questions: • "Are you thinking about hurting yourself?" • "Are you thinking about killing yourself?" * * If the answer is yes, keep asking questions: • "How are you planning to do it?" • "When are you going to do it?" • "Do you have what you need to do it?" (i.e. access to drugs, guns, knives, rope, a car) • The more dangerous and definite the plan, the greater the risk of a suicide attempt.

16. If the risk of suicide is very high • Do not leave the youth alone • Call your family doctor and make an appointment as soon as possible for an assessment • If your family doctor is unavailable, take the youth to the hospital Emergency Ward

17. Know who to contact if you are concerned • Call your family doctor (Paediatrician and/or Psychiatrist if involved) • Call the local crisis line for support • Contact the school counsellor and school administrator • Contact a community counsellor and/or mental health agency

18. Keeping kids safe Youth who are experiencing suicidal thoughts often act impulsively. During this time it is important to restrict access to any items your teen might use to harm themselves. Access to knives, firearms, ropes, razor blades, car keys, and excessive amounts of medications must be restricted. Kitchen knives, razor blades, car keys, and medications can all be locked away. Firearms and ropes must be kept in a safe place, inaccessible in case your teen feels the impulse to act.

19. A large number of people who take their own lives do so using a vehicle. Carbon monoxide poisoning and single vehicle accidents are lethal options, so limiting your teen's access to a vehicle while they are expressing thoughts of suicide is necessary. • Keep the discussion of suicide out in the open. Develop an interest in the positive aspects and thoughts that the youth has towards life. • Prepare a support network of caring people for your teen.With the input of your teen you can carefully select support people your teen trusts, with whom they can share, and who can also watch out for suicide warning signs. • Increasing a teen's natural support network apart from time limited professional involvement is one of the most important and effective ways to reduce the risk of further attempts.

20. Common feelings … Initially you might feel some negative reactions to suicide that might include: • shock - doubt - denial - shame - guilt - fear - anger - blame While these are all common reactions to a suicide attempt, it is important that you respond in a helpful, more productive manner.

21. Communication Youth who are contemplating, or have attempted suicide are struggling with feelings of rejection. They often feel abandoned by everyone especially their parents. Let them know that you are available to listen and talk, that you are willing to spend time with them. Isolation only reinforces the feelings of rejection and abandonment, so stay close, stay involved. The most important message to send to your teen are the messages, • "I love you and I want to understand what is going on in your life." • "I take you seriously." • "I care about you." • "I want to help."

22. Listen & encourage discussion • Adults are often too willing to give advice, make judgements, and try to solve problems for them. What they really want are parents who will simply listen. • Do not attempt to solve your teen's problems • Do not downplay their fears and concerns • Do not defend yourself, your spouse, relatives, friends, teachers, or their peers • Do not tell your teen how lucky they are or what they have to look forward to • Do not ask, "Why did you try to kill yourself?" - this implies that there is only one reason behind their decision when usually there are compounding reasons

23. Talking is important … • Talking gets the problem out in the open • Talking eases stress and tension • Talking gets you both thinking about where you can go for help • Talking about suicide with your teen shows them that you can handle the discussion, and that they don't need to protect you anymore

24. How to approach the topic • Use "I feel" statements when talking with your teen about your feelings or reactions to their behaviour. This avoids blaming the teen, and then they are less likely to become defensive. Avoid such statements as; "You make me so angry!" instead say, "When you do this I feel angry." • This change in your approach with your teen might initially be met with some suspicion or distrust, but after you show some genuine interest in their life they will start to share with you.

25. Parental self-care • People who live in a state of long term high stress are themselves at risk for clinical depression, as well as other stress aggravated physical illnesses (i.e. migraine headaches, gastrointestinal discomfort). They often lose their ability to effectively manage family, relationship, and work issues. • Involve others - don't try to handle the crisis alone

26. Get support • It is important that you connect with a good friend, family member, church personnel, counsellor, or any other support person to provide assistance during this difficult time. • Keep a list of these support people handy so that you can access them for support when you need extra assistance, or when you feel overwhelmed. • Ask for help with the practical things like driving to the hospital, making phone calls, or attending meetings. • Find someone who is not directly involved to talk to for more long term support • Share your situation with your GP who can provide support and a possible referral.

27. Look after yourself • Recruit supportive relatives and friends - you might have to educate your support people. • Pay close attention to your physical and mental health; nutrition, sleep, exercise, recreation, and relaxation. • Spend time doing activities that you enjoy. • Schedule a date night with your spouse or partner. • Find a supportive group of people who have experienced situations similar to yours. • Attend to your spiritual self through religion, meditation, nature, etc.

28. The role of school counsellors and teachers • Support the students by being a positive, caring adult who listens • Report self-harm or warning signs to guidance, the parent/guardian, and to Children’s Aid where the student is under 16 years old • Provide referral to community agencies

29. Community Resources for Individuals in Crisis • Kids Help Phone 1-800-668-6868 • Distress Centre 905-433-1121 • Mobile Crisis Unit (16+) 1-800-742-1890 • Mobile Crisis Unit (<16) 1-888-337-0841 • Crisis Intervention Lakeridge Oshawa 905-433-4384 • Lakeridge Health Bowmanville 905-623-3331 • Lakeridge Health Oshawa 905-576-8711