Treatment was noninferior to "it's just a phase"
April 24, 2019 9:57 AM Subscribe
Medical visits for suicide-related issues among adolescents has doubled from 2007 to 2015, and is now over a million annual visits in the US. Suicide is the second leading cause of death among American youths age 10 to 18 years and attempted suicide is the strongest predictor of subsequent death by suicide (journal article). What can be done?
Treat the parents of kids with anxiety disorders (journal). Supportive Parenting for Anxious Childhood Emotions (SPACE) has been found to be noninferior to treating just the kids themselves (Book/manual: Treating Childhood and Adolescent Anxiety: A Guide for Caregivers). The focus is on the parent's behavior with a series of gradual steps to reach the goal. The kid is informed of this plan and rewarded for changing their behavior but is not directly required to change. The success and implementation of the SPACE plan is with the parents.
Second: earlier interventions and a more comprehensive treatment model. The First Episode Mood and Anxiety Program (FEMAP) uses 'multiple therapeutic modalities' to provide a more effective mental health services for emerging adults (Journal). Participants were three times more likely to see a therapist and significantly less like to require emergency services.
Finally - let the kids be alone when they want it. Research suggests solitude isn't a red flag for isolation or depression, if the kid chooses to be alone.
Treat the parents of kids with anxiety disorders (journal). Supportive Parenting for Anxious Childhood Emotions (SPACE) has been found to be noninferior to treating just the kids themselves (Book/manual: Treating Childhood and Adolescent Anxiety: A Guide for Caregivers). The focus is on the parent's behavior with a series of gradual steps to reach the goal. The kid is informed of this plan and rewarded for changing their behavior but is not directly required to change. The success and implementation of the SPACE plan is with the parents.
Second: earlier interventions and a more comprehensive treatment model. The First Episode Mood and Anxiety Program (FEMAP) uses 'multiple therapeutic modalities' to provide a more effective mental health services for emerging adults (Journal). Participants were three times more likely to see a therapist and significantly less like to require emergency services.
Finally - let the kids be alone when they want it. Research suggests solitude isn't a red flag for isolation or depression, if the kid chooses to be alone.
Gee, I wonder what might have happened right around 2007 to have contributed to this issue. It's almost like some new influence on vulnerable kids came along at about that time.
posted by EmpressCallipygos at 10:12 AM on April 24, 2019 [14 favorites]
posted by EmpressCallipygos at 10:12 AM on April 24, 2019 [14 favorites]
psa: if you do not have a kid who has been through this and you are tempted to come in here with "the reason the kids these days are doing this is because of [my hobbyhorse]" please consider not doing that
posted by prize bull octorok at 10:23 AM on April 24, 2019 [65 favorites]
posted by prize bull octorok at 10:23 AM on April 24, 2019 [65 favorites]
We can blame social media, sure. But it's life trajectory in general. Kids don't have adulthood to look forward to anymore.
We tell the queer kids and the weirdos that "it gets better," but there's a bunch of folks who make a career out of making it get worse.
We tell children that they can grow up, get a job, and start a family, but they're getting burdened with debt from the get-go.
Climate change has been a concern for a lot longer than they've been alive, but it's never been clearer that there are folks devoted to halting any efforts to save the planet.
Social media certainly is a magnifying glass for these issues, but I think if the world weren't so shitty right now, less would get magnified through social media.
posted by explosion at 10:24 AM on April 24, 2019 [43 favorites]
We tell the queer kids and the weirdos that "it gets better," but there's a bunch of folks who make a career out of making it get worse.
We tell children that they can grow up, get a job, and start a family, but they're getting burdened with debt from the get-go.
Climate change has been a concern for a lot longer than they've been alive, but it's never been clearer that there are folks devoted to halting any efforts to save the planet.
Social media certainly is a magnifying glass for these issues, but I think if the world weren't so shitty right now, less would get magnified through social media.
posted by explosion at 10:24 AM on April 24, 2019 [43 favorites]
Gee, I wonder what might have happened right around 2007 to have contributed to this issue.
I thought this link was going to lead to an article about the recession and I was like, yes, as it turns out, hearing your parents wonder how they're going to make their mortgage payments is pretty depressing. Kids are like little lightning rods for adult crises.
posted by coffeeand at 10:25 AM on April 24, 2019 [19 favorites]
I thought this link was going to lead to an article about the recession and I was like, yes, as it turns out, hearing your parents wonder how they're going to make their mortgage payments is pretty depressing. Kids are like little lightning rods for adult crises.
posted by coffeeand at 10:25 AM on April 24, 2019 [19 favorites]
Mod note: Folks if we're going to have a post on this at all, it very much needs to not be 'the world is fucked so this is only rational' or similar. If anyone reading this is having suicidal thoughts, please reach out and talk to someone - there's a list of resources including text and online chat at ThereIsHelp.
posted by LobsterMitten (staff) at 10:29 AM on April 24, 2019 [24 favorites]
posted by LobsterMitten (staff) at 10:29 AM on April 24, 2019 [24 favorites]
The sad truth, at least for the US, is that suicide rates are on the increase across the board, with the highest increases among both adolescents and the over-65 crowd. Interestingly, both groups share some common issues, such as feelings of isolation, and the lack (or loss) of a sense of purpose.
posted by Thorzdad at 10:32 AM on April 24, 2019 [3 favorites]
posted by Thorzdad at 10:32 AM on April 24, 2019 [3 favorites]
> It's almost like some new influence on vulnerable kids
I mean, if we're talking about major things that happened to this cohort of children in the US I think there are maybe some more relevant places to look than social media because similar countries are not reporting similar trends.
posted by 100kb at 10:37 AM on April 24, 2019 [23 favorites]
I mean, if we're talking about major things that happened to this cohort of children in the US I think there are maybe some more relevant places to look than social media because similar countries are not reporting similar trends.
posted by 100kb at 10:37 AM on April 24, 2019 [23 favorites]
You're all right. My apologies.
posted by EmpressCallipygos at 10:46 AM on April 24, 2019 [4 favorites]
posted by EmpressCallipygos at 10:46 AM on April 24, 2019 [4 favorites]
These methods sound fine, but what about the tried and true method of calling it a "cry for help" and then years, or even decades later denying that any suicide attempts were ever made in the first place?
In all seriousness, I wonder if we're also seeing more ER visits because parents are more aware of the problems, and kids are raised to speak up more. If parents are more likely to see it as a real problem, less likely to be ashamed, etc. I mean this as an honest question -- I can just as easily imagine that things are no better than they used to be, as far as "it's just a phase" and "why are you doing this to me" attitudes go.
posted by shapes that haunt the dusk at 11:05 AM on April 24, 2019 [10 favorites]
In all seriousness, I wonder if we're also seeing more ER visits because parents are more aware of the problems, and kids are raised to speak up more. If parents are more likely to see it as a real problem, less likely to be ashamed, etc. I mean this as an honest question -- I can just as easily imagine that things are no better than they used to be, as far as "it's just a phase" and "why are you doing this to me" attitudes go.
posted by shapes that haunt the dusk at 11:05 AM on April 24, 2019 [10 favorites]
For those curious as to the underlying data and trends: QuickStats: Suicide Rates for Teens Aged 15–19 Years, by Sex — United States, 1975–2015 (CDC)
posted by bonehead at 11:14 AM on April 24, 2019 [5 favorites]
posted by bonehead at 11:14 AM on April 24, 2019 [5 favorites]
I wonder if we're also seeing more ER visits because parents are more aware of the problems, and kids are raised to speak up more.
I think there are multiple factors happening here. The base rate of suicide is up in the past decade. The rate of attempts seems to be up higher though, suggestive that, in addition to rates increasing, more kids are being brought to help by themselves or by their guardians. I don't think this is simple or can be attributed to a single factor. It may well be both good and bad.
posted by bonehead at 11:18 AM on April 24, 2019 [4 favorites]
I think there are multiple factors happening here. The base rate of suicide is up in the past decade. The rate of attempts seems to be up higher though, suggestive that, in addition to rates increasing, more kids are being brought to help by themselves or by their guardians. I don't think this is simple or can be attributed to a single factor. It may well be both good and bad.
posted by bonehead at 11:18 AM on April 24, 2019 [4 favorites]
Yeah, and I should have clarified that I'm specifically curious about ER visits for thoughts of suicide, along with other kinds of intervention. I struggled with daily thoughts of suicide starting at age 8 (and for decades after), and I never knew it as something you'd go to the ER for. It blows my mind to hear of it as something that's taken so seriously. I don't know if my experience is specific to the circumstances I grew up in, or if it's indicative of past attitudes that are (hopefully) changing, with this now being treated as more of a serious medical problem.
posted by shapes that haunt the dusk at 11:27 AM on April 24, 2019 [8 favorites]
posted by shapes that haunt the dusk at 11:27 AM on April 24, 2019 [8 favorites]
We don't have an adolescent but rather a 1.5 year old who will be an adolescent all too soon for us. So we've been working suuuuper hard on ourselves and each other in therapy to deal with all the shitty stuff we got from our respective dysfunctional parents, and the anxiety that that emotional / psychological damage put in us and manifests itself in marital dysfunction. It's hard, hard work but it actually feels really awesome to be breaking bad cycles, recognizing our behaviors and emotions for what they really are, and practicing new ways of parenting ourselves so that we can parent our kid better.
The book The Conscious Parent was super helpful to us, and we highly recommend it to anyone who's going to have / does have kids. Her basic premise is that 99% of parents who come to her for an issue they are having with their kid don't realize that the problem is actually one that the parent is unconsciously perpetuating out of how they were mis-parented themselves. There's a whole lot more to it than that, but it has helped us realize that this is work worth doing, to give our little guy the best shot he can get in this hard, hurting world.
Be kind; everyone you meet is fighting a hard battle.
posted by allkindsoftime at 11:51 AM on April 24, 2019 [9 favorites]
The book The Conscious Parent was super helpful to us, and we highly recommend it to anyone who's going to have / does have kids. Her basic premise is that 99% of parents who come to her for an issue they are having with their kid don't realize that the problem is actually one that the parent is unconsciously perpetuating out of how they were mis-parented themselves. There's a whole lot more to it than that, but it has helped us realize that this is work worth doing, to give our little guy the best shot he can get in this hard, hurting world.
Be kind; everyone you meet is fighting a hard battle.
posted by allkindsoftime at 11:51 AM on April 24, 2019 [9 favorites]
It is a triumph of public health that they recognize that parents can be a vector. Suicidal ideation masquerades itself as its hosts own thoughts, but it's a mental space invader. Suicide is a contagious disease that wants to isolate its hosts and kill them.
posted by otherchaz at 12:14 PM on April 24, 2019 [10 favorites]
posted by otherchaz at 12:14 PM on April 24, 2019 [10 favorites]
I am not always very attached to being alive
Chronic, passive suicidal ideation is like living in the ocean. Let’s start talking about how to tread water.
posted by robbyrobs at 12:15 PM on April 24, 2019 [37 favorites]
Chronic, passive suicidal ideation is like living in the ocean. Let’s start talking about how to tread water.
posted by robbyrobs at 12:15 PM on April 24, 2019 [37 favorites]
I'm and adult now but I was an adolescent at the beginning of this time frame. I don't feel like its helpful to create a literal list of all the reasons that I was suicidal in high school. But I can say that if my parents had been brought in on a treatment plan, it would have drastically changed the course of my life, for the better. Instead, it was ignored and therefore I ignored it into adult hood, and didn't start addressing things until I was about 22. I'm 29 now and just starting to get my life together. There are dozens of thousands of other young adults like me that have delayed milestones for this and similar reasons.
My 16 year old niece witnessed a classmate harm herself in the girl's restroom in middle school. The girl in question specifically wanted an audience to cause as much disturbance and upheaval as possible. (Ask me how I feel about shows like 13 Reasons Why). My niece went to therapy for this, and other things, as did her now-13 year old brother. My sister is a single mother and has done everything in her power to make sure that her kids aren't suffering silently the way that we did as children. My niece does have a pretty bright future ahead, but is still a part of the jokes/overall aesthetic that witchen mentions above. We're trying to work on this.
"Generational Trauma" is a phrase that gets used a lot in the online circles I run in (queer, focus on tenderness, healing, empathy), and i see it in my life. I'm exceptionally happy that programs are being developed to help parents take a hands-on/DIY approach to their child's mental health. Unfortunately the US works in a way that the time we spend interacting with clinicians is less and less each year. I've mentioned this like..too much already on metafilter, but I'm getting my degree in public health and I really appreciate these kinds of posts that people put together.
posted by FirstMateKate at 12:17 PM on April 24, 2019 [12 favorites]
My 16 year old niece witnessed a classmate harm herself in the girl's restroom in middle school. The girl in question specifically wanted an audience to cause as much disturbance and upheaval as possible. (Ask me how I feel about shows like 13 Reasons Why). My niece went to therapy for this, and other things, as did her now-13 year old brother. My sister is a single mother and has done everything in her power to make sure that her kids aren't suffering silently the way that we did as children. My niece does have a pretty bright future ahead, but is still a part of the jokes/overall aesthetic that witchen mentions above. We're trying to work on this.
"Generational Trauma" is a phrase that gets used a lot in the online circles I run in (queer, focus on tenderness, healing, empathy), and i see it in my life. I'm exceptionally happy that programs are being developed to help parents take a hands-on/DIY approach to their child's mental health. Unfortunately the US works in a way that the time we spend interacting with clinicians is less and less each year. I've mentioned this like..too much already on metafilter, but I'm getting my degree in public health and I really appreciate these kinds of posts that people put together.
posted by FirstMateKate at 12:17 PM on April 24, 2019 [12 favorites]
Yeah, the whole trajectory of my life would have been changed if mental health issues had been adequately addressed when I was a kid. There were measurable markers, like how I never slept at night and eventually dropped out of high school. I'm willing to talk openly about this stuff now because I'm shocked when I look back and realize that the adults around me were largely unaware. I'm frankly shocked, and forever will be, that teachers could have seen my behavior and chalked it up to being "a bad kid" and not a kid with serious problems. Sometimes all it takes is one person to recognize what's going on to get things on a different track.
I keep asking about changing attitudes because I don't want kids' lives to be as fucked as mine has been. These are problems that tend to snowball -- an inability to cope at a young age can create yet more problems as that kid grows up. I'm glad there's research showing that suicide attempts are predictors of later life incidents, because it has so often seemed like people view it as something you "get over" and are done with. I can imagine that it's especially difficult for parents to confront, because it's only now that I'm an uncle, not even a parent, that I can begin to understand how upsetting it is to think of a kid dealing with these issues.
posted by shapes that haunt the dusk at 12:41 PM on April 24, 2019 [8 favorites]
I keep asking about changing attitudes because I don't want kids' lives to be as fucked as mine has been. These are problems that tend to snowball -- an inability to cope at a young age can create yet more problems as that kid grows up. I'm glad there's research showing that suicide attempts are predictors of later life incidents, because it has so often seemed like people view it as something you "get over" and are done with. I can imagine that it's especially difficult for parents to confront, because it's only now that I'm an uncle, not even a parent, that I can begin to understand how upsetting it is to think of a kid dealing with these issues.
posted by shapes that haunt the dusk at 12:41 PM on April 24, 2019 [8 favorites]
I am dealing with this now, and it is terrifying. I mean, some of you remember my askmes from when Boy was born, and when I accidentally killed his dinosaurs, and how to handle a pet's death, and first days of school... and now he's about to drive, and he's caught in this riptide of depression and anxiety, and I don't know what to do. We've been to multiple different therapists, I'm currently shopping for a family therapist, even before I saw this thread, because my logic was "Well, nothing we've tried is working, maybe I just don't have the right tools."
Try to find a therapist after work hours or on the weekend. It's nigh onto impossible, and the ones I have found all practice "Christian therapy", which...I don't know what that is, but I'm sure it would be a terrible thing for my currently nihlist existentialist.
My parents think it's because we never used physical discipline. My inlaws think it's because I've spoiled the Boy. My husband thinks we should go through his phone, which I've thus far not done because it feels like such an invasion of privacy, and I can't see how that is going to make things better.
It's devastating to be a parent that wants so much to help, but just doesn't know how.
While I'm waiting for calls back from Dr.s I've left messages with, I'm start reading the ebook about the SPACE program, which is available here: Treating Childhood and Adolescent Anxiety: A Guide for Caregivers
Edit: That is not the actual book, but rather summaries of each chapter.
posted by SecretAgentSockpuppet at 1:11 PM on April 24, 2019 [14 favorites]
Try to find a therapist after work hours or on the weekend. It's nigh onto impossible, and the ones I have found all practice "Christian therapy", which...I don't know what that is, but I'm sure it would be a terrible thing for my currently nihlist existentialist.
My parents think it's because we never used physical discipline. My inlaws think it's because I've spoiled the Boy. My husband thinks we should go through his phone, which I've thus far not done because it feels like such an invasion of privacy, and I can't see how that is going to make things better.
It's devastating to be a parent that wants so much to help, but just doesn't know how.
While I'm waiting for calls back from Dr.s I've left messages with, I'm start reading the ebook about the SPACE program, which is available here: Treating Childhood and Adolescent Anxiety: A Guide for Caregivers
Edit: That is not the actual book, but rather summaries of each chapter.
posted by SecretAgentSockpuppet at 1:11 PM on April 24, 2019 [14 favorites]
I know that my failed adolescent suicide attempt did not register as such with my parents. And I remember my requests for family therapy being met with, "You're the one with the problem; why should we have to go to therapy?" If even a small part of the increase in numbers is due to parents taking it more seriously, then that's a step in the right direction.
posted by The Underpants Monster at 1:45 PM on April 24, 2019 [6 favorites]
posted by The Underpants Monster at 1:45 PM on April 24, 2019 [6 favorites]
I wonder if we're also seeing more ER visits because parents are more aware of the problems
That would explain an increase in ER visits, but doesn't explain the increase in completed suicides.
I mean, if we suppose that the underlying incidence of depression and suicidal ideation hasn't changed, but ER visits are up, then we'd hopefully see fewer completed suicides—people are getting treatment, right? That's what you see for other conditions when we get better at recognizing warning signs and getting people to definitive care earlier: the number of reported cases in hospitals goes up, but generally there's a corresponding drop in fatalities or more-serious late-stage cases elsewhere.
But that doesn't seem to match what's going on. Unless those ER visits are actually worsening the problem—which is not impossible, but something we can probably control for so I'm skeptical of it—we wouldn't expect to see both an increase in ER visits and an increase in completed suicides and other indicators of severe mental health distress.
> I am not always very attached to being alive
Thanks robbyrobs for posting that; I hadn't read it before, but it's... very familiar. I've never really heard a hard number of how common chronic/passive suicidal ideation is, and I think most of us who just exist that way learn fairly early on not to share it. I've been periodically asked "when did you first started having suicidal thoughts", and it's a very weird question that I have difficulty answering—it's like being asked "when did you start thinking?" Intellectually, you know there has to be an answer, and there's certainly an identifiable lower bound, but damned if I can tell you the exact date. I know when I first encountered the word 'suicide', down to the exact book it was in and where I was when I read it, but that merely put a label on it (and, more valuably, gave me a strong hint that the way I felt was Not Normal and probably something best kept locked down, unless I wanted to get locked up).
My personal pet theory is that some people are just wired to be passively suicidal, and that perhaps this was a positive evolutionary adaptation under some circumstances. Bravery and being passively suicidal are really just a matter of social convention. When I was younger, I used to amuse friends by stepping off the curb to cross the street the barest second after the "Walk" light had gone on, occasionally leaving the odd "orange light" runner to come to a screeching halt rather than hit me. My friends thought this was hilarious; I just did it because it seemed to make them happy, and why not?—the worst-case scenario is that somebody wouldn't stop, I'd end up dead, and that would be that. It never seemed like that big a deal. (As I got older, I realized that in fact the worst-case scenario was much worse than that—I could end up paralyzed, or mentally damaged, or locked-in to a still-breathing corpse, or any number of other outcomes that would make a clean death seem like a pleasant alternative. Such was the naiveté of youth.)
Sometimes I've gotten the impression that other societies have been more accepting of suicidal ideation without either encouraging it or pathologizing it. I remember the first time I read Aurelius' Meditations and being struck by how blunt he is about, basically, "sure we'd all like to die today, but we got shit to do so we can't, suck it up" and finding it oddly refreshing. Because that's how I managed my suicidal ideation for much of my life when it started to get bad: you feel like killing yourself all the time but ugh wow so much on the schedule today, guess I'll have to reschedule dying for, hmmm, maybe next Thursday and you just never really get around to it. But not because you don't want to, just because other shit—you know, that obnoxious stuff people call living—gets in the fuckin way. C'est la vie.
posted by Kadin2048 at 2:26 PM on April 24, 2019 [37 favorites]
That would explain an increase in ER visits, but doesn't explain the increase in completed suicides.
I mean, if we suppose that the underlying incidence of depression and suicidal ideation hasn't changed, but ER visits are up, then we'd hopefully see fewer completed suicides—people are getting treatment, right? That's what you see for other conditions when we get better at recognizing warning signs and getting people to definitive care earlier: the number of reported cases in hospitals goes up, but generally there's a corresponding drop in fatalities or more-serious late-stage cases elsewhere.
But that doesn't seem to match what's going on. Unless those ER visits are actually worsening the problem—which is not impossible, but something we can probably control for so I'm skeptical of it—we wouldn't expect to see both an increase in ER visits and an increase in completed suicides and other indicators of severe mental health distress.
> I am not always very attached to being alive
Thanks robbyrobs for posting that; I hadn't read it before, but it's... very familiar. I've never really heard a hard number of how common chronic/passive suicidal ideation is, and I think most of us who just exist that way learn fairly early on not to share it. I've been periodically asked "when did you first started having suicidal thoughts", and it's a very weird question that I have difficulty answering—it's like being asked "when did you start thinking?" Intellectually, you know there has to be an answer, and there's certainly an identifiable lower bound, but damned if I can tell you the exact date. I know when I first encountered the word 'suicide', down to the exact book it was in and where I was when I read it, but that merely put a label on it (and, more valuably, gave me a strong hint that the way I felt was Not Normal and probably something best kept locked down, unless I wanted to get locked up).
My personal pet theory is that some people are just wired to be passively suicidal, and that perhaps this was a positive evolutionary adaptation under some circumstances. Bravery and being passively suicidal are really just a matter of social convention. When I was younger, I used to amuse friends by stepping off the curb to cross the street the barest second after the "Walk" light had gone on, occasionally leaving the odd "orange light" runner to come to a screeching halt rather than hit me. My friends thought this was hilarious; I just did it because it seemed to make them happy, and why not?—the worst-case scenario is that somebody wouldn't stop, I'd end up dead, and that would be that. It never seemed like that big a deal. (As I got older, I realized that in fact the worst-case scenario was much worse than that—I could end up paralyzed, or mentally damaged, or locked-in to a still-breathing corpse, or any number of other outcomes that would make a clean death seem like a pleasant alternative. Such was the naiveté of youth.)
Sometimes I've gotten the impression that other societies have been more accepting of suicidal ideation without either encouraging it or pathologizing it. I remember the first time I read Aurelius' Meditations and being struck by how blunt he is about, basically, "sure we'd all like to die today, but we got shit to do so we can't, suck it up" and finding it oddly refreshing. Because that's how I managed my suicidal ideation for much of my life when it started to get bad: you feel like killing yourself all the time but ugh wow so much on the schedule today, guess I'll have to reschedule dying for, hmmm, maybe next Thursday and you just never really get around to it. But not because you don't want to, just because other shit—you know, that obnoxious stuff people call living—gets in the fuckin way. C'est la vie.
posted by Kadin2048 at 2:26 PM on April 24, 2019 [37 favorites]
I know when I first encountered the word 'suicide', down to the exact book it was in and where I was when I read it, but that merely put a label on it
I had a slightly different experience. I don't think I learned to hide it so much as I never knew it was worth sharing. I think I was 28 when I figured out that daily thoughts of suicide weren't normal, and even then it was a while before I talked about it openly. I was genuinely surprised -- I thought being suicidal meant more than "just" what I was going through, so I had literally never thought it was anything serious.
At the same time, I don't know how common chronic ideation is, especially among kids and teens. I tend to think of ideation as a separate issue, because not every attempt comes from a place of ideation, and not everyone who fixates on suicide ends up attempting it. So I don't know if we're seeing more kids with suicidal ideation, or just more kids attempting suicide. Or if that's even a distinction worth making.
posted by shapes that haunt the dusk at 3:29 PM on April 24, 2019 [5 favorites]
I had a slightly different experience. I don't think I learned to hide it so much as I never knew it was worth sharing. I think I was 28 when I figured out that daily thoughts of suicide weren't normal, and even then it was a while before I talked about it openly. I was genuinely surprised -- I thought being suicidal meant more than "just" what I was going through, so I had literally never thought it was anything serious.
At the same time, I don't know how common chronic ideation is, especially among kids and teens. I tend to think of ideation as a separate issue, because not every attempt comes from a place of ideation, and not everyone who fixates on suicide ends up attempting it. So I don't know if we're seeing more kids with suicidal ideation, or just more kids attempting suicide. Or if that's even a distinction worth making.
posted by shapes that haunt the dusk at 3:29 PM on April 24, 2019 [5 favorites]
I've been periodically asked "when did you first started having suicidal thoughts", and it's a very weird question that I have difficulty answering—it's like being asked "when did you start thinking?"
Yeah, even professionals tend to not seem to believe me when I honestly answer, "Age 4." It's the first actual conscious "thought" I can still remember.
posted by The Underpants Monster at 3:37 PM on April 24, 2019 [9 favorites]
Yeah, even professionals tend to not seem to believe me when I honestly answer, "Age 4." It's the first actual conscious "thought" I can still remember.
posted by The Underpants Monster at 3:37 PM on April 24, 2019 [9 favorites]
The most direct thing we can do as a society to reduce suicides is to control guns. The biggest contributor to youth suicide rate is the rate of gun ownership. Locking up guns makes a difference, but the safest homes are those with no guns at all.
posted by rockindata at 6:12 PM on April 24, 2019 [11 favorites]
posted by rockindata at 6:12 PM on April 24, 2019 [11 favorites]
Link to (paywalled, sorry) paper about suicide rates and gun ownership rates
Link to paper about storage practices
posted by rockindata at 6:19 PM on April 24, 2019 [3 favorites]
Link to paper about storage practices
posted by rockindata at 6:19 PM on April 24, 2019 [3 favorites]
I'm not surprised about the gun ownership/suicide rate connection. A cousin of mine shot himself a few weeks ago; nobody who knew him well believes he would have have killed himself if the gun hadn't been so handy.
posted by The Underpants Monster at 8:10 PM on April 24, 2019 [1 favorite]
posted by The Underpants Monster at 8:10 PM on April 24, 2019 [1 favorite]
I don't always think it's a case of wanting to die, it can also be a case of "I really don't want to be in this life situation any more, but there's no other way out but death," or "I don't necessarily want to die, I just want to Not Exist," or the cry for help/"I just wanted the pain to stop" a la Crazy Ex-Girlfriend. That passive article sounds very relevant.
posted by jenfullmoon at 10:46 PM on April 24, 2019 [7 favorites]
posted by jenfullmoon at 10:46 PM on April 24, 2019 [7 favorites]
There was a natural experiment in the UK about the accessibility of suicide methods and suicide rates. The UK used to have a type of gas oven that would asphyxiate a person very quickly if they put their head in it, and a lot of people killed themselves that way. So eventually the UK made those kinds of ovens illegal and replaced them with a safer model. Suicide rates fell by a lot.
Apparently, most people who attempt suicide do it impulsively -- they think of it maybe only five minutes or less beforehand. (This is coming from a study, but can't cite right now, on my phone). The point is, if people can get to a relatively fast, easy method of suicide within those five minutes, they're in a lot of danger. If they're forced to wait the impulse out, they're much less likely to make an attempt. So the accessibility of things like guns and lethal gas ovens really do affect the suicide rate.
posted by rue72 at 5:36 AM on April 25, 2019 [16 favorites]
Apparently, most people who attempt suicide do it impulsively -- they think of it maybe only five minutes or less beforehand. (This is coming from a study, but can't cite right now, on my phone). The point is, if people can get to a relatively fast, easy method of suicide within those five minutes, they're in a lot of danger. If they're forced to wait the impulse out, they're much less likely to make an attempt. So the accessibility of things like guns and lethal gas ovens really do affect the suicide rate.
posted by rue72 at 5:36 AM on April 25, 2019 [16 favorites]
Per rue72's comment, obstacles don't just delay suicide attempts, they prevent them.
posted by Etrigan at 5:41 AM on April 25, 2019 [8 favorites]
posted by Etrigan at 5:41 AM on April 25, 2019 [8 favorites]
One of the reasons listed, "shortage of care," reminded me of this: Why You Cant Find a Therapist.
posted by Obscure Reference at 5:48 AM on April 25, 2019 [7 favorites]
posted by Obscure Reference at 5:48 AM on April 25, 2019 [7 favorites]
There’s also been a steady increase in young people taking psych meds. Teens are often at much higher risk for suicide after they begin antidepressants. No one is exactly sure why, but it may be differences in brain chemistry and/or the medication loosening inhibitions that previously restrained suicidal impulse.
(I didn’t read all of the articles in the FPP, so I apologize if this has already been mentioned).
posted by stillmoving at 1:23 PM on April 25, 2019 [3 favorites]
There was a natural experiment in the UK about the accessibility of suicide methods and suicide rates. The UK used to have a type of gas oven that would asphyxiate a person very quickly if they put their head in it, and a lot of people killed themselves that way. So eventually the UK made those kinds of ovens illegal and replaced them with a safer model. Suicide rates fell by a lot.
Small point of fact: this wasn’t the ovens, but rather the source of the gas burnt in them. Up until the late 60s early 70s the UK was still using "coal gas" i.e. combustible gases made by heating coal in an anaerobic environment. This gas contained a significant fraction of carbon monoxide which was responsible for many deaths, both accidental & deliberate. Following the discovery of oil & gas fields in the North Sea the UK switched over to natural gas, which contains no carbon monoxide, so people no longer had that method of suicide readily available in their own homes.
posted by pharm at 3:23 PM on April 25, 2019 [2 favorites]
Small point of fact: this wasn’t the ovens, but rather the source of the gas burnt in them. Up until the late 60s early 70s the UK was still using "coal gas" i.e. combustible gases made by heating coal in an anaerobic environment. This gas contained a significant fraction of carbon monoxide which was responsible for many deaths, both accidental & deliberate. Following the discovery of oil & gas fields in the North Sea the UK switched over to natural gas, which contains no carbon monoxide, so people no longer had that method of suicide readily available in their own homes.
posted by pharm at 3:23 PM on April 25, 2019 [2 favorites]
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posted by Brocktoon at 10:08 AM on April 24, 2019 [8 favorites]