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In the last section, we discussed five theories why adolescents choose suicide. These five theories are, motivations for suicide, depression and mental illness, rebellion and escape, low-self esteem and lack of communication, and suffering a loss.
In this section, we will discuss three warning signs for teen suicide. These three warning signs are verbal clues, behavioral changes, and situational clues.
After Lonnie, 17, attempted suicide with a firearm, I met with his parents, Roy and Karen while Lonnie was in intensive care. Roy stated, "Lonnie didn’t act like those kids you read about in the papers. He was a happy boy, and doing well in school. I had no way of knowing this was coming! I mean, he was a little moody lately, but all teenagers have those phases. If only I had known!" As Roy described the weeks leading up to Lonnie’s suicide attempt, it became clear that Lonnie had actually attempted multiple times to let those around him know he was thinking about suicide.
Statements such as "I am going to commit suicide" or "I don’t want to live anymore" are fairly clear cut messages, but I have found that individuals who hear these comments may not understand the full degree of severity of the statement. Individuals are likely to react to the word suicide with fear and confusion. They do not want to believe what they are hearing, and the message from the teen goes unheeded.
"Subtle Clues Checklist" Technique
The items on the checklist are:
I feel that providing this checklist technique to the parents of teen clients is a good way to encourage parents to pay more attention to subtle clues that the teen may be giving out. Would providing this technique to the parents of a potentially suicidal teen be helpful to your clients?
♦ Warning Sign #2 - Behavioral Changes
The inability to concentrate, boredom, and listlessness are also predictors of a depression and possible suicidal ideation. I also advise parents to be aware of changes of sleep or eating patterns, giving away prized possessions, obsession with death, increased use of drugs or alcohol, lack of energy, guilt, self reproach, and expression of worthlessness. A copy of these behavioral changes which you might provide to the parents of at risk teen clients is provided at the end of the Manual that accompanies this course.
♦ Warning Sign #3 - Situational Clues
Other situations teens might experience that provide situational clues for suicide risk include alcohol or other drug abuse, pregnancy, delinquency, or trouble at school. Acting out in ways that are unacceptable to society is related to the incidence of suicide. Teens who are placed in juvenile detention centers, or young mothers who seek abortion, are the most likely to threaten or attempt suicide.
Additionally, the presence of a mental or serious physical illness should always be taken into consideration, especially when the teen has a perceived or actual lack of social support. During sessions with teen clients, I am especially mindful of the expression of a sense of isolation through comments such as "I could never tell my parents, they just don’t listen," or "all they do is tell me this is my fault. I’m tired of being stupid and lazy!"
Clearly, these statements indicate a rift in the communication link between the teen client and her or his social support, and send up a red warning flag. What other red flag statements regarding situational clues do you look for when assessing suicide risk in a teen client?
In this section, we have discussed three warning signs for teen suicide. These three warning signs are verbal clues, behavioral changes, and situational clues.
In the next section, we will discuss three aspects of addressing thoughts and feelings with a suicidal teen client. These three aspects are communicating feelings, separating thoughts and feelings, and active listening.