Confronting a rising tide of suicide deaths

America has a suicide problem.

From 1999 through 2014, the rate of suicide deaths increased by 24 percent – from 10.5 per 100,000 population to 13 per 100,000. The increases occurred among males and females and in all ages from 10 to 74. The greatest increase occurred in females ages 10 to 14 and in males ages 45 to 64.

Among young people, the prevalence of suicidal thoughts and actions is especially striking. In 2013, the Centers for Disease Control and Prevention cited these statistics for U.S. students in grades 9 through 12:

• 17 percent seriously considered attempting suicide during the previous 12 months.
• 13.6 percent made a plan during the previous 12 months for how they would attempt suicide.
• 8 percent attempted suicide one or more times during the previous 12 months.
• 2.7 percent of students made a suicide attempt that resulted in an injury, poisoning or an overdose that required medical attention.

Rates are higher among people in rural areas and young people who identify as LGBTQ.

“We shouldn’t avoid talking about suicide,” says Providence psychologist Dr. Jeri Turgesen. “If we’re open and authentic in talking to each other, it helps give people space – safe space to feel heard and connected.” Having these conversations and creating space can help identify concerns and link the individual with the appropriate level of care.

The “13 Reasons Why” phenomenon

In the context of rising suicide rates, the popular Netflix series “13 Reasons Why” raises awareness of the problem. It has also drawn fire from mental health advocates who say the show increases the risk factors for young people. The show revolves around the messages that a girl who kills herself addresses to other young people whom she blames for her troubles.

Dr. Turgesen says the show depicts issues that adolescents can relate to, such as depression, bullying and social media. “My concern is that the graphic depiction of suicide is potentially triggering to sensitive teens. It also makes suicide seem romantic, particularly with the revenge component.”

One problem is that the show’s depiction of adolescent suicide is targeted to an audience that isn’t entirely ready to handle it.

“Teens have trouble thinking long-term,” Dr. Turgesen says. “Their frontal lobes aren’t fully developed, so many have trouble thinking into the future. Suicide can feel like an immediate escape from distress. This show makes it seem like you can speak beyond the grave, but you can’t.”

Still, she says, young people are watching the show. And that presents an opportunity for conversation.

“I don’t think the show is well done, but if it opens up a real conversation between kids and trusted adults, that’s at least a good thing,” she says. “Having the conversation, reaching out to help someone you’re concerned about – that doesn’t cause suicide.”

Know the signs of trouble and how to respond

Parents and concerned adults should recognize that young people do think about suicide. In fact, occasional thoughts about suicide are normal, said Dr. Turgesen. But if those thoughts become persistent or frequent, “that’s a problem.&rdquo

Here are some questions that can highlight warning signs and risk factors:

• Does the young person show big changes in personality, behavior and social activity?
• Does the youth feel hopeless? Does he or she have a plan for the future?
• Has his or her performance in school deteriorated?
• Is he or she neglecting his or her appearance?
• Is he or she having relationship problems?
• Has he or she given away possessions?
• Does he or she know someone who’s tried to kill himself?
• Has he or she developed a substance abuse problem?
• Is he or she spending time (or more time) writing about, drawing or seeking out media around suicide?

And here are some tips for adults to talk constructively with a young person about suicide:

• Ask how your child is doing. And if you’re worried, be direct. Ask “Have you ever had thoughts of suicide? How can I help you?”
• Take things kids say seriously. Something that seems small to you may be huge and triggering for an adolescent. High school crushes and breakups are devastating to teens.
• Ask open-ended questions. Focus on providing empathy and support. Find ways to help them act and react in positive ways.

Seeking professional help

If a child is depressed or dealing with suicide, urgently reach out to his or her care team or primary care provider. If the child has a clinical psychologist, call him or her. If not, ask to talk to the primary care provider immediately and explain that you need to connect to an integrated behavioral health team. Providence Medical Group clinics designated as medical homes should have this integrated team, which includes a clinical psychologist. You can also reach out to a school counselor.

Whichever course you take, stay with the child.

“Don’t leave them alone,” Dr. Turgesen says. “Hear and listen to them, and be sure you get to a place where they can be safe.”

If you’re searching for a mental health provider, remember, the best treatment is the one the young person feels positive about. That can build a sense of hope for the child and help them believe that seeing the provider will be effective, says Dr. Turgesen.

“You need a licensed professional who is willing and able to connect,” she says. It’s also important to make sure your child has positive, healthy, strong relationships with adults, such as parents, teachers, coaches and others. “Positive social supports and connections make a big difference.”

Here are two resources that a person thinking about suicide should know about:

• National Suicide Prevention Hotline, 1-800-273-TALK (8255), has trained call-takers who listen without judgment and can offer resources. The call is free and confidential.
• The Trevor Project LGBTQ Crisis Hotline, 1-866-488-7386