by Brenda Keller
How common is suicide among children and youth:
The World Health Organization reports that suicide is a leading cause of death worldwide and one of the three leading causes of death for young people under 25. Studies show that youth in foster care are two and a half times more likely to contemplate suicide than youth not in foster care and four times more likely to attempt suicide. Building research indicates a strong connection between childhood abuse or trauma and increased risk of suicide attempts and completions. Suicide is a very serious and common issue in foster care, but unfortunately, not enough education and training is provided for caregivers involved in the lives of these young people.
Warning signs and risk factors:
As trusted adults working with young people who have experienced trauma, we need to understand what to look out for that might indicate a youth is at risk for experiencing suicidal thoughts and behavior and notice when youth are actually showing signs that they are likely experiencing suicidal thoughts. The first step is understanding the difference between risk factors and warning signs. Risk factors are characteristics or conditions that increase the chance that someone may attempt suicide. They are a source of distress. Risk factors decrease our resiliency. Suicide warning signs are indicators either through what youth say or do that they may be in acute danger of attempting suicide. It is changes in behavior or the presence of entirely new behaviors.
Common risk factors often include symptoms of or being treated for depression, use of substances, being bullied, access to lethal means, parent’s divorce or separation from family, exposure to suicide, having a history of experiencing abuse/neglect, lack of friends, previous suicide attempt/s, chronic physical pain, family history of suicide, recent relationship break up, exposure to domestic violence, exposure to a traumatic event, history of sexual abuse or assault, and severe, prolonged stress. This list includes many experiences that youth in foster care are likely to have experienced, which underlines the importance of being aware of and actively looking out for risk factors and warning signs in the youth we work with.
Common warning signs often include if the youth talks about killing themselves, feeling hopeless, feeling trapped, being a burden, having no reason to live, having unbearable pain, experiencing a painful loss, feelings of humiliation and/or shame, and experiencing a painful or difficult change. Other common warning signs that involve observable behavior include increased use of drugs/alcohol, youth looking for an actual suicide method, withdrawing from activities, decrease in self-care, a sudden loss of concentration, isolating from family, friends, or trusted adults, sleeping too much or too little, telling people goodbye, giving away possessions, and acting aggressively/irritable.
Why is it important to be aware of and proactively address suicide risk among youth in the Child Welfare system? Many professionals working in the field have minimal to no formal training on suicide prevention or how to respond to youth who report experiencing suicidal thoughts. Suicide-specific training is not commonly or frequently offered in our organizations. And until recently, with the current health pandemic opening up more discussion around the topic of suicide, there were not many workshops or continuing education opportunities around suicide prevention. It is sometimes believed that talking to a youth about suicide can actually trigger them to become suicidal, but this is a total misconception. The opposite is true. Often youth do not initiate the conversation when they are experiencing suicidal thoughts because of fear of judgment or overreaction. As trusted adults in their lives, it is our responsibility to start these conversations anytime we see warning signs of suicide.
Responding to youth who have risk factors:
One of the ways we can attempt to mitigate the risk factors many of our youth have is by counterbalancing that risk by identifying existing and cultivating new protective factors. Protective Factors are characteristics, traits, or supports that make an individual less likely to attempt suicide. They are an element of resilience. Some common protective factors are access to effective mental health treatment, family and friend support, having a trusted adult in their life, healthy coping skills, lack of easy access to lethal means, having a sense of purpose, hope for their future, effective problem-solving skills, willingness to seek help when needed, ability to talk about and get advice about their future plans, believing they have control over their future, and cultural and religious beliefs that discourage suicide. Each of us can play a role in increasing resiliency, protective factors, and coping with the youth we work with. Because foster youth have been separated from their families and experienced frequent moves, they often have little to no social support. Helping youth build a stronger social support system is a great place to start building that resiliency.
Suicide Prevention Resources:
Below are a few of the many resources available to help youth experiencing suicidal thoughts or behaviors and the adults who care about them:
988 has been designated as the new three-digit dialing code for the National Suicide Prevention Lifeline. When people call, text, or chat 988, they will be connected to trained counselors who listen, provide support, and connect them to resources.
Ask Suicide-Screening Questions (ASQ)
The ASQ tool is a brief suicide prevention screening tool validated for use with youth of all ages as well as young adults. It is a set of four questions that take less than 20 seconds to ask.
The Columbia Suicide Severity Rating Scale (C-SSRS)
The C-SSRS is a brief suicide screening tool validated for use with youth ages 11 – 18. It is a set of six questions that helps differentiate between suicidal thoughts and suicidal behavior.
The Trevor Project is a suicide prevention and crisis intervention organization that supports young people 24/7 with suicidal thoughts who identify as LGBTQ+
Texas Suicide Prevention Collaborative
The Texas Suicide Prevention Collaborative builds and supports locally available resources for youth and organizations that serve youth who may be at risk of suicide.
Words to Use When Talking About Suicide by the National Child Traumatic Stress Network
Provides information to help youth know what words to use when talking about suicide with friends and peers. This fact sheet includes when you should ask, examples of what to say, when to get help, as well as next steps.
Suicide Prevention Resource Center
Funded through SAMHSA and operated by The University of Oklahoma Health Sciences Center, the Suicide Prevention Resource Center provides education, resources, and training on suicide prevention.
Foster Care Providers: Helping Youth at Risk for Suicide
A fact sheet issued by the Suicide Prevention Resource Center that addresses suicide prevention among youth in foster care.