SUICIDE COUNSELING AN URGENT NEED
19% of the students polled said they had attempted suicide.
• By DINA L. DOOLEN •
Citizen Staff Writer
A seventh-grader, he was attending a new school. His mother had just gotten remarried. His father no longer lived in Tucson.
Robert, 13, had tried to be tough and not let the stress of all of the newness get to him, but, one day, he snapped.
He tried to kill himself.
Now 15 and a sophomore in high school, Robert (not his real name) has tried to kill himself twice more.
“I tried to be a tough guy, but one day it just slam-dunked me,” he said, recalling his first suicide attempt.
Robert was one of 2,249 students in the 2000 Tucson Citizen High School Student Opinion Poll who said they had attempted suicide. That’s 19 percent of the 12,055 ballots cast, more than twice the national rate of 8.7 percent.
Robert credits a school counselor, his mother and his best friend with helping him get through his “seemingly incurable depression.”
“My Mom has been pretty open,” Robert said.
He also has several friends he can talk to now, plus, “I have a really good friend. He knows exactly where I’m coming from.”
Pima County statistics show, between Jan. 1 and June 1, four of the 63 suicides were teen-agers – ages 16, 17, 18 and 19. All four were males. By comparison, 42 homicides occurred in the county in that time.
Robert isn’t in counseling right now. The only counseling he’s had was after his first attempt.
“The second time and the last time, I figured I could get through this by myself,” he said.
Robert is not alone. Of the Opinion Poll respondents who said they had attempted suicide, 1,904 – or about 85 percent of those who said they had attempted suicide – had not sought help.
However, experts say the need for counseling is urgent.
Dr. William Marshall, the University of Arizona College of Medicine’s professor of clinical pediatrics, recommends counseling for anyone who has contemplated or attempted suicide.
“In something this serious, I’d pull out all the stops. Nothing is 100 percent, but rarely is counseling harmful,” he said.
The U.S. Surgeon General’s Call To Action To Prevent Suicide 1999 says, “A suicidal person should not be left alone and needs immediate mental health treatment.”
But mental health issues, such as depression, are still so stigmatized, many people who are suicidal don’t seek any help, let alone professional help.
“They may think that if you go to a psychologist you may be `crazy’ or stigmatized in some way,” Marshall said.
Yet, a person who already has attempted suicide is at high risk to try it again.
In addition, a person or public figure killing himself also may make suicide more appealing to somebody on the verge.
Robert was in just such a situation.
After his first suicide attempt, a friend of his killed himself at a party.
Robert said his friend, who frequently used LSD and “speed” was high on drugs when he killed himself and “didn’t know what he was doing.” Still, Robert found himself on the brink again. But he persevered.
“It made me depressed, no doubt about it,” he said. “But I kept saying, `No, I can’t do this.’ ”
Talking to people helped. He first told his stepsister that he had contemplated suicide. She told his father, who talked to him on the phone for four hours. His relationship with him has improved, but, Robert says, they still aren’t as close as before his parents divorced.
Robert’s latest suicide attempt was just after starting his freshman year. His mother walked into his room as he held a knife to his wrist.
“My freshman year, it hit me again,” he said. “I can’t really pinpoint what it was. I felt I couldn’t go on anymore.”
Experts say suicide attempts should not be dismissed as harmless. The Centers for Disease Control and Prevention report that, nationally, for every 16 attempted suicides, one is completed.
“Suicide attempts are expressions of extreme distress that need to be addressed, and not just a harmless bid for attention,” said the surgeon general’s report.
As far as adults are concerned, Robert echoes experts’ recommendations: The key is paying attention to kids’ needs.
“The best thing (schools) can do is, if a teacher or faculty member thinks a kid is depressed, refer them to a counselor,” Robert said.
“(Suicide) is quite a problem . . . at all schools and all around the world.”
Robert says all sorts of things lead kids to consider suicide. For some, they face “constant” name calling: “faggot,” “queer,” “nerd,” “geek,” he said.
“All kinds of derogatory names,” Robert said. “You hear it every day at school . . . at work.”
Others, like his friend who killed himself, are “too drugged up to know the difference between right and wrong. And, some just haven’t had a good life at all.”
For Robert, being able to talk to friends and family about his feelings has helped him tremendously. He has even helped others who have been on the brink.
“One of my really good friends now approached me,” Robert said. “After I talked to him . . . we started becoming really good friends.”
“I’m doing pretty good now,” he said.
If you have attempted suicide, why did you do it?
Personal loss 3%
Relationship breakup 3%
Felt isolated at school 2%
People teased me 3%
From whom did you seek help?
A family member 7%
A friend 9%
A counselor 3%
A teacher 2%
No one 10%
Detecting risks vital
Doctors are taking a more proactive role in trying to identify signs of suicidal behavior.
• By DINA L. DOOLEN •
Citizen Staff Writer
When it comes to suicide, silence may be deadly.
The fact is, more people commit suicide each year than are murdered, but only when people start openly talking about suicide will lives be saved and preventative measures taken, experts say.
Suicide is the third-leading cause of death among people ages 13 to 19 and the eighth-leading cause of death overall in the country.
But the complex and subtle issues related to suicide, as well as its associated shame and secrecy, make a public discussion difficult – leaving distressed teens alone in the dark.
“The hope is to have better acknowledgement by the public and help reach out to these kids,” said Dr. William Marshall, a professor of clinical pediatrics at the University of Arizona College of Medicine.
He said society needs to know that suicide isn’t all that rare.
In 1997, the latest year nationwide statistics were available, 2,029 people between the ages of 13 and 19 committed suicide, according to the U.S. Centers for Disease Control and Prevention.
That year, CDC found in its annual survey of 10,000 high school students around the country that 20.5 percent of teens seriously considered suicide.
A 1999 survey found that 19.3 percent had such thoughts.
The 2000 Tucson Citizen High School Student Opinion Poll found that 19 percent – or 2,249 of the 12,055 respondents – said they had attempted suicide.
Every suicide “attempt” should be taken seriously, experts say.
Dr. Richard Wahl, director of adolescent medicine in UA’s Department of Pediatrics, notes that the Opinion Poll results on suicide attempts correspond to national figures on teens who’ve contemplated suicide. (This year’s poll did not ask teens whether they had “contemplated” suicide.)
The CDC survey found that about 8 percent of U.S. teens have attempted suicide.
Experts say detecting risks early is the key to preventing suicide. And new doctors are learning to be more proactive, Marshall said.
“We now teach our residents, during routine (office) visits, to ask teens if they’ve considered hurting or killing themselves. Most teens in a confidential setting will tell you what’s going on,” he said.
Nationally, the American Academy of Pediatrics is encouraging doctors to regularly question teens during office visits. Teens are queried about their home and education life, social activities, drug status and concerns over their sexuality.
In the first half of the 20th century, pediatricians were focused on infectious diseases, which killed most people, Wahl says. Now, violence – be it from automobile accidents, homicides or suicides – is the big killer.
Recognizing this “new morbidity,” about 20 years ago, the American Academy of Pediatrics began trying to raise awareness of the risk of teen suicide. It is rededicating itself to that effort, Wahl said.
“As opposed to being completely in the hands of the pediatrician, the new morbidity is completely in society’s hands,” Wahl said.
Despite the group’s efforts, the teen suicide attempt rate has hovered between 8 percent and 9 percent.
From 1950 to 1990, the suicide rate for 10-19 year olds has tripled.
The single greatest predictor of teen suicide is the presence of a firearm in the home, Wahl said, noting that a gun in the home makes a teen more likely to succeed in a suicide attempt.
The 1997 Morbidity and Mortality Weekly Report noted that the suicide rate in the United States for youths 15 and younger is twice that of the average industrialized nation, primarily due to a firearms-related suicide rate 11 times that of the average of other industrialized countries.
Among 15- to 19-year-olds, firearms-related suicides accounted for 63 percent of the increase in all suicides from 1980-1996, says the CDC. A 1991 study found in 4 of 5 suicides committed in the home, a gun had been kept there.
In 1997, among 10- to 19-year-olds, 1,261 committed suicide with guns, and 54 percent of all gun deaths were suicides, according to the Johns Hopkins Center for Gun Policy and Research, which also cites 1992 research concluding that a gun in the home increases the risk for suicide there 4.8 fold.
While firearms may make a suicide attempt more likely to be successful, alcohol is a factor in half of all suicides.
“Research shows that almost all people who kill themselves have a diagnosable mental or substance abuse disorder or both, and that the majority have depressive illness,” states the Surgeon General’s Call to Action to Prevent Suicide 1999.
UA’s Wahl says many depressed adults and teens “self-medicate” with alcohol.
“Serious alcohol use is not uncommon among teens and it can lead to further depressive feelings,” he says.
Yet, pediatricians can do only so much, since most teens do not visit their doctor regularly. In fact, in this year’s Opinion Poll, most respondents who said they sought help after a suicide attempt said they turned to a friend or family member.
Schools must be careful in their approaches because suicide intervention has backfired, Wahl said. Instead, schools should deter teens, before they even consider suicide.
“Within the curriculum, they should focus on (teens’) resiliency, identifying their own strengths and support systems. It should let them know they have alternatives for support,” Wahl said.
Marshall makes similar suggestions, saying schools should offer information on depression, in order to make students realize that such feelings aren’t unique and can be relieved.
• a family history of psychiatric disorders (especially depression and suicidal behavior)
• a personal history of suicide attempts
• depression (about 90 percent of adolescent suicides have a diagnosable psychiatric disease, most commonly depression, and/or drug or alcohol abuse, and/or anxiety or impulsivity)
• substance and/or alcohol abuse (alcohol use has been associated with 50 percent of suicides)
• aggressive or disruptive behaviors
Source: American Academy of Pediatrics and U.S. Centers for Disease Control and Prevention
• Help On Call Crisis Line (24 hours): 323-9373
• Southern Arizona Mental Health Corp. (24 hours): 622-6000
Gays more at risk
More help from parents is one way to help stem the high suicide rate of this group, experts say.
• By DINA L. DOOLEN •
Citizen Staff Writer
While suicide is the third-leading cause of death among teens, it is the No. 1-killer of gay teens.
Research says gay teens are about three times more likely to attempt suicide than their peers, with homosexual males being as much as seven times more likely to attempt suicide than their heterosexual counterparts.
Local advocates for gay youth say the big reason gay teens are more at risk and make up about 30 percent of teen suicides is their parents.
“What I hear over and over and over again is that parents don’t know how to help their kids who are gay,” says Mike Pollack, coordinator for QueerVoice.
While most teens can get family support if they are having trouble at school, gay teens often are afraid to talk to their parents about their sexual orientation.
“The gay kid who is called `faggot’ is not going to run home and tell his parents because he doesn’t know how they’re going to react,” says Alan Storm, Sunnyside Unified School District’s student services director and president of the national Gay and Lesbian Education Network chapter here.
Records on gay teen suicides are not kept in Pima County, where four teens committed suicide between Jan. 1 and June 1.
While many consider Tucson progressive on gay rights, Storm and others note homophobia still is common in schools here. A GLSEN survey this year of about 700 students in Tucson found 90 percent had heard slurs such as “faggot,” “dyke” and “queer” on campus made by students and teachers.
“It’s just the last acceptable prejudice,” said Bill Jacobs of Parents, Friends and Families of Lesbians and Gays’ local chapter. “If a student called someone a `nigger’ or `kike,’ they’d be all over them. But, the teachers pretend they don’t hear (gay slurs).”
With that going on at school, teens need to be able to turn to family, say experts. And parents need to make sure their kids know they can come to them for help, Jacobs said.
“What I tell people is, when you’re taking that baby out of the hospital, you should look down at it and tell it, `I will love you forever, no matter what. And tell it that over and over again throughout life,” he said.
Despite homophobia in schools, Jacobs and others say more gay youth are realizing and accepting their sexuality at younger ages, which has led schools here and around the country to form clubs for gays, lesbians and their friends.
“It’s a start,” said Pollack of the five high schools in the area that recently started such clubs.
Physical and/or verbal abuse from peers and family members are not the only reasons gay teens consider suicide. Other reasons include social and emotional isolation and low self-esteem.
The Wingspan Youth Group, which meets every Saturday, and QueerVoice’s youth group, which meets monthly, give participants a sense of belonging they likely lack.
“By hearing each others’ stories, they know they are not alone and they can help each other,” Pollack said of the two groups, noting that QueerVoice’s group offers social events, something gay teens otherwise might not have access to.
Emotional health is one of the strategic priorities of the QueerVoice youth group’s board of directors, which is made up of its members. Pam, a facilitator for the Wingspan group, said some participants are dealing with suicide, though not all because of their sexual orientation.
Dr. Richard Wahl, director of adolescent medicine in the University of Arizona’s Department of Pediatrics, said pediatricians must realize that 10 percent of the population is gay.
“If one assumes that all of his patients are heterosexual, you’ll be misidentifying up to 10 percent of your clients,” said Wahl, also a UA assistant professor of pediatrics.
He said some of the most noted and respected research on gay youth suicide in the last 10 years has been done by Dr. Gary Remafedi at the University of Minnesota. Some of Remafedi’s latest work found gay adolescent males are seven times more likely to commit suicide.
PFLAG’s Jacobs said homophobic slurs seem to be the put-down of choice on campuses. Also troubling in the GLSEN survey, he said, is the fact that students were more likely than teachers to confront those using the slurs.
“What schools absolutely have to do is stop the harassment,” said Jacobs, who is co-president, with his wife, Anna, of PFLAG Tucson. “You’ve got to remember that almost all teens are going to consider suicide and anything you throw into the mix – like sexual orientation – is going to increase the chance they’ll try it.”
• Trevor Helpline: (800) 850-8078
A national suicide prevention hot line for gay, lesbian, bisexual and transgender youth, with counselors available 24 hours a day. It also provides general information. For more on the Trevor Project, go to www.trevorproject.com
• Wingspan, 300 E. Sixth St.
Community center for gay, lesbian, bisexual and transgender people. Its youth group for ages 13 to 23 meets every Saturday from 3-4:30 p.m.
For information: 624-1779 or www.wingspanaz.org
• GLSEN Tucson, 4800 W. Placita del Quetzal
For information: 520-743-4800, e-mail: Stormal@aol.com or on the Web: http://hometown.aol.com/stormal/myhomepage/index.html
• Parents, Families and Friends of Lesbians and Gays
P.O. Box 36264, Tucson, Ariz., 85740
It meets on the first Wednesday of each month at 7 p.m. at Rincon Congregational Church Fellowship Hall, 122 N. Craycroft Road.
For information: Confidential message phone: (520) 575-8660, e-mail: PFLAGTucson@aol.com or on the Web: www.pflag.org
• QueerVoice, 375 S. Euclid Ave.
For information: call 628-7223; (800) 771-9054 or e-mail: email@example.com
HIGH SCHOOL ORGANIZATIONS
Local high schools with organizations for gay, lesbian, bisexual and transgender students. They are gay-straight alliances:
• Amphitheater High School
• Canyon del Oro High School
• Desert View High School
• Tucson High Magnet School
• University High School
GRAPHIC: YOUTH SUICIDES: A CLOSER LOOK
PHOTO CAPTION: VAL CANEZ/Tucson Citizen
Most girls today think they have to be skinny to get a guy. Many girls that I’ve talked to say that they get jealous when they see skinny girls with a figure all up on guys.
It happens a lot at school. The girls with makeup and a figure have the boyfriends. Many girls today have become bulimic or anorexic. When will this all stop and when will we be able to accept who we are?
- Celest Garcia,
Desert View High School freshman