Combating The Rise In Teen Suicide

Weekends on All Things Considered guest host Arun Rath talks to pediatrician Stephen Teach about teen suicide and how to prevent it. Teach recently published new research on how and why children as young as 10 years old commit suicide.

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ARUN RATH, HOST:

And if you're just joining us, this is WEEKENDS on ALL THINGS CONSIDERED from NPR News. I'm Arun Rath.

Here's a somber statistic. The suicide rate in America has been climbing steadily since 1999. That's according to the Centers for Disease Control. And every year, thousands of those deaths are among children and teens who in nearly half of those cases, take their own lives using guns.

Stephen Teach is an emergency room doctor who led a study on the topic. He says approximately 1 in 5 youth at risk for suicide have access to a firearm. He joins us now from Children's National Medical Center here in Washington. Welcome.

DR. STEPHEN TEACH: It's good to be with you.

RATH: So this is a hard one to talk about, but it turns out that suicide is a leading cause of death among young people. Can you give us some context here - just how common, how prevalent is this?

TEACH: Sure. Well, suicide is the - either the second or the third most common cause of death among teenagers and young adults, depending on the exact year. Sometimes, it's a bit ahead of homicide; sometimes it's a bit behind them. And the interesting thing about that is about half of the completed suicides in this age group involve firearms.

RATH: Wow. And I know that the first question every parent is going to want to know is, how do we know when a young person is at risk? We're hoping that there are some pretty major warning signs.

TEACH: Yeah, the warning signs of suicide typically overlap with those of depression. So withdrawal from social activities; a drop-off in performance at school; a change in friends, withdrawal from friends; withdrawal from school activities, including sports or arts programs; a drop in grade; a change in sleeping behaviors; change in appetite - those can all be signs that a depressive disorder is coming on. And that's really the time when a parent wants to engage their child in a dialogue about exactly what's going on.

RATH: Well, I know a lot of parents would worry - you know, if I ask my child about suicide, is that going to put the idea in their head, especially if they're young?

TEACH: There's absolutely no evidence whatsoever that talking about suicide with young people puts the idea in their head. In fact, in our research, we found that children and young adults welcome the opportunity to talk about suicide, and are actually glad that we ask, that we care enough to ask.

RATH: Well, and so is there a particular approach that's good, or you just talk to them straight out?

TEACH: Well, I think it speaks to the importance of just having an open line of communication with teenagers, and just keep the questions coming; everything from how was your day to, you know, tell me the favorite thing you did in school today - and just stay in touch with them. And that way, it's easier to notice when worrisome symptoms begin to develop, worrisome changes in behavior. And that's when the questions and the dialogues need to become a little bit more direct. And if at any point, a parent becomes concerned that a child or a teenager may be at risk for self-harm, that's when they really need to get in for some expert evaluation and care.

RATH: Now, speaking of medical care, you're an emergency room doctor, and the ER is often the first point of contact for young people who have tried to injure themselves. Do ER doctors have the sort of tools they need in order to deal with situations like this, to help prevent child suicide?

TEACH: Well, the initial phase of our research really sought to develop a brief, practical, straightforward questionnaire which would identify teenagers at increased risk of suicide. And what we were able to do is develop a simple, four-question questionnaire. And it's for use in emergency departments by clinicians - nurses and docs. And using this, they can identify kids at increased risk of suicide.

RATH: And what are those four questions?

TEACH: In essence, the questions go to whether the child has been thinking a lot about death or suicide, and whether he or she has tried suicide in the past. And then the follow-up questions - which we feel are critical in this nature - is what is at that child's or that young person's disposal, to actually complete the suicide? And this is where guns come up. We simply need to ask whether the child has access to firearms in the home. Our own research finds that nearly 20 percent - or 1 in 5 - of the teenagers who test positive for risk for suicide have firearms in the home. Access to those firearms needs to be restricted, for the child's safety. Parents need to do what they need to do, to protect their children.

RATH: Stephen Teach is an emergency room physician at Children's National Medical Center here in Washington. Dr. Teach, thank you so much.

TEACH: You're welcome. It was a pleasure being with you.

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