It springs from pain and results in ripples of anguish. Suicide always is a tragedy, but when the life that ended had just begun, the loss is magnified. And such losses are mounting.
Between 2007 and 2015, the suicide rate doubled among girls, reaching its highest in 40 years, and rose by more than 30 percent among teen boys, according to a 2017 report by the Centers for Disease Control and Prevention. Suicide is the second leading cause of death in U.S. teens (accidents cause more), and Oregon ranks among states with the highest numbers.
Students in Catholic schools are not immune, and high schoolers in the Archdiocese of Portland also have taken their lives, including a senior at Marist High School in Eugene last spring and a student from Central Catholic in Portland two years ago.
This growing public health crisis — and the breadth of heartbreak it represents — means “suicide is everybody’s business,” said Phyllis Alongi, a licensed professional counselor and clinical director of the New Jersey-based Society for the Prevention of Teen Suicide.
‘A bundle of different reasons’
“Teen angst” is a cliche, and adolescence always is filled with intense emotions and experiences. But many experts say the suicide rate is linked to increasing cases of clinical anxiety and depression; nine out of 10 youths who die by suicide have a mental health condition, according to the National Alliance on Mental Illness, and a 2016 study by the journal Pediatrics found the number of teens reporting a major depressive episode climbed 37 percent over a nine-year period.
A report last year by Children First For Oregon, a nonprofit advocacy group, concluded suicide is more prevalent on a per capita basis in rural parts of the state — reflecting a reality across the country. Suicide rates in rural regions are higher for a variety of reasons, including the prevalence of firearms, limited access to mental health and emergency health care services, and economic hardship, according to the CDC report.
Nationwide, lingering economic stress from the Great Recession in the 2000s may influence the number of suicides.
“In times of economic prosperity, suicide rates go down,” said CDC suicide expert Thomas Simon. “In times of economic instability, rates go up.”
Still another factor may be teens’ immersion in technology. A growing body of research shows that internet and social media use can influence suicide-related behavior. It leads to constant comparisons, isolation and a new form of bullying, said Alongi.
“Bullying has always existed, and it always attacks the basic dignity of another human being through demeaning the person,” writes Denver Archbishop Samuel Aquila in a column following several teen suicides in Colorado last year. “But when we crossed the threshold in 2012 of more than 50 percent of Americans owning a smartphone, bullies gained access to their peers on a scale never seen before.”
Chuck Blickle, a counselor at Central Catholic, points out that in past generations, young people had a respite from teasing or bullying on the weekends or during summertime.
“Now students never get away from it,” he said.
Dr. Kyle Johnson specializes in child and adolescent psychiatry at Oregon Health and Science University’s Doernbecher Children’s Hospital and is responsible for tending to kids who have attempted suicide. In his experience, teens’ social media engagement can be a Catch-22 for parents. He’s seen instances in which adolescents attempt or contemplate suicide after parents take a phone away or put limits on use. “It’s complicated,” said Johnson. “Kids feel like, ‘That’s my world and you’re taking away connections with friends, the way I cope.’”
More boys end their lives than girls — 14 per 100,000 boys compared to five per 100,000 girls. Yet the drastic increase in the number of girls dying from suicide is alarming, and the reasons for the 40-year high are not clear.
Johnson said one of his hypotheses is that girls may be more vulnerable to online social aggression.
Caitlin Ryan, a junior at Central Catholic, believes the overall suicide rate would be lower without the enduring stigma surrounding mental illness.
“Whenever people mention suicide, everyone quiets down, but we need to be talking about it,” said Ryan, who volunteers weekly at YouthLine, an Oregon hotline dedicated to preventing teen suicide and drug use. Youths can call or text 24 hours a day to connect with fellow teens or adults.
Ryan takes all sorts of calls. Peers are struggling with academic stress or their sexual orientation, with self-harm behavior or worries that they might be pregnant.
“Some just want a friend to talk to,” she said.
Sister Michael Francine Duncan, a Sister of St. Mary of Oregon and a licensed counselor, said there typically are “a bundle of different reasons” why a teen would contemplate suicide.
Risk factors include not only a clinical diagnosis but also exposure to suicide by a peer or family member, loss or trauma. Along with cyberbullying, “things that sensationalize or glamorize suicide are risk factors,” said Alongi.
Some contend, for example, that “13 Reasons Why” — a teen-oriented Netflix drama about a high school student who takes her own life — glamorizes suicide as a way to escape trauma or emotional pain.
How parents can help
The good news is that four out of five youths give warning signs before attempting to take their own life, according to the Jason Foundation, a suicide-prevention nonprofit.
Warning signs include talking about suicide; statements about feeling hopeless, helpless or worthless; a preoccupation with death; taking unnecessary risks or exhibiting self-destructive behavior; or a loss of interest in the things a teen typically cares about.
“The signs are not always in your face, but there are common signs,” said Alongi. She added that a teen’s distress may “come out in artwork or a school assignment or a journal,” which is why schools play an important role in prevention.
Two of the most effective ways parents can help their struggling son or daughter is through self-education about mental health and frank conversations with their child. There’s a myth that talking about suicide “plants the idea in their head,” said Alongi. “Research tells us that we need to talk about it with them,” she said, adding that it’s OK to tell your child about your discomfort. “Tell them, ‘This is really uncomfortable to talk about.’”
Parents also must reach out to mental health professionals, “who are the ones who can determine the risk level,” said Alongi. Some teens will benefit from medication and many from therapy.
Johnson notes one of the earliest preventions is “ensuring kids feel connected.”
At-risk kids “feel alone, isolated and neglected,” but bolstering friendships through faith-based youth groups, sports and other extracurricular activities can help, he said.
Even if a child does not exhibit warning signs, Johnson suggests parents buy lock boxes for medications. About 90 percent of the youths he sees who attempt suicide do so my means of an overdose, often using over-the-counter medications common in homes, said Johnson.
He added that parents with firearms must be vigilant with storage. “Guns are the No. 1 method that a teen completes a suicide,” said Johnson. More than 80 percent of teens who commit suicide with a gun are using a family member’s firearm, according to CDC data.
Sister Michael Francine said that when a teenager is struggling, parents need to offer compassion and love but also take a long-term view.
“It’s an ongoing job” to help a teenager who’s at risk of suicide, she said. It requires parents to spend ample time with their child and listen and observe attentively.
“It’s not a matter of talking to them once or twice or taking them to therapy and then thinking they’ll snap out of it,” she said. “It takes time to help them find stability, help and hope.”