The subject of suicide and discussion of it draws wide differences of opinion among mental health experts and laypersons. For some, it’s a topic to talk about in the open, to acknowledge the growing numbers of attempts – particularly among teens – to effectively address and engage in prevention. For others, the subject is virtually taboo, one to avoid discussing.
The 2020 numbers are hard to ignore. According to the National Alliance on Mental Illness (NAMI), suicide is the second leading cause of death among youth ages 10-14 and the third leading cause of death among people ages 15-24 in the United States. Overall, suicide claimed the lives of nearly 46,000 people in 2020, making it the 12th leading cause of death in the U.S.
As for prevalence of serious thoughts of suicide, 4.9% were adults, 11.3% were ages 18-25, 18.8% were high school students and 45% identified as LGBTQ.
According to local mental health professionals, the number of young people they see with suicidal thoughts has increased substantially over the past five years, likely exacerbated by the COVID-19 pandemic and subsequent isolation.
“Every person I see in our program has suicidality,” said Dr. Jennifer Zumarraga, who is involved in the After-School Program Interventions and Resiliency Education (ASPIRE) program at El Camino Health in Mountain View. “When we first started, that wasn’t the case. There was a lot of depression and anxiety, of course, but not everybody had suicidal thoughts or suicidal attempts. And what I’m finding here is that it’s something that we deal with all the time.”
Taking note of September as National Suicide Prevention Awareness Month, NAMI officials see an opportunity to “shift public perception, spread hope and share vital information to people affected by suicide.”
Zumarraga, who works at the Scriver Center for Mental Health and Addiction Services at El Camino Health, believes parents should engage in direct and frank discussion of the issue.
“We help them and teach them how to ask directly (about suicidal thoughts), because if it’s such a taboo subject, then the kids won’t be able to talk about it,” Zumarraga said.
Locally, residents became acutely aware of the issue in 2009 in the wake of four student suicides out of Gunn High School in Palo Alto – the public high school for many Los Altos Hills residents. The disturbing outbreak drew national attention, prompting investigation by the national Centers for Disease Control and Prevention and inspiring a documentary, “The Edge of Success.”
Some point to the Gunn suicides as a prime example of contagion – when one student act inspires another to commit that same act.
“I was a marriage and family therapist intern at Gunn at the time,” recalled Joanna Carson-Young, director of school-based services at the Community Health Awareness Council (CHAC). “What was going on in the culture, perhaps with anxiety or school pressure or pressure to succeed, to where (suicide) becomes a choice, where it becomes what feels like the only option?”
On the other hand, the incidents inspired community action that resulted in the creation of the ASPIRE program.
“At the time, we really didn’t have a lot of (mental health) programs, or anything for the teens,” Zumarraga said.
While acknowledging contagion as a risk factor, Zumarraga said “that doesn’t mean we shouldn’t be talking about it, because if it is a risk factor, then we want to know so we can help them and support them.”
Multiple factors can contribute. Anxiety, isolation and the feeling of being a burden on others are leading indicators.
In the case of young adults, lack of brain development also is an issue.
“Our brains aren’t developed until the mid- to late-20s,” Zumarraga said. “The last part of our brain that develops is the frontal lobe – that region is actually in charge of executive functioning. And what’s interesting is executive functioning means that it includes impulse control, attention, organization and planning for the future and then, of course, emotion. … So when you see a teen, they’re not going to have a lot of those skills, really, because their brains are not developed yet. So that’s why they tend to be more impulsive – they have more difficulty coping with stresses.”
Mental health experts emphasize that suicide prevention involves talking things over and helping troubled individuals understand they’re not alone.
“Disconnection from others, if unattended, can lead to self-harming behaviors,” said Marsha Deslauriers, CHAC executive director.
Preventing that involves teaching social-emotional skills, she said, which creates self-awareness and the ability to make better choices.
“One of the main goals that we have, especially with our school-based services, is to normalize mental health for kids,” Carson-Young said. “So even in elementary school, we’re talking about feelings, talking about mental health, talking about challenging thoughts or ideas – that is just a normal part of their normal school day.”
Carson-Young acknowledged that some mental health practitioners have at one time been in crisis themselves and feel the need to pass along what they have learned to others.
“It really is important to kind of use some of the life experiences to help people,” she said, “because we all, as corny as it might sound, we are definitely trying to instill hope and helping them to see their strengths, even when they can’t see it, and help them to identify what those strengths are.”
• ASPIRE program, El Camino Health: (650) 988-8468;
• 988, national hotline for mental health emergencies
Addressing crisis head-on is best approach, according to mental health experts.
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