In an effort to raise awareness, Record editor Terry Farrell recently had an in-depth discussion with a couple of St. Joseph’s Hospital’s most respected authorities in the field of teen distress. Vicki Sheppard, clinical nurse leader for crisis and SANE (sexual assault nurse examiner) services, and David Hext, outreach counsellor for adolescent outpatient services, have made careers of helping teens with mental health issues. The following is the second of a two-part series.
According to the Canadian Mental Health Association (as published on the Canadian Children’s Rights Council website, www.canadian crc.com), suicide and suicidal thoughts among teens is more prevalent than ever before.
In a survey of 15,000 Grade 7 to 12 students in British Columbia, 34 per cent knew of someone who had attempted or died by suicide; 16 per cent had seriously considered suicide; 14 per cent had made a suicide plan; seven per cent had made an attempt and two per cent had required medical attention due to an attempt.
“I see a lot of suicidal teens – some of them have cut, some of them have taken overdoses, some of them have just said they are suicidal, and you really have to ask people what that’s all about, because I think a lot of people use suicidal ideations as a means of problem-solving,” said Sheppard. “People become overwhelmed with their problems and they have thoughts of ending their life.”
She said it’s a fact of life now that wasn’t present when she was growing up.
“It was a word I never knew until I was in my 20s.”
“It’s something that has become a part of our vocabulary, where it didn’t used to be,” agreed Hext.
“Suicidal ideation, thinking about it more elaborately, that’s the first stage of suicidality,” said Hext. “Thinking about not only how to do it, but what happens after you die, what about the funeral service, how many people will be there.
“Then there’s suicidal gestures, which might mean taking seven pills for a headache; it might be drinking a bottle of whisky while driving your car; it might be snowboarding in out-of-bounds areas and taking wild chances – anything that is really reckless. Then there is suicide attempts, and then there is completion. So there is four steps.”
There are signs parents can look for that might suggest their children are having suicidal thoughts.
“One of the real danger signs is if your child is stockpiling (acetaminophen) pills,” said Hext.
“That’s scary because that is very dangerous.”
Another clear warning sign is the giving away of belongings.
“Here, have this – I don’t need it anymore – that’s a real red flag,” said Hext.
Good-bye notes in journals and sudden isolation from friends are other warning signs.
Sheppard said the most important way to address such thoughts is to do just that: address such thoughts. Talk about it.
“It’s talking to the teens about what they mean when they say that,” said Sheppard. “For a lot of teens, you hear ‘I don’t want to die. I just don’t want to feel what I am feeling.
“For a lot of people around them, the talk of suicide is kind of the end of the conversation; for me that’s the beginning. That’s when I ask what’s that all about? For a lot of people, it’s about problem solving. They have problems that are overwhelming them. If you can help them with those problems, the (suicidal) thoughts go away.”
“Approach your child, one on one,” said Hext. “Ask him or her directly: We’ve seen this, we’ve seen that, and we are really worried. Let’s talk about it. They won’t always tell them the truth, but it’s a start.”
Cutting: A new phenomenon
There was a time when taking a razor blade to one’s arm meant only one thing: suicide attempt.
Not so, today.
“Cutting,” as it’s known these days, is not necessarily a suicidal act. It’s an act of self-injury, but not meant to be fatal.
“I’ve had mothers call me in a complete panic, saying ‘my daughter has started to cut. She’s killing herself,” said Sheppard. “But it may not be about that at all.”
“It’s an instant way in changing the way you feel,” said Hext.
It redirects the pain of a situation. Hext added it is “very habit forming, and seems to be epidemic.”
According to the Canadian Mental Health Association website, an increasing number of teens are using cutting, and other forms of self–harm, such as burning, as coping mechanisms.
“People who self-injure are not trying to end their lives, but they can experience those thoughts. When they self-injure, they are trying to cope with difficult or overwhelming thoughts or feelings.”
Cutting is most common among teenagers – teenage girls, specifically.
The CMHA advises that anyone involved with self-harm seek help – if not professional, at least seek advice from someone you trust.
For a parent concerned about their child and signs of self harm, communication is key.
For more information on the signs of self-injury, see the CMHA website at bit.ly/1CmJQli
Eternal optimist
Sheppard said that while the issue is real, she remains an eternal optimist.
“There are people that I think I haven’t helped, and they do get better and I don’t know why – and there are people who don’t get better. But I always have hope.”
Dealing with teens in distress every day can be a daunting task. Sheppard said there are times when she feels as though she is dealing with the majority of teens in her community. But there is always one time of the year that brings her back to a positive light.
“It can seem like sometimes there’s this thought that this is the whole world, because that’s all you see,” she said. “But then I look at the grad pictures in the paper every year and I realize that I don’t know most of the kids. That is such a great feeling.”
Hext said seeing teens he has helped in those pictures is also encouraging.
“I will look through them and see someone I know and think, wow, I worked with that person two years ago and he was really struggling.
“Now he’s smiling, he’s graduating. I know that doesn’t mean all his problems are over, but it’s a start.”