Teen suicide: risk factors and prevention strategies

Teen Suicide and Schools

The recent spate of school shootings has focused attention on violent behavior among teenagers. However, little attention has been given to another insidious and more common form of violence among young people -- the rise in teenagers committing suicide.

This paper looks at the silent epidemic of teen suicide and the role schools could play in addressing this issue. The first part of the paper is an overview of teen suicide, looking at the scope of the problem and main causes of suicide among young people. In the second part, the paper looks at the changing role schools have played in preventing suicide and examines the current suicide prevention programs in place. Finally, the last part studies the barriers that stand in the way of such programs and suggests solutions to the problems.

Teen Suicide: An Overview

The suicide rate among teenagers has risen steadily over the last few decades. In 1997, suicide was the third leading cause of death among young people aged 15 to 24 years old, following only accidents and homicide. Suicide was also the third leading cause of death among 10 to 14-year-old children (NCIPC statistics).

Between 1998 to 1999, more than 2,700 adolescents committed suicide. Author Jessica Portner puts this figure in perspective, saying "more American youth now dies each year from suicide than from cancer, heart disease, AIDS, pneumonia, lung disease and birth defects combined. For example, in 1996, more than 3200 people under age 24 died of all those diseases, compared with more than 4600 who took their own lives" (3).

These figures do not take into account the teenagers whose suicide attempts are unsuccessful. Portner writes that for every teen who commits suicide, an estimated 100 more will try. Around 700,000 high school students in the United States try to commit suicide every year (Portner, 4).

Most adolescents who commit suicide do so by themselves. But many suicidal teenagers also turn their violence on others. In 1999, Dylan Klebold and Eric Harris tore through Columbine High School with automatic weapons and planted bombs in cafeteria before shooting themselves in the head (Brooke, A1).

There are several theories about the reasons behind the spiking suicide rate among the young. Researchers suggest that as parents are increasingly forced to work longer hours to support their families, more children are forced to navigate the murky waters of adolescence without adult of parental guidance. Others suggest that kids, driven by impulse, react to moments of crises without considering the consequences. Problems in school, in romantic relationships or with bullying, for example, appear insurmountable. The easy availability of guns increases the likelihood that adolescents will react with rashness. Finally, abuse and media violence are also factors that contribute to teen suicide (Thomerson, 30).

Despite the differences in opinion as to the cause of teen suicide, experts agree that suicide among teenagers is likely to increase. Though young Caucasian males continue to face the largest risk of suicide, the suicide rate among all age, racial and gender groups among teenagers and young adults. Homosexual youths are an especially vulnerable group, who are more than five times as likely as their heterosexual peers to attempt suicide.

Suicide Prevention Program in Schools

The advent of two-income households and single parent families has changed the role schools play in the lives of young people. After all, many adolescents spend at least one-third of the day in school, or more for those involved in extra-curricular activities (King, 132). This has led to a broader definition of the term in loco parentis, the principle of temporary parental power originally conferred by Roman citizens on their children's Greek teachers. In the United States, writes Portner, this power to discipline students also carried a corresponding responsibility to keep children from harm. (Portner, "Suicide,").

Parents now expect schools to take appropriate steps to ensure their childrens' safety. For many parents, this involves monitoring and taking steps to prevent teenagers from committing suicide. As several lawsuits indicate, the American courts seem to agree.

In the United States there have been many legal cases concerning a student's suicide that have involved educators, including school counselors, teachers, administrators, and school boards. Most of these cases stem from claims of negligence. In a 1995 case in Idaho, for example, a teacher and her school district were charged with negligence after a student committed suicide in his home. After the suicide, his English teacher discovered many entries related to death and depression in his class journal. The parents filed suit, charging that the district did not provide its teachers with adequate training. They also charged the teacher for failing to tell them of the journal's contents. In this case, the court eventually ruled in favor of the teacher, saying that due to lack of training, the teacher had no reason to be aware of the suicidal thoughts recorded in the journal (Milsom, 27).

In a 1991 case in Maryland, the board of education, superintendent, principal, and school counselor were all sued for negligence. The school counselor had earlier been informed of suicidal statements made by Nicole, a junior high student. After Nicole denied having made any suicidal threats, the school counselor did not inform Nicole's parents or the administration of the alleged statements. The student later killed herself in a murder-suicide pact with another schoolmate.

This time, the Court ruled that that the counselor did owe Nicole a duty and breached that duty by not warning the parents. Also, the court believed that the parents could have intervened if they had been aware of the suicide threats. The court argued that a reasonable person should have realized that Nicole's denial did not mean she no longer had suicidal thoughts. The counselor had a duty to call the parents (Milsom, 28).

In a watershed case in 1995, a federal district court in Tampa, Fla., found the Polk County school board guilty of negligence in 13-year-old Shawn Wyke's death. The Court also awarded his mother $167,000. The day before Shawn's suicide in 1989, another student discovered Shawn trying to hang himself in the school restroom and told the principal.

The principal, however, failed to notify the boy's mother about the incident. The next day, the 5th grader hanged himself from an oak tree in his back yard. (Milsom, 30).

The Maryland and Polk County decisions were landmark rulings that further broadened the scope of in loco parentis. It established the duty of educators and school personnel to keep parents informed about academic and personal concerns regarding their students. It also provided an impetus for many school districts to seriously consider developing suicide prevention programs.

Suicide Prevention Programs

Keith A. King, a professor of Health Education at the University of Connecticut, recommends a three-pronged approach towards developing an effective and comprehensive suicide prevention program for schools. First, he suggests a primary prevention level to educate adolescents regarding suicide. A secondary intervention program should also address the needs of teens who are already suicidal. Finally, a tertiary "postvention" program should attend to the need of adolescents who have attempted suicide, to protect against further suicide attempts (King, 132-137).

Most schools with suicide programs tend to fall under the first and second categories. The Braintree High School in Boston, for example, has a suicide prevention project as part of their sophomore health curriculum. The program also includes screening students for depression, a major factor in teen suicide School officials also regularly attend training conferences to learn about early warning signs of depression and suicidal thoughts (Atkins, 6).

A similar program exists on a much larger scale in the Los Angeles Unified School District's Suicide Prevention Unit. The Unit has three full-time employees who are on call and ready to rush to schools when there is an emergency involving students with suicidal thoughts. With the help of a district-run mental-health clinic, a city teeming with psychological clinics, and a $14 million annual investment from the district's budget in mental-health services, the number of suicides in the district dropped from 35 in 1989 to 19 in 1997. In addition to Los Angeles, California has an existing school-based prevention program includes training parents and school staff about the warning signs, providing a crisis hotline for kids and developing peer support groups. All these factors helped to shrink California's teen suicide rates, which have consistently remained lower than the national average (Portner, "Prevention").

In addition to programs that directly target suicidal teenagers, many schools have also tried to address the factors that contribute to depression and suicide. Many pre -- and elementary schools in Los Angeles, for example, have "conflict managers" who mediate between playground fights. In many instances, these conflict managers are older students who help younger children resolve their conflicts through talk and an eventual handshake. Experts believe that such programs prevent bullying and teach children coping skills which will be useful when they reach adolescence (source).

The programs described above have all had favorable results towards reducing depression and suicidal behavior among adolescents. However, despite their early successes and despite the rising rate of teen suicides nationwide, schools with suicide prevention programs remain in the minority.

Barriers to Suicide Prevention Programs

Even with the alarming increases in teen suicide and the threat of potential litigation, suicide prevention programs in schools remain inadequate. Currently, only one in ten schools have suicide prevention programs (Portner, "Many schools fall short on prevention).

One reason for the lack of programs is a reluctance on the part of the school boards and parents to recognize the problem. Many still feel that teen suicide is a family issue that should be dealt with at home. For example, the Eagle Forum, a conservative family-advocacy group, protests suicide education programs as "death education" (Portner, "Prevention"). The view expresses the stigma that remains attached to suicide and illustrates the difficulty of discussing, much less instituting, suicide prevention in many school districts.

But the main barrier towards establishing suicide prevention programs in school is the lack of money. Most states have limited budgets that barely cover basic education needs.

Most states do not allot money for mental health programs for students, despite studies showing that most students who visit health school clinics do so for mental and substance abuse problems, not stomach aches (Portner, "Budget Battles").

California's suicide prevention programs should serve as models for other states, but many legislatures are not willing to shell out the seed money. Such an unwillingness is myopic, however, since prevention can be seen ass a long-term investment due to the emotional and economic toll that suicide takes on the population. Aside from the loss of lifetime contributions when a citizen dies prematurely, emergency room use for suicide attempts costs states an average of $33,000 per visit. With approximately 730,000 attempted suicides per year nationwide, that can be a pretty hefty price tag (source).