Posted: 9/25/2017
Parkland experts say suicide is second leading cause of death for adolescents
For the first time ever, suicide has passed homicide as a leading cause of death for young people in America, prompting pediatricians and mental health experts to sound the alarm for parents, teachers and healthcare providers to be alert to warning signs that could signal children at risk. September is Suicide Prevention Awareness Month and experts urge adults to learn more about this growing threat to young lives.
Parkland Health & Hospital System began screening pediatric patients to identify kids at risk long before the Netflix 2017 season hit show “13 Reasons Why” put teen suicide in the headlines. In 2015, Parkland launched a unique Universal Suicide Screening Program to screen not only adults but also youth, ages 12 to 17, to help save lives by intervening immediately with those who need assistance.
“Research has shown that today’s teens are exposed to more stresses and pressures than ever before. According to the National Alliance on Mental Health, one in five kids experience a mental health condition, but only 20 percent receive services. Suicide is the second-leading cause of death for 15 to 24 year olds,” said Kimberly Roaten, PhD, Director of Quality for Safety, Education and Implementation, Department of Psychiatry at Parkland and Associate Professor of Psychiatry at UT Southwestern Medical Center.
“At Parkland we recognize that we have the opportunity to identify children and young adults coming to us for other health services who may also need mental health services. By asking a few questions of every patient, regardless of why they come in for medical care, we can determine if there are reasons for concern and take steps to help.”
Parkland uses the Columbia Suicide Severity Rating Scale (C-SSRS), a validated screening tool, with adults 18 and over and the ASQ (Ask Suicide-Screening Questionnaire) with 12- to17-year-olds.
The Parkland Algorithm for Suicide Screening stratifies patients into three suicide risk categories based on their answers to the screening questions: no risk identified, moderate risk identified and high risk identified. Those at high risk are immediately placed under one-to-one supervision, suicide precautions are implemented, and an evaluation by a behavioral health clinician is initiated. Patients at moderate risk are automatically referred to a psychiatric social worker and usually are seen during the same visit. Moderate risk patients who choose not to speak with a psychiatric social worker during the visit receive a follow-up phone call to provide additional support and resources. Parents and caregivers are engaged in the screening process and both patients and their caregivers are provided with printed information about suicide warning signs and community mental health resources.
“Social media, cyber-bullying, easy access to drugs and alcohol, dating violence and teen pregnancy are just some of the threats facing young adults,” Dr. Roaten said. Although the screening tool can help healthcare providers identify kids at risk, she added that it’s important for family, friends, teachers and school officials to know the warning signs that should prompt them to seek professional help for a young person struggling with depression or mental health problems.
Since May 2015, more than 67,000 suicide screenings have been completed for Parkland patients between the ages of 12 and 17. Approximately 2.8 percent of all adolescent patients were found to have potential suicide risk through the screening. According to Dr. Roaten, girls are almost twice as likely as boys to endorse at least one positive suicide screening item and older kids are more likely to endorse a suicide screening item than younger adolescents.
Following are common warning signs of potential suicide risk in adolescents to watch for:
• Threats or comments about killing themselves, also known as suicidal ideation, as well as preoccupation with death in conversation, writing or drawing
• Increased alcohol and drug use
• Aggressive or hostile behavior
• Social withdrawal from friends, family, school activities and the community
• Dramatic mood swings or personality change, such as from upbeat to quiet
• Giving away belongings
• Impulsive or reckless behavior
• Feeling excessively sad or low
• Confused thinking or problems concentrating and learning
• Changes in sleeping habits or feeling tired and low energy
• Changes in school performance
• Running away from home
• An intense fear of weight gain or concern with appearance or neglecting personal appearance
“It’s important to know that suicide is preventable and everyone should be familiar with warning signs and how to respond if a friend or loved one seems to be at risk,” Dr. Roaten said. “Asking a young person how they are feeling and whether they have thoughts of suicide can open the door to conversation about their problems so we can help them get the counseling or professional assistance they need,” she said.
If you or someone you know is in an emergency, call 911 immediately. If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255) or text the Crisis Text Line at 741741. Parkland’s Victim Intervention Program/Rape Crisis Center offers a Sexual Assault and Domestic Violence Crisis Line at 214-590-0430.
To learn more about services at Parkland hospital, visit www.parklandhospital.com