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drjohnson February 5, 2009


Suicide in young children



Many of you have probably heard of the suicide of a young boy in an elementary school in Illinois. This happened at our local school. I thought it might be useful to post some information about suicide in young children. Most information about suicide and children, focuses on teens. And it is extremely rare for a suicide to take place in a school building. 



The main ideas I've taken from putting this information together are:



1. Take any mention of suicide seriously, even from a young child.



2. Do not leave the child out of supervision.



3. Summon help. Call 911, a hot-line, or other appropriate personnel.


From the Chicago Tribune:



"A 10-year-old boy found hanging in an Evanston school restroom had threatened to take his life, sources said Wednesday, underscoring experts' warnings to take cries for help seriously even from the very young.



Scolded by a teacher, Aquan Lewis responded with a threat to kill himself the same day his body was discovered, said sources familiar with the investigation.



The 5th grader hanged himself Tuesday afternoon by his shirt collar on a hook in an Oakton Elementary School restroom stall where a footprint was found on a toilet, a source said."


Excerpted from a Yahoo,com article:



"Suicides among children as young as Aquan are extremely rare. There were on average just 10 U.S. suicides among 10-year-olds a year between 1999 and 2005, according to statistics from the U.S. Centers for Disease Control and Prevention's National Center for Injury Prevention and Control. By comparison, there were an average of about 75 suicides a year among 13-year-olds, and about 250 a year among 16-year-olds."


suicide prevention hotline:  1-800-273-TALK (8255)


Wallet cards assessing risk and another for symptoms:



http://www.suicidepreventionlifeline.org/help/warning_signs.aspx


excerpts from suicide risks in children: 



http://www.thefreelibrary.com/Assessing+suicide+risk+in+children:+guidelines+for+developmentally...-a0158907276


RISK FACTORS FOR SUICIDE



Biological Risk Factors



Biologically, children are at risk for suicide due to higher degrees of impulsivity, and this greater degree of impulsivity is reflected in suicide attempts and gestures that are closely related to opportunity and require little planning  . . . Although very young boys and girls boys and girls . . .  have similar rates of suicide attempts and completions, sex differences in rates of completed suicide emerge by age 10  . . .  by adolescence, boys complete and girls attempt suicide more often. In addition, the rates of suicide are very low among the very young and continue to increase as children mature; thus, age may be considered a risk factor even among 5 to 14 year-olds.



Psychological Risk Factors



. . .  psychological risk factors among young children to include feelings of inferiority and the "expendable child syndrome"  . . . Common symptoms most often include depression . . .  but may also include anxiety, aggression, and impulsivity  . . .  problems and stressors and present with poor coping skills  . . .


Cognitive Risk Factors



Cognitive risk factors for childhood suicide include immature immature  views of death, concrete thinking styles, and a child's degree of attraction and repulsion  to life and death. Certainly, a child who does not understand the nature of death and engages in rigid thinking will be less capable of understanding the implications of her or his behaviors. Juhnke (1996) further identified rational thinking loss as a risk factor for childhood suicide. Similarly, Pfeffer (2003) discussed the need for clinicians to be aware of potential auditory  or visual hallucinations . . .


Environmental Risk Factors



Environmental risk factors include a constellation of early loss, parental conflict, chaotic or inflexible family structures, abuse, neglect, and parental suicidal behaviors.  . . .  Families experiencing increased distress, dysfunction  or violence frequently have difficulty providing for the needs of a distressed child.  Risk for the child increases dramatically when one or both parents are experiencing mental health problems and/or suicidal behavior.



Similarly, children at risk for suicide are frequently isolated and alienated from their peers. These children often feel lonely, disconnected, and do not enjoy the protective benefits of acceptance and peer group identification. In addition, suicidal children frequently present with problems at school including learning disabilities and/or academic failure).



Precipitating Events



The presence of recent stressors and precipitating events must not be overlooked.  . . . stressors or changes may be particularly hard on a child and may include loss or threatened loss  such as moving, crises in the family, health problems, and other events toward which the child feels little or no control. Similarly, environmental factors including recent exposure to suicide or "contagion may place a child at even higher risk for considering suicide as a solution to her or his stressors.  . . .  triggering events for high-risk children often appear trivial to adults and may include events as simple as a denied privilege or seemingly ordinary punishment. Further, reviews of empirical literature indicate that prior suicidal ideation and attempts are the most predictive risk factors for future suicidal behavior and completion  . . . Finally, those with an organized plan for suicide should be considered as presenting with a much elevated risk.


School Intervention to Prevent Youth Suicide

This document provides considerable information on prevention, assessment, crisis response, and aftermath assistance.

http://smhp.psych.ucla.edu/pdfdocs/Sampler/Suicide/suicide.pdf


statistics from Health and Human Services :



http://www.ahrq.gov/research/feb02/0202RA8.htm



As many as 12 percent of children ages 6 to 12 and 53 percent of adolescents ages 13 to 19 think about suicide, and 8 to 10 percent of all U.S. children attempt suicide at some point during their childhood. A growing number of these troubled children and adolescents are showing up at hospital emergency departments (EDs) primarily for self-destructive behavior. A previous study showed that by simply asking these children four questions using the Risk Suicide Questionnaire (RSQ), ED triage nurses could identify 98 percent of children at risk for suicide.


Other relevant articles:



csmh.umaryland.edu/resources.html/suicide%20prevention%20brief.pdf



http://www.baltimorepsych.com/Suicide.htm



http://theguide.fmhi.usf.edu/



http://www.ericdigests.org/pre-9214/loss.htm



http://suicideandmentalhealthassociationinternational.org/preventionteachers.html



http://www.suicide.org/suicide-prevention-program-for-schools.html


 


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