children s health issues
Suicidal Behavior in Children and Adolescents
Treatment
Sometimes hospitalization Precautions to prevent future attempts Treatment of any disorder contributing to risk of suicide Referral to a psychiatrist and psychotherapy Children who express thoughts of wanting to hurt themselves or who attempt suicide need urgent evaluation in a hospital emergency department. Any type of suicide attempt must be taken seriously because one third of those who complete suicide have previously attempted it—sometimes an apparently trivial attempt, such as making a few shallow scratches to the wrist or swallowing a few pills. When parents or caregivers belittle or minimize an unsuccessful suicide attempt, children may see this response as a challenge, and the risk of subsequent suicide increases. Once the immediate threat to life has been removed, the doctor decides whether the child should be hospitalized. The decision depends on the degree of risk in remaining at home and the family’s capacity to provide support and physical safety for the child. Hospitalization is the surest way to protect the child and is usually indicated if doctors suspect the child has a serious mental health disorder such as depression. The seriousness of a suicide attempt can be gauged by a number of factors, including the following: Whether the attempt was carefully planned rather than spontaneous—for example, leaving a suicide note indicates a planned attempt Whether steps were taken to prevent discovery What type of method was used—for example, using a gun is more likely to cause death than taking pills Whether any injury was actually inflicted What the child's mental state was when suicide was attempted It is critical to distinguish serious intent from actual consequences. For example, adolescents who ingest harmless pills that they believe to be lethal should be considered at extreme risk. If hospitalization is not needed, families of children going home must ensure that firearms are removed from the home altogether and that medications (including over-the-counter medications) and sharp objects are removed or securely locked away. Even with these precautions, preventing suicide can be very difficult, and there are no proven measures for successfully preventing it. If the child has a disorder that may contribute to risk (such as Depression and Mood Dysregulation Disorder in Children and Adolescents or Doctors usually refer children to a psychiatrist, who can provide appropriate drug treatment, and to a therapist, who can provide Psychotherapy such as cognitive-behavioral therapy. Treatment is most successful if the primary care doctor continues to be involved. Family members of children and adolescents who committed suicide have complicated reactions to the suicide, including grief, guilt, and depression. They may feel purposeless, detached from everyday activities, and bitter. They may have difficulty continuing with their life. Counseling can help them understand the psychiatric context of the suicide and reflect on and acknowledge the child’s difficulties before the suicide. They may then be able to understand that the suicide was not their fault. After a suicide, the risk of suicide may increase in other people in the community, especially friends and classmates of the person who committed suicide. Resources (such asa toolkit for schools) are available to help schools and communities after a suicide. School and community officials can arrange for mental health professionals to be available to provide information and consultation. 