Suicide in recent years has increased by 300% in adolescent males aged 15 to 19 years old. Male adolescents were 6 times more likely to commit suicide then a female (Adolescence, C. O.,2000). Suicide between the ages of 15 to 19 is the third leading cause of death for adolescents (Edelman, C., Kudzma, E., Mandle, C., 2010). Adolescent suicide is preventable as problematic adolescents tend to give clues that can be verbal and nonverbal. It is important for people around the adolescent to recognize important warning signs.
There are many factors that contribute to suicide such as family history of mental illness, substance abuse, history of child abuse, and any type of abuse the adolescent has faced are leading factors of suicide. Depression leading from social problems, family problems, or environmental issues can also lead to suicide. There are three levels of suicide prevention first being the primary prevention which is reducing the risk factors and promoting the factors to end suicide by educating and giving the awareness of suicide. The second prevention is secondary prevention where a person has tendency of suicide and has been assessed as suicidal. It is then that the person is offered crisis counseling to help address any underlying problems and gets screening for suicide. The third prevention is the tertiary prevention where long term services and program are used to help the suicidal person because of the consequences of attempted suicide (Georgia Institute of Technology, 2018).
For a nurse it is hard to assess if an adolescent child is suicidal or not. There are warning signs & symptoms that a nurse can look for to make an assessment. Behavioral changes such as substance use and abuse, writing notes or letters, poems and essays with suicidal material written in them, the adolescent becomes more of a risk taker, and increased physical violence to themselves or others.(Edelman, C., Kudzma, E., Mandle, C., 2010). Other symptoms include mood change like increased anger, sleep problems, hearing voices or talking to people not there, taking interest in death related things, and an expression of hopelessness (Edelman, C., Kudzma, E., Mandle, C., 2010). Other symptoms that are physically noticeable are posture, body movements, unusual dressing, and grooming and hygiene (Jarvis, C., 2012).
New Jersey state has a peer support & suicide prevention hotline where people can call 1-855-NJ-HOPELINE 24 hours a day to talk to someone confidentially. They can help provide support to people who just needs someone to talk to when life becomes stressful. The NJ hopeline can provide further counseling, support and referrals to local resources in your difficult times. Another resource the state offers is nj211 which also can help not only for suicide, financial assistance, food, utilities, and housing. The local community resource that that helps suicidal people is the National Alliance on Mental Illness organization. The organization offers help to all ages providing them the programs to go to receive education and peer to peer learning. The National Alliance on Mental Illness offers professional help and support by providing trained professionals. The organization can be reached at http://www.naminj.org/ or 732-940-0991.
As a nurse and health care provider it is important to provide their patients with prevention methods. It is important for a nurse to asses the mental health status of the patient and offer help. Help can be in the form of patient safety, or referral to a religious organization, peer to peer help, and educating the patient on understanding self-harm. The nurse will educate the patient on coping skills to help the patient handle the stressful situation they are going thru.
Depression is “a common and serious medical illness that negatively affects how you feel, the way you think and how you act” (American Psychiatric Association, 2013). Depression can come on gradually or it can arise suddenly, after a crisis situation such as a death of a loved one or a divorce (Jarvis, 2016). Depression can occur in children and adolescents. Nearly 20% of teenagers suffer from depression at some point (I Need a Lighthouse.org, 2018).
Signs and symptoms of depression can mimic some “typical” teen behaviors so it may be hard to determine if a teen is “just being a teen” or if he or she is exhibiting signs of clinical depression. Signs can include inability to concentrate, irritability, angry outbursts, and changes in eating or sleeping habits (Mayo Clinic, 2017). Illicit drug use can also have similar side effects. Therefore, it is important to be alert for other factors that may be contributing to this behavior in order to identify a teen at risk for depression.
Teenagers are faced with fluctuating hormones and major changes to their bodies. This can make them seem “moody” and disengaged. Teens are learning how to manage these changes as well as their evolving emotions. They also are learning to cope with stresses in their lives such as peer pressure and family expectations. If a teen is overweight or underweight; has been the victim of bullying or abuse; or has a physical, mental, or developmental disability, this can increase his or her likelihood of experiencing depression (Mayo Clinic, 2017). Teens need to learn coping skills and stress management. This is an example of primary prevention. A supportive home environment with open communication is needed as well.
Teens who have a family history of depression or other mental health issues are at increased risk for experiencing depression, as are those who grew up in a dysfunctional home environment. Many of these teens do not learn the coping skills needed to manage their day to day experiences, or they have learned negative coping skills such as alcohol and substance abuse.
When these mood or behavior changes also include feelings of sadness, low self-esteem, self-harm, and/or thoughts of suicide, and have been occurring for greater than 2 weeks, immediate intervention is needed. Secondary prevention equals early detection. There are several screening tools for depression including Patient Health Questionnaire (Jarvis, 2016) and the Beck Depression Inventory-II tool (Bennet, Jones, & Smith, 2014). The results can help determine appropriate interventions. Nurses can help connect teens and parents with a counselor or support group.
Tertiary prevention is preventing or minimizing long term effects of depression (Bennett, et.al., 2014). Therapy and medications are ways to help treat and manage depression. The Crisis Center of Family Services is a local resource in Green Bay, WI for counseling and crisis services. Bellin Health also has a psychiatric center with inpatient and outpatient services.