Comment 1 Suicide in recent years has increased by 300% in adolescent males aged 15 to 19 years old. Male adolescents were 6 times more likely to commit suicide then a female (Adolescence, C. O.,2000). Suicide between the ages of 15 to 19 is the third leading cause of death for adolescents (Edelman, C., Kudzma, E., Mandle, C., 2010). Adolescent suicide is preventable as problematic adolescents tend to give clues that can be verbal and nonverbal. It is important for people around the adolescent to recognize important warning signs. There are many factors that contribute to suicide such as family history of mental illness, substance abuse, history of child abuse, and any type of abuse the adolescent has faced are leading factors of suicide. Depression leading from social problems, family problems, or environmental issues can also lead to suicide. There are three levels of suicide prevention first being the primary prevention which is reducing the risk factors and promoting the factors to end suicide by educating and giving the awareness of suicide. The second prevention is secondary prevention where a person has tendency of suicide and has been assessed as suicidal. It is then that the person is offered crisis counseling to help address any underlying problems and gets screening for suicide. The third prevention is the tertiary prevention where long term services and program are used to help the suicidal person because of the consequences of attempted suicide (Georgia Institute of Technology, 2018). For a nurse it is hard to assess if an adolescent child is suicidal or not. There are warning signs & symptoms that a nurse can look for to make an assessment. Behavioral changes such as substance use and abuse, writing notes or letters, poems and essays with suicidal material written in them, the adolescent becomes more of a risk taker, and increased physical violence to themselves or others.(Edelman, C., Kudzma, E., Mandle, C., 2010).  Other symptoms include mood change like increased anger, sleep problems, hearing voices or talking to people not there, taking interest in death related things, and an expression of hopelessness (Edelman, C., Kudzma, E., Mandle, C., 2010).  Other symptoms that are physically noticeable are posture, body movements, unusual dressing, and grooming and hygiene (Jarvis, C., 2012). New Jersey state has a peer support & suicide prevention hotline where people can call 1-855-NJ-HOPELINE 24 hours a day to talk to someone confidentially. They can help provide support to people who just needs someone to talk to when life becomes stressful. The NJ hopeline can provide further counseling, support and referrals to local resources in your difficult times. Another resource the state offers is nj211 which also can help not only for suicide, financial assistance, food, utilities, and housing. The local community resource that that helps suicidal people is the National Alliance on Mental Illness organization. The organization offe ...

1. Comment 1
Suicide in recent years has increased by 300% in adolescent
males aged 15 to 19 years old. Male adolescents were 6 times
more likely to commit suicide then a female (Adolescence, C.
O.,2000). Suicide between the ages of 15 to 19 is the third
leading cause of death for adolescents (Edelman, C., Kudzma,
E., Mandle, C., 2010). Adolescent suicide is preventable as
problematic adolescents tend to give clues that can be verbal
and nonverbal. It is important for people around the adolescent
to recognize important warning signs.
There are many factors that contribute to suicide such as family
history of mental illness, substance abuse, history of child
abuse, and any type of abuse the adolescent has faced are
leading factors of suicide. Depression leading from social
problems, family problems, or environmental issues can also
lead to suicide. There are three levels of suicide prevention first
being the primary prevention which is reducing the risk factors
and promoting the factors to end suicide by educating and
giving the awareness of suicide. The second prevention is
secondary prevention where a person has tendency of suicide
and has been assessed as suicidal. It is then that the person is
offered crisis counseling to help address any underlying
problems and gets screening for suicide. The third prevention is
the tertiary prevention where long term services and program
are used to help the suicidal person because of the consequences
of attempted suicide (Georgia Institute of Technology, 2018).
For a nurse it is hard to assess if an adolescent child is suicidal
or not. There are warning signs & symptoms that a nurse can
look for to make an assessment. Behavioral changes such as
substance use and abuse, writing notes or letters, poems and
essays with suicidal material written in them, the adolescent
becomes more of a risk taker, and increased physical violence to

2. themselves or others.(Edelman, C., Kudzma, E., Mandle, C.,
2010). Other symptoms include mood change like increased
anger, sleep problems, hearing voices or talking to people not
there, taking interest in death related things, and an expression
of hopelessness (Edelman, C., Kudzma, E., Mandle, C., 2010).
Other symptoms that are physically noticeable are posture,
body movements, unusual dressing, and grooming and hygiene
(Jarvis, C., 2012).
New Jersey state has a peer support & suicide prevention
hotline where people can call 1-855-NJ-HOPELINE 24 hours a
day to talk to someone confidentially. They can help provide
support to people who just needs someone to talk to when life
becomes stressful. The NJ hopeline can provide further
counseling, support and referrals to local resources in your
difficult times. Another resource the state offers is nj211 which
also can help not only for suicide, financial assistance, food,
utilities, and housing. The local community resource that that
helps suicidal people is the National Alliance on Mental Illness
organization. The organization offers help to all ages providing
them the programs to go to receive education and peer to peer
learning. The National Alliance on Mental Illness offers
professional help and support by providing trained
professionals. The organization can be reached at
http://www.naminj.org/
or 732-940-0991.
As a nurse and health care provider it is important to provide
their patients with prevention methods. It is important for a
nurse to asses the mental health status of the patient and offer
help. Help can be in the form of patient safety, or referral to a
religious organization, peer to peer help, and educating the
patient on understanding self-harm. The nurse will educate the
patient on coping skills to help the patient handle the stressful
situation they are going thru.

3. Comment 2
Depression is “a common and serious medical illness that
negatively affects how you feel, the way you think and how you
act” (American Psychiatric Association, 2013). Depression can
come on gradually or it can arise suddenly, after a crisis
situation such as a death of a loved one or a divorce (Jarvis,
2016). Depression can occur in children and adolescents. Nearly
20% of teenagers suffer from depression at some point (I Need a
Lighthouse.org, 2018).
Signs and symptoms of depression can mimic some “typical”
teen behaviors so it may be hard to determine if a teen is “just
being a teen” or if he or she is exhibiting signs of clinical
depression. Signs can include inability to concentrate,
irritability, angry outbursts, and changes in eating or sleeping
habits (Mayo Clinic, 2017). Illicit drug use can also have
similar side effects. Therefore, it is important to be alert for
other factors that may be contributing to this behavior in order
to identify a teen at risk for depression.
Teenagers are faced with fluctuating hormones and major
changes to their bodies. This can make them seem “moody” and
disengaged. Teens are learning how to manage these changes as
well as their evolving emotions. They also are learning to cope
with stresses in their lives such as peer pressure and family
expectations. If a teen is overweight or underweight; has been
the victim of bullying or abuse; or has a physical, mental, or
developmental disability, this can increase his or her likelihood
of experiencing depression (Mayo Clinic, 2017). Teens need to
learn coping skills and stress management. This is an example
of primary prevention. A supportive home environment with
open communication is needed as well.
Teens who have a family history of depression or other mental

4. health issues are at increased risk for experiencing depression,
as are those who grew up in a dysfunctional home environment.
Many of these teens do not learn the coping skills needed to
manage their day to day experiences, or they have learned
negative coping skills such as alcohol and substance abuse.
When these mood or behavior changes also include feelings of
sadness, low self-esteem, self-harm, and/or thoughts of suicide,
and have been occurring for greater than 2 weeks, immediate
intervention is needed. Secondary prevention equals early
detection. There are several screening tools for depression
including Patient Health Questionnaire (Jarvis, 2016) and the
Beck Depression Inventory-II tool (Bennet, Jones, & Smith,
2014). The results can help determine appropriate interventions.
Nurses can help connect teens and parents with a counselor or
support group.
Tertiary prevention is preventing or minimizing long term
effects of depression (Bennett, et.al., 2014). Therapy and
medications are ways to help treat and manage depression. The
Crisis Center of Family Services is a local resource in Green
Bay, WI for counseling and crisis services. Bellin Health also
has a psychiatric center with inpatient and outpatient services.