(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
Youth Suicide: Prevention Works! <ul><li>Presented by: </li></ul><ul><li>Sue Eastgard, MSW </li></ul><ul><li>Director, Youth Suicide Prevention Program of Washington State </li></ul><ul><li>www.yspp.org </li></ul>
Youth Suicide: The Facts <ul><li>An average of 2 youth between the ages of 10 and 24 kill themselves each week in Washington State </li></ul><ul><li>In a recent state survey, more than one in every 10 high school students reported having attempted suicide; nearly one in four (20% - 25%) had seriously considered it </li></ul><ul><li>Over 30% of GLBQ youth report at least one suicide attempt within the past year </li></ul><ul><ul><li>Over 50% of Transgender youth will have had at least one suicide attempt by their 20th birthday </li></ul></ul><ul><li>Youth suicide outnumber youth homicides </li></ul>
Number of suicides vs. number of attempts Washington State youth (2000-2004)
The Point is <ul><li>We need to be concerned about youth who complete suicide as well as those who make suicide attempts </li></ul>
Males complete suicide more often than females Washington State youth (2000-2004)
The Point is <ul><li>Boys and young men are at higher risk of dying by suicide because: </li></ul><ul><ul><li>They choose more lethal means </li></ul></ul><ul><ul><li>They are less likely to seek help </li></ul></ul><ul><ul><li>They are socialized to solve problems </li></ul></ul>
Females are more likely to be hospitalized for suicidal behavior than males Washington State youth (2000-2004)
The Point is <ul><li>Girls and young women are much more likely to be hospitalized for suicidal behavior because: </li></ul><ul><ul><li>They talk and tell others </li></ul></ul><ul><ul><li>They give us the opportunity to intervene </li></ul></ul>
Males use more immediate & less reversible means than females Washington State youth ages 10-24 (2000-2004) N= 402 N=97
The Point is <ul><li>The most common ways in which males and females end their lives are the same: guns and hanging </li></ul>
Rate of suicides by race/ethnicity Washington State youth 10-24 (2000-2004)
Child & Adolescent Depression: The Facts <ul><li>One in every 33 children may have depression </li></ul><ul><li>The rate of depression for adolescents may be as high as 1 in 8 </li></ul><ul><li>The majority of children and adolescents with depression do not get help they need </li></ul><ul><li>Depression can lead to school failure, alcohol/drug use, and suicide </li></ul>
Child & Adolescent Depression: WA State Facts <ul><li>39% of Washington State 6 th graders reported feeling “depression or sad MOST days in the past year” </li></ul><ul><li>Over 30% of Washington State 10 th graders indicated that they sometimes think, “life is not worth it” </li></ul>
Child & Adolescent Depression: The Signs <ul><li>Irritability </li></ul><ul><li>Persistent feelings of sadness </li></ul><ul><li>A drop in school performance </li></ul><ul><li>Problems with authority </li></ul><ul><li>Indecision, lack of concentration </li></ul><ul><li>Poor self-esteem </li></ul><ul><li>Overreaction to criticism </li></ul><ul><li>Frequent physical complaints </li></ul>
Additional Risk Factors for GLBT Youth: <ul><li>Gender nonconformity </li></ul><ul><li>Coming out: </li></ul><ul><ul><li>Early </li></ul></ul><ul><ul><li>Not coming out to anyone </li></ul></ul><ul><li>Homophobia </li></ul><ul><li>Internalized homophobia/Internal conflict </li></ul><ul><li>Heterosexism </li></ul><ul><li>Lack of access to gay/trans friendly services </li></ul>
Youth Suicide: Warning Signs <ul><li>A previous suicide attempt </li></ul><ul><li>Current talk of suicide or making a plan </li></ul><ul><li>Strong wish to die, preoccupation with death, giving away prized possessions </li></ul><ul><li>Signs of serious depression, such as moodiness, hopelessness, withdrawal </li></ul><ul><li>Increased alcohol and/or drug use </li></ul>
Youth Suicide: Risk Factors <ul><li>Readily accessible firearms </li></ul><ul><li>Impulsiveness and taking unnecessary risks </li></ul><ul><li>Lack of connection to family and friends (no one to talk to). </li></ul>
Focus on How Vs. Why <ul><li>When lethal coal burning wood stoves were replaced with cleaner burning natural gas, overall suicide rate in the UK went down by 1/3 </li></ul><ul><li>When barrier was erected on popular “suicide bridge” the incidence of suicide did not increase on another nearby bridge </li></ul><ul><li>Storing guns in a lock box, putting ammunition in a different room or keeping a gun unloaded significantly reduces chances that gun will be used in a suicide </li></ul>
LIFE’S SLOT MACHINE School Community Family Individual Protective Factors
<ul><li>Show you care </li></ul><ul><li>Ask the question </li></ul><ul><li>Call for help </li></ul>Youth Suicide: Intervention
Youth Suicide: Resources <ul><li>School counselor </li></ul><ul><li>Crisis telephone hotline (1-800-273-TALK) </li></ul><ul><li>(1-800-4U-Trevor-GLBT support) </li></ul><ul><li>Physician/health care provider </li></ul><ul><li>Mental health specialist </li></ul><ul><li>Coaches & youth leaders </li></ul><ul><li>Parents & clergy </li></ul><ul><li>GLBT friendly services/people in community and schools </li></ul>
Suicide death rates on the decline Washington State youth 10-24 (1997-2004)
The Point is <ul><li>Suicide rates have gone down, but not far enough </li></ul>
Youth Suicide: Prevention Works! Presented by: Sue Eastgard, MSW Director, Youth Suicide Prevention Program of Washington State www.yspp.org
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