Youth suicide: the physician's role in suicide prevention

Article Abstract:

Since most young people who commit suicide have given warning signs to those around them, physicians are likely to have opportunities to intervene and prevent this tragedy. Many high schools now offer suicide prevention programs, but a research article in the December 26, 1990 issue of The Journal of the American Medical Association questions their effectiveness. The results showed that attempters were more disturbed by the suicide prevention programs, had more negative attitudes, and were less likely to seek help or tell others about their feelings, than nonattempters. Attempters continued to believe, even after the programs, that suicide was a possible solution to their problems. Suicide prevention programs that target young people in general are probably not as effective as those that could identify youth at risk for suicide, about whom much is known. Five main risk factors have been identified, including: demographic factors (white males, Native Americans, older youth, and those who have attempted suicide, are at higher risk); presence of a psychiatric illness (conduct or mood disorders); psychosocial, personality, and environmental factors (early loss, aggression, or substance abuse); genetic or familial variables (biological relatives of adopted suicide victims have a higher rate of suicide); and biological factors (levels of serotonin, or growth hormone). Help for suicidal patients may involve psychosocial and psychotherapeutic intervention, medication, psychiatric consultation, and environmental intervention. Primary care physicians can play a pivotal role by making particular efforts, such as contacting families, helping in problem-solving, and making appropriate referrals. Public health activism aimed at restricting firearm access, improving education about the warning signs of suicide, and developing community clinics for youth at risk should be included in physicians' professional activities. Research is needed to better identify people at risk, and learn more about preventive interventions. Often, physicians see suicidal young people in their offices only days before they make an attempt. Failure to detect and intervene to prevent an attempt can lead to irreversible tragedy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physicians, Medical professions, Social policy

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Adolescent suicide attempters: response to suicide-prevention programs

Article Abstract:

Suicide-prevention programs for adolescents, most of which follow a model that considers suicide a result of stress common to that stage of life, are increasingly widespread in high school curricula. However, the effectiveness and safety of such programs need to be evaluated. To this end, the effects of two suicide programs serving high school students were assessed. Several schools without such programs served as controls. The prevention programs lasted three or one and one-half hours, and were presented by teachers who had received several hours of training. Students were given a 48-item questionnaire to complete before and after participating in the programs: the questionnaire concerned such matters as warning signs of suicide and attitudes about seeking emotional support. The controls completed a questionnaire that omitted questions about the programs. Based on consistent responses to a question regarding previous suicide attempts, students were classified as attempters (63) and nonattempters (910). Attempters were more likely than nonattempters to agree with such statements as suicide is a possible solution for someone with a lot of problems and, if depressed, it is a good idea to keep such feelings to yourself. They were also more likely to have called a hot line or telephone crisis counseling service. Reactions of 35 attempters and 524 nonattempters to the suicide prevention programs were compared; the programs seemed to have little impact on students' attitudes toward suicide. In fact, there were signs of negative effects of the programs. Attempters felt that talking about suicide in the classroom could make some people more likely to try to kill themselves. They were more upset by the programs, and were less likely to think that other students should participate in them. In summary, suicide-prevention programs for students in this age group deserve careful evaluation; the development of alternative approaches to this problem seems warranted. The authors note that the prevalence of suicide attempts was greater, as indicated by the questionnaire, than in studies based on interviews. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Surveys, Adolescent psychology

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Suicide prevention strategies: A systematic review

Article Abstract:

Evidence for the effectiveness of specific suicide-preventive interventions are examined and recommendations for future prevention programs and research are made. Results reveal that physician education in depression recognition and treatment and restricting access to lethal reduce suicide rates.

United States, Care and treatment, Methods, Risk factors, Depression, Mental, Depression (Mood disorder), Health education

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