Teen-Age Suicide: A Cry for Help

One reporter who called had the kindness to ask how I felt when I heard the news of the four teen-agers who asphyxiated themselves in New Jersey. I told him I cried. I cried for the kids who could see no better way to solve their problems. I cried for their families who will have to live with their grief and their guilt. I cried for the friends who will have to live with the memories.

Then he told me about the two kids in Chicago who died by carbon monoxide poisoning, and the 11-year-old who hanged himself from a tree in Upstate New York.

I thought about the boy who hanged himself in his high school auditorium two weeks ago, less than two miles from where I live. And the girl in the same school who killed herself with an overdose of barbiturates the day before.

Are these events unusual he asks? Or will I soon be crying again? Asphyxiation is an unusual method of teen-age suicide. Four kids who make a suicide pact is unusual. An 11-year-old who hangs himself is unusual. A young girl who takes her life with pills is much more common, but fortunately, not yet a frequent occurrence. Statistically, suicide is still unusual--5,200 kids in the United States kill themselves each year. But as a cause of death among young people, suicide is not unusual. And it’s becoming less unusual all the time. Suicide is the second leading cause of death among adolescents.

The word epidemic has been used in talking about suicide--an epidemic that is selectively affecting our youth, ages 15 to 24. The death rate for every age group in the United States has gone down in the last two decades, except for our youth, whose death rate is now higher than it was 20 years ago--primarily due to suicide. This is an international “epidemic” involving modern industrialized nations. The youth of Switzerland, Austria, Australia, Canada and the United States are finding--in spite of affluence and technological advances--life is not worth living.

Then the problem must be the publicity, the reporter suggests. It’s a problem, but not the only problem. Sensationalizing a death is damaging. The boy who made a poor choice to deal with his troubles becomes a hero when his picture hits the front page. The girl who attempts suicide and appears on television to tell her tale gets attention. We are glamorizing a tragedy and romanticizing a mistake. If we dedicate a yearbook or hold a pep rally or call off school in honor of a suicide we are giving a very wrong message. Instead we should be applauding the wisdom of the youngster who starts psychotherapy and takes constructive action to deal with his concerns.

The troubled child, struggling to find an identity and to feel important, will grasp at a negative model as a way of gaining much wanted notoriety. He does not understand, that after death, he won’t be around to enjoy our attentions.

Does that mean we shouldn’t talk about suicide, he asked? No, not at all. We must talk about it. In fact, had we been more willing to talk about suicide, the four teen-agers from Bergenfield might be alive today. Let me explain.

Others Who Died

There were four other kids from Bergenfield who died last year. One was hit by a freight train in June in what was called an “alcohol-related incident.” His best friend died the same way three months later. A third boy was found last August, drowned in Coopers Pond. In September, the fourth, Joe Major, died in a 200-foot fall off the Palisades while his friend watched him. This was also called an “alcohol-related incident.” No one acknowledged these deaths as suicides.

The boy who watched Joe fall in September was in the car this March. One of the sisters in the car had dated Joe. If these kids had had the opportunity to grieve and to deal with their guilt over what part they might have played in their friends’ deaths--perhaps they would not have felt compelled to die. Joe’s mother said she thought the suicides were “in tribute” to her son.

And all four of these kids gave clues. They talked about dying. One girl said, “I’d be better off dead.” There were slash marks on the wrists of one of the boys, probably from an earlier suicide attempt. They tried to pull a 10-foot hose from a car vacuum cleaner at the gasoline station where they bought the lethal gas. They didn’t tell the attendant what they needed it for. All of these kids had recently lost their status as students. Three had left school and the fourth had just been suspended. They abused alcohol. Kids drink and take drugs to belong to a group, to solve their problems. But alcohol and drugs become the problem. Kids who drink find themselves more depressed and less able to think clearly. Many adolescents use alcohol or drugs before they pick up the gun, the knife, drown themselves, walk off a cliff, or die of carbon monoxide poisoning.

Why are so many of our kids dying? Why are our teen-agers so vulnerable?

We live in a violent society. There is little value placed on human life. In fact, when we read about 300 people being buried alive in a Honduras earthquake, we barely flinch before we go on sipping our coffee and turn the page to see what else is new. Teen-agers are greatly influenced by the violence they see at home and in the media. For example, it’s estimated that by his 18th birthday the average American child will have seen 15,000 television murders. Kids see violence as a way of resolving conflicts. And the weapons are readily available.

Firearms are the leading method of suicide, and also the one method that has increased significantly along with the increase in the suicide rate. Guns now account for more suicides than all other methods combined: 65% of all teen-age suicides are committed with firearms. About 25 million households have handguns and half of these keep their guns loaded. Adolescents are impulsive. Having a loaded gun around the house is an invitation to disaster.

Our kids are vulnerable because there are so many of them. The number of teen-agers is positively correlated with the number of suicides in this age group. The more teen-agers there are the greater the competition for honors, for employment, and the fewer the chances for success.

Kids in these rapidly changing nations grow up too fast, taking the privileges usually reserved for adults--drugs, money, sex--while still young, often with disastrous consequences. This puts enormous pressures on teen-agers who are psychologically still children.

Mobility has caused additional problems. Families who move frequently have higher suicide rates than those who are stable. Teen-agers become isolated and lonely as they move into unfamiliar surroundings. We have seen a high incidence of suicide among adolescents in “new” towns such as Plano, Tex. Kids who commit suicide are often loners. They feel they don’t fit in. So many kids feel estranged, unattached to friends, tradition, family, or home. They’ll do anything to fit into a group, to belong.

Some adolescents welcome change but many are frightened by it. For youngsters who are uncertain of themselves, reassurances of a stable home life, a stable religion, a predictable place to live, a predictable place to go to school, may be absent. A transition such as senior year in high school with no college or job in sight, may make kids especially vulnerable to suicide. Rather than face continual insecurity, some youths choose to die.

The traditional family is disappearing. Half of today’s children will be adolescents in a divorced home. Even where there are two parents present, both parents may be working. But the question is not one of working or divorced parents, but one of involved parents. American parents spend less time with their children than those of almost any other nation of the world. The attitude of many American parents is that their children are an inconvenience, an impediment to freedom or success.

The presence of a supportive family, whether living under one roof or two, helps teen-agers get through adolescence. Adolescents who are without parental support may be vulnerable to impulsive, self-destructive behaviors. In addition, in families where there’s little concern for adolescents by adults, early symptoms of suicidal behaviors may go unheeded. The adolescent who is neglected or unheard may see attempting suicide as the only way to get attention. Occasionally this attempt may turn out to be lethal.

Why So Vulnerable?

Why are our kids so vulnerable, the reporter asked. Sometimes it’s difficult for me to imagine why our kids stay alive.

Is this going to happen again? Yes, it will. Where? In your town or mine. Can we do something about it? Yes and we better, before it’s too late.

What can we do about teen-age suicide?

Three things. The most important method of prevention is a program in positive mental health, depression recognition and suicide prevention for students, teachers, school administrators and parents. These programs must begin with helping children to develop self-esteem. A child who does not love himself cannot love life. Older children can learn how to communicate and listen. Teen-agers can learn how to identify a friend who is in trouble and how to reach him. They must know where to go to find a trusted adult and when to go to a professional. The school faculty needs to know what to do to prevent one suicidal incident from triggering multiple suicides.

Over a period of years, education is our best bet for decreasing suicide. Here I use the analogy of sanitation and its effects on infectious disease. More lives have been saved by sanitation than by antibiotics. Even before we knew what caused the disease we could cure it. Based on the good effects of public education in the areas of child abuse, drunk driving and discrimination, teen-age suicide could be reduced by as much as 20% through education.

Having a loaded gun around the house is an invitation to disaster.

I recognize that safety training and education on the dangers of handguns would not solve the underlying problems of self-esteem and depression that drive our young people to suicide, yet it would result in fewer deaths. Adolescents who can’t get a lethal weapon don’t necessarily choose another. If they do, it’s usually a less-lethal method and you have a chance to intervene. Often if they can’t get a weapon, the impulse passes.

Lack of Gun Regulations

I estimate that of the teen-age suicides committed with a gun, 70% of those kids could not have gotten guns if there had been regulations and 50% of these kids might have chosen another method. By making it harder to get handguns and firearms we could save the lives of another 20% of our youth.

Our kids use pills as the second most common method of suicide. Eleven percent choose an overdose as the way to die. If we could restrict the number of tablets the doctor prescribes with each prescription of sedative and hypnotic drugs we could probably save another 3% of our kids. This worked in Australia where they reduced the suicide rate in the 1960s and ‘70s by restrictions on the sale of these drugs. In addition, tricyclic antidepressants could be sold with an antidote or emetic. If a teen-ager overdosed and changed his mind, or was found, the antidote could be given without waiting to get to the hospital.

With three practical programs we could save 43% of our youth. Certainly, many factors are associated with the problem of suicide. They are far-reaching and deeply rooted in the problems of society, family and the biochemistry of the individual. Each suggests a different set of intervention. The majority of risks for teen-agers, however, centers in two areas: the cultural pervasiveness of violence and negative social factors of stress and neglect. We must decrease violence as a way of life, make lethal agents such as guns, drugs, alcohol, and medications less available and begin education programs for youths, parents and teachers. What are we waiting for?