MANAGING YOUTH SUICIDAL BEHAVIOUR
EXTRACTED FROM THE 4R'S: -By Stephen J Edwards & Jon J Pfaff

ISSUES

Australia has on e of the highest rates of suicide in young people in the industrialised world. The frequency of suicide has risen considerably since the 1950's and now claims more lives than motor vehicle related deaths .While suicide is statistically a rare event, the incidence of attempted suicide is much higher, with ratios of attempted to completed suicide reported from 50:1 to 120:1. While males complete suicide four times as often as females, females attempt suicide four times as often as males. Approximately 10% of our country's young people attempt suicide at least once.

Suicidal behaviour in young people can be conceptualised along a continuum, from suicidal ideation to attempted and completed suicide. Suicidal ideation may consist of non-specific, fleeting thoughts of death; well-organised plans to end one's life; or psychotic command hallucinations to kill oneself. Attempted suicide ranges from verbal threats to serious, unsuccessful attempts. The term suicide is applied when individuals die from their own direct or indirect actions which they believe would result in death. Overdosing, cutting, or piercing behaviours represent an attempt to cope with painful feelings. Such self-harming behaviours are evidence, not only of poor coping skills, but also of a higher risk for completed suicide at some later time.

Young people with the recent onset of sleep problems, mood disturbances, low self-esteem, a loss of hope, substance use, and/or anxiety, should alert one to the risk of suicide.

RISK FACTORS

Apart from one's "gut feeling" the following factors can be used to assess the risk of suicide:

• Current Thoughts of Suicide - Suicidal ideation can range from non-specific, fleeting thoughts of death; to well-organised plans to end one's life; to psychotic command hallucinations to kill oneself. The frequency and intensity of these thoughts alters the risk.
• Suicide Plan and Method - The more detailed and feasible the plan, the greater the risk. While young people who complete suicide usually employ highly lethal methods (eg. hanging, carbon, monoxide poisoning, firearms), risk assessment must also consider the young person's beliefs about the lethality of their chosen method. The timing of the plan may affect the urgency of clinical intervention.
• Availability - If the means of carrying out the plan are readily available, the risk increases. When the means are not presently available, one must determine if the young person has the ability to acquire them.
• Rescue - When the young person plans to attempt suicide in an isolated location, with a low chance of discovery, the risk for completed suicide increases.

NATIONAL CONTACT NUMBERS

The following telephone numbers are toll free & accessible throughout Australia.

• They are useful contact numbers to give at risk young people for telephone counselling.
• In crisis situations these telephone services will refer the young person to the nearest professional health service.

1. Kids Help Line………………………………………1800 55 1800
(For young people 5 years to 18 years old: 24 hours 7 days a week)

2. Life Line……………………………………………..13 1114
(All ages: 24 hours 7 days a week.)

3. Parentline ...................................................................13 2289

Websites

Lifeline Australia: www.lifeline.org.au
Suicide Information & Education Centre: www.siec.ca
Reach Out: www.reachout.asn.au
Grieflink:    www.grieflink.asn.au
Suicide pamphlet

Also of interest:  http://www.clockhealth.com.au/ --  The website includes information for young people, teachers and parents on areas such as mental health, healthy eating and lifestyle, stress management, sexual health, relationships, licit and illicit drugs