Monday, October 14, 2019

Teen suicides are on the rise. Here’s what parents can do to slow the trend

 

The two middle-schoolers had never met in person, but they both struggled with depression and were drawn to the same dark group chat. When one wrote that he planned to kill himself, the other took an image of his post. “I’m so freaked out,” she told me, her school counselor. “Please find him and make sure he’s okay.”

With some assistance, I was able to figure out what Washington-area school the boy attended. When I called his principal, she was bewildered. Her student could be disruptive in class, she told me, but he didn’t seem sad.

I wasn’t surprised. In early adolescence, depression can resemble rage or irritability or be mistaken for normal mood fluctuations. She acted quickly to make sure the student was safe. At a time when the Centers for Disease Control and Prevention is reporting a spike in suicide rates among 10- to 14-year-olds, educators are leaving nothing to chance.

“When talking about adolescent suicide, half the time we’re talking about kids who are depressed, and half the time we’re talking about kids who are impulsive,” says Ken Ginsburg, an adolescent developmental pediatrician at Children’s Hospital of Philadelphia and co-founder of the Center for Parent and Teen Communication. “Kids this age can’t articulate their pain as clearly as older teens, their peers are less mature and don’t know how to recognize the signs, and they don’t want to snitch.”

[What does childhood anxiety look like? Probably not what you think.]

Put this all together, and it’s easy to see why parents can be the last to know their child is suffering, says Christina Conolly, director of psychological services for Montgomery County Public Schools.

Adolescent children are far less likely to commit suicide than adults, but they have not been immune from a nationwide increase in suicides over the past two decades. The CDC reports that from 1999 to 2017, the suicide rate among boys ages 10 to 14 grew from 1.9 suicides per 100,000 people to 3.3. Among girls, suicides roughly tripled from 0.5 per 100,000 to 1.7. Researchers recently reported in the journal Pediatrics that while 50 percent of parents are unaware that their 11- to 17-year-olds are having suicidal thoughts, younger teens are more likely than older teens to deny their pain.

To plug the gap on the issue, Conolly implemented the Signs of Suicide Prevention Program in every middle school in her district this year. Students learn to recognize the signs of depression, care for struggling friends and report concerns to adults.

As depression and anxiety skyrocket, communities are scrambling to meet kids’ needs with limited resources. Here are six ways parents and schools can combine forces to tackle the spike in tween suicide.

Maintain open communication

Two-way communication is critical, but it can be thwarted by logistical and emotional barriers. Educators may feel unequipped to help distressed students or apprehensive about calling home with nonacademic concerns. To build their comfort, many schools now offer mental-health training to teachers.

One program, Youth Mental Health First Aid, partnered with Lady Gaga’s Born This Way Foundation to teach school personnel how to “recognize the signs of a mental health or addiction crisis, initiate a conversation, and connect young people to professional help and community resources,” says Betsy Schwartz, who oversees the program at the National Council for Behavioral Health.

Even teachers who would readily intervene are squeezed for time. “I want our children’s needs to be met, but I also want people to understand how much teachers do every day,” says Traci Townsend, principal of Silver Creek Middle School in Kensington. Parents can help. To improve dialogue, signal that you’re open to hearing unsettling news about your child.

“Adopting an accusatory or defensive posture will get in the way of sharing key information, such as ups and downs of the young person’s mood, concerns brought forward by peers, and changes in a student’s academic performance, that can be key to keeping students safe and making sure that treatments are working as they should,” says psychologist Lisa Damour, author of “Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls.”

Transparency is critical in middle school, says social worker Amy Morin, author of “13 Things Mentally Strong Women Don’t Do.”

“When we most need to have eyes and ears on the ground, communication really drops off,” she says. “Email the school and say, ‘Everything seems fine, but what are you seeing?' ” Be proactive and alert the school when your child needs more support, whether they’re grieving a death, adjusting to a change in family structure or coping with depression.

Susan Levine, the resource counselor at Silver Creek, is seeing a shift toward more openness, but it comes with a twist. “Parents are more honest, but children are less resilient,” she says. “If a kid’s friend says 20 nice things and one bad thing, we can spend a whole day undoing that.”

Prioritize self-directed play

As recess decreases and testing increases, there has been a rise in children’s mental disorders, says Peter Gray, a research professor at Boston College and the author of “Free to Learn: Why Unleashing the Instinct to Play Will Make Our Children Happier, More Self-Reliant, and Better Students for Life.” The cause and effect should be obvious, he notes. “Life without play is depressing.”

“Children are almost like prisoners today,” he says. “They’re constantly being monitored, their sense of control over their lives has declined, and that sets them up for depression and anxiety.” Instead of just going out to play, they are frequently put in competitive, anxiety-provoking conditions, such as trying to earn a spot on a team or win a game.

Gray co-founded Let Grow with Lenore Skenazy, founder of Free-Range Kids, to help communities prioritize play. Michael Hynes, the schools superintendent of the Patchogue-Medford School District in New York, now offers elementary and secondary students one hour of self-directed play before school. “It’s the closest thing to a silver bullet I’ve ever seen in my 20-plus years serving children in education,” he says. “Kids are less anxious, upset and depressed.”

Parents can help change the tide. Make the case for more recess at school and prioritize unstructured play at home. Organize weekend block parties and coordinate with neighbors to send kids outside at the same time to just play.

Identify helpers

To normalize help-seeking behavior, prompt kids to silently name the adult they’d approach in a crisis. When I do this with my middle school students, I invite anyone who is stumped to come meet with me. Willing educators can self-identify as helpers, too. Teachers may need backup support, but Morin urges them not to send a student to their counselor alone. For starters, the American School Counselor Association is reporting an average student-to-school counselor ratio of 406 to 1, so they may not even know that person. “They also might not know what to share, so walk them there and say, ‘This is what I’m hearing,’ ” Morin says. “It’s powerful for a teacher to say, ‘I really know this kid, he’s not a complainer, and here’s some background.’ ”

Parents also can make an effort to be a trusted adult in their kid’s friends’ lives. Ask questions and show genuine interest in their well-being. If your own child is suffering, convey to them that they’re not alone. Ginsburg recommends saying, “I feel like you’re really uncomfortable, and I need you to know it doesn’t have to be that way. You deserve to feel better, you can get better, and I will be by your side as you do.”

Sweat the small stuff and the big stuff

A child’s concern may seem overblown, but take it seriously anyway. Middle schoolers have intense emotions but little perspective. “It’s easy for them to imagine that every circumstance is an emergency,” Ginsburg says.

That said, some experiences should raise a red flag. Bullying, for example, is strongly linked to suicidal thoughts and attempts, says Sameer Hinduja, co-director of the Cyberbullying Research Center and professor of criminology at Florida Atlantic University. Listen to your children, validate their experiences and involve them in problem-solving. “Well-meaning parents and educators need to avoid secondary victimization by responding callously or incompletely when a tween or teen summons enough courage to tell them what’s going on in the first place,” he says.

Stay calm, engaged and nonjudgmental. “If a child says, ‘I hate myself and want to die,’ don’t respond with, ‘But you’re so great at this and great at that,’ ” says psychologist Mary Alvord, the author of “Conquer Negative Thinking for Teens.” “Pull from them, ‘What have you done well this month?' Give choices; ‘Were you nice to people? Were you a loving or helpful son or daughter?’ ”

Alvord created the Resilience Builder Program, now in several schools in the District and Maryland, to build kids’ sense of agency. “We might say, imagine you didn’t do well on a test and were really upset,” she says. “We explain that if you’re reactive, you rip up the paper or cry. If you’re passive, you hold it in, which doesn’t make it go away. But if you’re proactive, you ask, ‘Is there extra credit? Could I study more next time?’ ” At home, ask your child, “What can you control and what do you need to let go? How can you take initiative?”

Bolster kids’ sense of belonging

When students leave elementary school, they trade the constancy of a homeroom teacher for a revolving cast of educators. “They can feel progressively alienated from staff in the school at a time when they need nonparental adults more than ever,” says Robert Dodd, principal at Walt Whitman High School in Bethesda.

In response, some schools are prioritizing relationship-building. White Oak and Argyle middle schools in Montgomery County implemented Project Success to make it possible for some sixth-graders to spend half of each schoolday with one teacher and an intact peer group. The data shows it’s working incredibly well, says Dodd, who founded the program after many years as a middle school principal. “These kids are more likely to feel their teachers value and care about them and their peers want to help them.”

Care starts at the top and is contagious, Townsend says. “When you feel care from your colleagues, you pass that down to kids. You’re more likely to sit down next to that one kid in the cafeteria who is by himself and say, 'What are you doing — where’s everybody?’ That’s care.”

Parents can help strengthen community ties, too. Get to know other families in the school and make a pact to exchange information, whether you hear that a child is giving away prized possessions, making comments about dying or disengaging from friends, all signs of serious trouble.

Encourage kids to care for one another

Middle schoolers may think they’re a bad friend if they disclose that a peer is off-kilter. “We give them permission and tell them it’s more important to save someone’s life,” Conolly says. “We say, ‘Put your phone down, have a conversation, tell them you want what’s best for them, and you’re going to seek help.’” Parents can relay that same advice.

Kids can even make a pledge to prioritize emotional health, says consultant Mimi Darmstadter, the parent chair of Stressbusters Committee at Walt Whitman High School. The PTSA subcommittee coordinated with school officials to distribute “Oath of Wellness” cards that every student could sign. Dodd says he hopes to duplicate the effort in the cluster’s middle and elementary schools, and parents can do the same exercise at home. Ask your child how they plan to take care of themselves and look out for others. Then model self-care and self-compassion in your own life, and verbalize any strategies you use to cope with frustration, sadness or disappointment.

“Parents and schools have to work closely together to evaluate shared norms about parenting,” Dodd says. “Are we completely performance-oriented, or are we modeling empathy, resilience and wellness?”

Phyllis L. Fagell is the school counselor at Sheridan School in the District, a therapist at the Chrysalis Group in Bethesda and the author of “Middle School Matters.” She blogs at phyllisfagell.com and tweets @pfagell.

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