Adolescent Suicide
Dr. SHUBHANGI R. PARKAR DPM, MD. PhD
Professor & Head, Department of Psychiatry,
Seth G. S. Medical College & K. E. M. Hospital, Mumbai

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There is a contradiction in recent theorizing about adolescent suicidal risk. On the one hand, by all objective standards, the quality of life for adolescents in recent times is far better in comparison to earlier times. Therefore, it is expected the reduction in incidence of suicidal behavior. However the incidence of youth suicide seems to have risen in some nations of the world in recent years, and so some scholars have concluded that the quality of life for adolescents must have declined.

The most important correlate for youth suicide is a previous attempt. Injurious suicide attempts by adolescents are more frequent than completed suicides. Suicide attempts among youth have been shown to be associated with depression, substance use, loss of a family member or friend to suicide, access to firearms, and female gender. Other factors contributing to suicide risk have included a family history of either suicide or unemployment among older youth, a history of sexual abuse and a previous suicide attempt. Chronic medical conditions such as type 1 diabetes mellitus, asthma and epilepsy have also been implicated.

Suicidal behavior is also risk factors for involvement in interpersonal violence among youth, including alcohol and illicit drug use, and experiencing somatic symptoms. Exposure of adverse life events may make a fundamental contribution to suicidal behaviour. In adolescents Suicidal behaviour may indicate an attempt to resolve, solve or escape personal difficulties or stresses associated with life event exposure. Presence of life events may contribute indirectly to suicidal behaviors by precipitating psychiatric symptoms (notably, depression) which may become important risk factors for suicidal behaviour. Some studies reveal that the major stressors for this group are personal identity difficulties (sexuality, personal violation), family problems (illness and conflict) and external problems (achievement pressure and failure).

Emotional well-being is also a major protective factor for attempting suicide, consistent with the findings of others that the majority of adolescent suicides are characterized by psychopathology, primarily depression. The question that needs to be attended is why are the majority of adolescents who commit suicide still those with personal and social risk factors? Identifying the environmental risk factors especially in family and in school is advisable. Applying family level interventions to adolescents at a high risk for suicidal behavior, including those with previous suicidal behavior or depression, is also supported by the significant protective effect of parent-family connectedness on attempting suicide in some study.

Some research reports suggest a profile by which professionals working with this client group may identify individuals at the pre-act stage. A vulnerable adolescent appears to be depressed, with feelings of hopelessness and with a tendency toward self-blame and impulsivity. He/she is likely to be experiencing personal worries with pressure from school or relationships. Most specifically, a susceptible individual is also not able to delineate his problem and solve it. All adolescents with a possible suicide attempt

should receive a comprehensive mental health and psychosocial assessment.

Identifying some friendly relative member within the family or the school/college system would go some way to addressing the adolescent’s immediate needs. Further potential approaches include routine screening of adolescents to identify those at risk and helping teachers recognize such pupils.