The Thought And Act Of Teen Suicide

Posted: April 04, 1991

Into every teen-age mind, the notion of suicide probably has intruded at some point.

"If you go into any school and hand out a questionnaire, 100 percent would say they've thought of suicide," said Dr. Jerry Kaplan, Hahnemann University professor of clinical pediatrics. "There's no one who hasn't read 'Hamlet' and had it cross their mind.

"To think about suicide is not abnormal. But when it gets to be an obsessive thing, that's when you get worried."

To be or not to be - when that becomes more than an academic exercise, parents, teachers and counselors worry. They are taught to notice the warning signs of suicide - to watch for a child who drops out of sports and social programs, who talks about the world without him, who gives away his prized possessions.

A recent Gallup poll found that 6 percent of American teen-agers have tried to commit suicide and 15 percent say they have come close to trying.

Experts here says there's no way to document the extent of the problem or to determine how Philadelphia compares to the national average. But in 1989, the last year for which statistics are available, the state reported that 19 people ages 19 and younger committed suicide here.

However, these 19 deaths are believed to under-represent the problem,

because physicians may be reluctant to indicate suicide as a cause of death, said Dr. Herbert Mandell, chief of child and adolescent psychiatry at Albert Einstein Medical Center and Philadelphia Psychiatric Center.

"Suicide is the third leading cause of death after homicide and accidents" for teen-agers, Mandell said. "But are these really suicides or suicide equivalents, like when someone is depressed and plays chicken on the highway and dies, or he falls from a high structure?"

Philadelphia's estimated population for ages 10-19 is 218,839. If for every completed suicide, there are 50 attempts - as the Pennsylvania Department of Education says - or 100 attempts or gestures, as Kaplan cited - that would mean as many as 2,100 teens attempt suicide annually.

Teens considering suicide can call the city-run Suicide and Crisis Intervention hot line, which operates 24 hours daily at 686-4420. Also, the Roxborough-based Talk Line (483-TALK) for teen-agers has distributed posters throughout schools, and the School District has counselors in each school trained to recognize the signs of suicide.

"We tell our counselors that if a child even mentions 'life has no meaning' - that is a warning sign and we take it seriously. We encourage everyone to take it seriously," said Beulah Wilson, School District specialist for student support services. "Very few high schools in the city haven't had some threats - at least one in each school each year."

While across the state and nation, white teen-age boys are more likely to commit suicide, that statistic is reversed in Philadelphia. Of the 19 suicides here in 1989, 12 were committed by non-white males and five by white males - and one white and one non-white female.

"I think there are more minority suicides in part because of the stress these kids are under," Mandell said. "They're exposed to racism. They have less opportunities, while certain drugs may be more available. The overall stresses of living in hostile environment are not to be minimized.

"Also, Asian kids I have seen have the additional trauma of having been boat people or stuck in transit camps, where there was physical or sexual abuse. That predisposes to suicidality, as does physical and sexual abuse in general."



* Statement of wish to die like "Things would be better without me; there's no purpose in living."

* Depression.

* Crying.

* Fixation on death.

* Sudden changes in behavior, including changes in school performace or attendance, changes in eating and sleeping patterns.

* Moodiness.

* Aggression.

* Previous suicide attempts.

* Giving away prized possessions, making final arrangments.

* Sudden accident-proneness or risk-taking.

* Substance abuse.

* Self-imposed social isolation.

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