After moving vehicle accidents and homicide, suicide is the third major threat to the survival of adolescents (see my previous posts). While the media sensationalizes teen suicide, the actual rate is much lower than believed, about 10 in 100,000 (Berman, Jobes, and Silverman, 2006). Even so, suicidal ideation and threats of self harm should not be ignored. The loss of even one life is tragic.

So, is it possible to identify adolescents at risk for suicide and help them? This is a simple question with a complicated answer. Years of scientific research have focused on this question without definitive results (Berman, Jobes, and Silverman, 2006). While there is no clear profile of the suicidal adolescent, epidemiological studies have identified variables correlated with suicide risk. The are:
• Anti-social behaviors, rage and aggressiveness
Alcohol and substance abuse
• Suicidal ideation
• Impulsivity
• Hopelessness
• Family problems
• Interpersonal loss
• Family history of suicide
• Stressful or anticipated stressful events
Furthermore, studies have shown that girls make more suicide attempts but boys are more likely to commit suicide. And, most adolescent suicide takes place at home with means, pills or firearms, found in their own homes.

What can be done to prevent adolescent suicide? Here are some preventative suggestions based on the combined work of an in-depth government study (Alcohol, Drug Abuse, and Mental Health Administration, 1989), the Centers for Disease Control (Centers for Disease Control and Prevention, 2001), and Gould and Kramer (2001):
• Adults can restrict access to lethal means such as guns and pills
• Teach help seeking behavior
• Teach positive coping skills
• Increase access to telephone counseling and drop-in centers
• Educate teens, teachers, counselors, and parents to the warning signs
• Link schools with community services
For a more in-depth explanation of prevention strategies, the reader is directed to Adolescent Suicide: Assessment and Intervention by Berman, Jobes, and Silverman.

Teaching positive coping skills and help seeking behavior should start with elementary aged children. It is the responsibility of parents and teachers. Because children are congregated in schools, schools are the natural place to deliver health information. My own favorite idea is a public health van that travels from school to school providing information and services about hygiene, nutrition, dental care, birth control, physical exams, immunizations and mental health. While attending school is required by law, health care isn't. So, providing services to minors is always a delicate matter which involves their parents.

Finally, if you are worried that someone you know is at risk for suicide, GET HELP IMMEDIATELY. If you are a teen, tell trusted adults like a parent, teacher, school counselor, or family doctor. If you are a parent, seek professional help through your doctor, church, or local mental health community. If these alternatives are not available to you, contact a suicide hotline in your area. Here are some places to start: and

Alcohol, Drug Abuse, and Mental Health Administration. (1989). Report of the Secretary's Task Force on Youth Suicide: Volumes 1-4. (DHHS Publication No. DM 89-1621). Washington, DC: U.S. Government Printing Office.
Berman, A.L., Jobes, D.A., & Silverman, M.M. (2006). Adolescent Suicide: Assessment and Intervention. Washington, DC: American Psychological Association.
Centers for Disease Control and Prevention (2001). School health guidelines to prevent unintentional injuries and violence. Morbidity and Mortality Weekly Report. 50, 1-74.
Gould, M.S., & Kramer, R.A. (2001). Youth suicide prevention. Suicide and Life-Threatening Behavior, 31 (Suppl.), 6-31.

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