Adolescent Suicide Research Paper

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Adolescent Suicide: An Overview of Nursing Interventions

Despite the idea that adolescents are in the prime of life, adolescence is one of the most fraught periods of development, at least within the context of contemporary Western culture. Adolescent suicide was an acknowledged mental health risk even before reliable statistics were kept on this issue, and the numbers continue to be sobering. According to Bloch (2016), suicide is the second most common cause of death for adolescents ages 10–19 and even more adolescents contemplate suicide, an estimated one in every 7; one in every 13 make a so-called unsuccessful attempt (p.1). Even more sobering is the fact that rates are apparently increasing; adolescent suicides have increased by 25% in the past 15 years (Bloch, 2016). The reasons for this are unclear and continue to be debated. Regardless, the act of an adolescent forcibly taking his or her own life through extraordinary means must remain a public health priority. Furthermore, the degree to which it is a feminist or female issue must be considered, given that the spike in suicides among females has been particularly dramatic: a 75% increase over the past 15 years (Bloch, 2016, p.1).

Factors Contributing to Adolescent Suicide

History of Mental Illnesses

According to a British Medical Journal study of 2399 Norwegian adolescents published by Strandheim (et al., 2014), a history of anxiety and depression had been previously been strongly correlated with suicide, suicide attempts, and suicidal ideation. Conduct disorder, attention deficit hyperactivity disorder (ADHD) obsessive compulsive disorder (OCD), and other psychological issues were also associated with suicide, albeit to a lesser degree. The study itself found that the adolescents it surveyed with a history of anxiety and depressive symptoms, attention and conduct problems, were all twice as likely to experience some type of suicidal behaviors. This suggested that an even broader view of mental illnesses contributing to depression should be undertaken when evaluating adolescents for suicidal risk factors. Not only illnesses presumed to be associated with suicidal and depressive behaviors by their very nature (as suicidal thinking is often considered a symptom of depression in and of itself). Initially non-suicidal self-harm has also, in other studies, been associated with increased suicidal behavior later on (Bloch, 2016).

The study also found a weaker but still present association between obesity (compulsive overeating, which is now classified as a medical disorder), smoking (a form of substance abuse), and suicidality. The one surprising finding of the Strandheim (et al., 2014) study was that binge drinking was not associated with a higher risk of suicidal behavior, but noted that given that the study was exclusively on Norwegian teens, who often binge drink socially, the social aspects of the drinking may have had a protective effect. Social isolation has been associated with greater risk of suicidal behaviors. All of these findings point to the need for greater awareness and vigilance of suicidal behavior in any adolescent with other mental health issues, including but not exclusively anxiety and depression.

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Bullying and Social Media Use

Heavy use of social media use has also been strongly associated with depressive symptoms and corresponding suicidality, according to the American Academy of Pediatrics. (AAP) This has often been called the Facebook effect, or the sense that individuals are leading much cooler, better existences based upon their carefully curated online lives. But social media use overall, not just Facebook, Instagram, and sites that allow for public sharing of personal information, has been associated with greater suicidality (both ideation and attempts) as well as higher levels of depression: self-reported use of video games and simply being online more than five hours a day increases an adolescent’s risk (Shain, 2016). Whether this is due to a correlation or causative factors is unclear, as adolescents with social problems and who are socially withdrawn from their peer group may be more apt to seek refuge in video games and online.

The AAP study found other Internet-related factors may contribute to the association. The Internet allows depressive teens to search forums related to suicide, including ways to commit suicide. These may include pro-suicide websites and online suicide pacts or materials geared to individuals with serious illnesses, which still provide adolescents with potential tips to commit suicide and normalize the behavior. The Internet can also intensify the copycat effect of suicidality for adolescents, given that teens who learn about suicide online may be more apt to replicate the behavior (Shain, 2016).

The Internet can also provide a forum for bullying in and of itself. Online behavior of teens is unregulated in a manner that interactions during the school day are not. Teens can engage in social aggression directed at their peers in a fairly free manner, often without any oversight from adults, and adults may poorly understand the degree to which teen’s social lives revolve around the computer. Certain teens may be more apt to find themselves the target of bullying, particularly LGBT teens, who are at a higher risk of suicidal behavior already.

Antidepressant Use

Use of antidepressants is positively associated with a higher risk to adolescents. Once again, in regards to this particular factor, the question of correlation versus causation arises. Teens who are on antidepressants may be presumed to be suffering at depression at a higher rate than the general adolescent population. On the other hand, the increased risk of taking certain kinds of antidepressants for teens has been strong and demonstrable enough for the FDA to issue a specific black box warning regarding the subject (Shain, 2016). It should be noted that the warning, which has existed since 2004 and the specific rise of prescribing the new class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), does not prohibit the prescription of the flagged antidepressants for adolescents but highlights the need for greater monitoring of teens who are taking these medications (Shain, 2016).

Problems Caused By Adolescent Suicide in Society

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