25. Youth Suicide: Prevention Works! Presented by: Sue Eastgard, MSW Director, Youth Suicide Prevention Program of Washington State www.yspp.org
Notas do Editor
(Data from 7 different state/city based Youth Risk Behavior Studies conducted within the past 10 years). ** http://transdada.blogspot.com/2006_11_19_archive.html
GLBQ youth are around 21/2 times more likely than their peers to attempt suicide regardless of age and family background. (Russell & Joyner. Adolescent Sexual Orientation & Suicide Risk: Evidence from a National Survey. August, 2001.)
We also must be aware of the “high risk” groups for suicide such as GLBT youth and Native American youth.
We know that GLBTQ youth are at increased risk for suicide, self, harm, and depression. Because many GLBT youth who complete suicide haven’t disclosed their sexual orientation and/or gender identity to anyone, the actual impact of these factors on completed suicide are impossible to find.
Biological Clues: family history of mental illness, including mental illness; puberty; cognitive impairments, sexual orientation; disability; chronic illness; substance abuse, anxiety, mood disorders and conduct disorder. Sociological: peer pressure; family conflicts; drug and alcohol abuse; abuse; academic pressures; expectations of school, family and self; break-up in a relationship, societal reaction to sexual orientation/gender identity, negative school climate for GLBT youth; interpersonal losses; legal or disciplinary issues; bullying Psychological: negative self-talk, like “I’m no good” or “ I am not worthy”; poor distress tolerance; poor resiliency, internalized homophobia; poor interpersonal problem-solving; cognitive inflexibility – black and white thinking; Existential: failure to see the good in the world; hopeless; “What’s the point – it’s not going to change”, fear that situation will never improve for GLBT individuals **if all of the slots are full SIMULTANEOUSLY, we have a much higher concern for depression and potentially suicide. GLB youth report a significantly higher occurrence of suicide risk factors such as drug & alcohol abuse, victimization experiences, rejection by family/friends, internal conflict, feelings of hopelessness & depression, and attempted suicide by family member. For GLBTQ youth, studies establish links between attempting suicide and the following: gender nonconformity, early awareness of sexual orientation, stress, violence, lack of support, school dropout, family problems, homelessness, and substance use. (Remafedi G. Sexual orientation and youth suicide. JAMA 1999; 282:1291.)
This list is not exhaustive and a few of these can affect “straight” identified youth also. In fact, the majority of youth who report being called names such as “faggot” and “dyke” don’t actually identify as homosexual-they may experience this due to gender non-conformity and/or perceived sexual orientation, or because name calling such as this is prevalent within the school system. We also need to be aware of stressors that are apparent in the youth's life that may feel overwhelming and lead to depression, self harm, and suicidal thought. Stressors that all youth face, but that GLBTQ youth face higher instances of, some examples are: emotional isolation, social rejection, internal conflict, threat of personal loss, and family rejection (both real and the fear of). Homophobia: An irrational fear or intolerance of homosexuality, or behavior that is perceived to uphold and support traditional gender role expectations. Homophobia is expressed in many ways, some examples are: telling “gay” jokes, verbal harassment, physical violence, institutionalized discrimination Heterosexism: This bias is not the same as homophobia, but rather is the discrimination against non-heterosexual behavior due to a cultural or sociobiological bias. The basis for this bias is not found in the individual per se but rather has a broader cultural or biological basis that results in weighted attitudes towards heterosexuality over other sexual orientations. “Straight is the only way to be”
July 6 th 2008 NY Times article written by Scott Anderson cites a study by Richard Seiden involving suicidal individuals who were prevented from jumping off the Golden Gate Bridge; 94% of those in the study group did not attempt suicide again. One study participant reported being grabbed on the eastern promenade of the bridge after passers-by noticing him pacing and growing despondent,. He had picked out a spot on the western promenade that we wanted to jump from,, but separated by 6 lanes of traffic, he was afraid of getting hit by a car on his way there.
Individual: social and coping skills; supportive friends; the ability to distract themselves and/or to self-soothe, condemn heterosexism/homophobic remarks Family: adults who spend time and listen; reasonable boundaries and reasonable expectations; positive reactions to youth coming out, acceptance of all youth School: adults who pay attention and have clear expectations; clubs; sports; network of friends; counselors and caregivers; GSA (gay straight alliance) or other GLBT supportive organization, teacher/staff identified as GLBT friendly, GLBT inclusive policies, clear/explicit anti-bullying/harassment policies Community: plentiful opportunities for meaningful work and safe play; adequate mental health resources, GLBT friendly resources, GLBT youth drop in centers **What is important about protective factors is that one thing could make an enormous difference. It is not necessary to have each slot full to ensure safety for the young person. **We recognize that some of these factors are expressed in the ideal; we might look at them at targets for us to be striving for. GLBT youth report lower levels of protective factors such as adult caring, parental support (of sexual orientation and/or gender identity), high self esteem, positive role models, family connectedness, school safety.
Specifically related to the strategy of getting help there needs to be a greater understanding that the hospital is not necessarily THE answer. Bed space is limited; insurance is variable; mental health laws require that a suicidal person meet a specific standard for involuntary admission. Mental health agencies have limited resources for youth and families who are not receiving Medicaid. Community organizations have long waiting lists and in some cases limited expertise in teen depression and suicide. Advocacy is essential and still not a guarantee of service.
Given that mental health resources are very limited we are left to utilize what is available. Specialized training in assessment and intervention with at-risk youth is not necessarily a standard for all of these identified resources. Additional resources for GLBT youth and youth of color: Identified gay friendly adults/peers: staff/teacher at school, physician/health care provider, Mental health specialist, coaches, youth leaders, parents, & clergy, GLBT youth Drop in Centers such as Lambert House Crisis Clinic Teen Link (SEATTLE): (206) 461-4922 – King County GLBT specific: 1-866-4-U-Trevor (488-7386) Seattle Counseling Service for Sexual Minorities: 1-800-527-7683 – King County