Suicide Prevention in Youth

The severity of the mental health crisis in American youth has been clearly documented again by the shocking research reported in the Wall Street Journal that over the ten year period 2007 to 2017 the suicide rate among people ages 10 to 24 years old climbed 56%.

The author of the CDC report, Sally Curtin, stated, “The chances of a person in this age range dying by suicide is greater than homicide, when it used to be the reverse.” She added, “When a leading cause of death among our youth is increasing, it behooves all of us to pay attention and figure out what’s going on.”

The severity of the mental health crisis of suicide in youth and in adults must be accepted and not ignored as is presently occurring. The findings need to be widely studied origins and risk factors clearly identified and new responsibilities undertaken primarily by parents to protect American youth. Something is very wrong in American families and in the culture in regard to how we are fostering psychological health in youth and in adults and in addressing conflicts that lead to severe depression in youth.

The Epidemic of Depression and Other Psychiatric Disorders Related to Suicide

Earlier this year, Dr Jean Twenge, professor at San Diego State University, presented very troubling research findings on the extent of the severe psychiatric illnesses affecting American youth which can place youth at risk for suicidal thinking and acts.

The research she cited, a National Survey on Drug Use and Health, conducted by the US Department of Health and Human Services found:

• Between 2009 and 2017, major depression among 20 to 21-year-olds more than doubled, from 7 to 15 percent;
• depression surged 69 percent among 16 to 17-year-olds;
• between 2008 and 2017serious psychological distress, including feelings of anxiety and hopelessness, jumped 71 percent among 18 to 25-year-olds;
• twice as many 22 to 23-year-olds attempted suicide in 2017 as in 2008, and 55 percent more had suicidal thoughts;
• increases were more pronounced among girls and young women;
• by 2017, one out of five 12 to 17-year-old girls had experienced major depression in the previous year.

Epidemic of Suicide also in Adults

Other startling suicide findings that have received too little attention include this: between 2000 and 2016, the age-adjusted suicide rate increased 30 percent nationwide with a 50% increase in women and a 21% increase in men.

Also, a 2016 study of suicide risk from the Centers for Disease Control and Prevention identified a 24% increase in suicides in the United States over the 15-year period between 1999 and 2014 with the tripling of the suicide rate for females 10–14. Unfortunately, the CDC did not have data on what percentage of these girls were children of divorce, were born of single mothers, or grew up without fathers because such vital data are not politically correct.

Risk Factors, Origins, and Responses

Numerous factors have contributed to the depression and marked rise of suicide in youth and adults in this culture that parents and mental health professionals need to understand. These include divorce trauma when youth are deprived of the experience youth of the love of a father and a mother in the home; hopelessness about a committed loving relationship associated with the absence of a sense of mission or purpose in life, lack of parental responsibility in the personality development of youth; selfishness and a turning inward due to excessive use of social media; the experience of being repeatedly used as a sexual object and resultant loss of trust in relationships; depression and excessive anger and the failure to find effective treatment.

Parental Divorce

Happiness and hope in youth are dependent upon being in a home in which the parents love each other. The flow of love between a father and a mother brings comfort, security, and confidence to youth. Its absence, and worse, the absence of a parent, can create intense sadness and the fear that one may never have a stable loving relationship in the future.

Another study in 2011 demonstrated the suicide risk in those whose parents divorced before they were 18. This research with 6,647 adults revealed that 695 participants had experienced parental divorce before the age of eighteen and that the men from divorced families had more than three times the increased risk of suicidal ideation in comparison to men whose parents had not divorced.¹ Adult daughters of divorce had an 83 percent higher risk of suicidal ideation than their female peers who had not experienced parental divorce. Again, there are no statistics on how many grew up without fathers for whatever reason. It is time to examine such statistics for the sake of the children.

Research on the children of divorce provide overwhelming evidence to disprove the myth that divorce does not harm children. In fact, the divorce epidemic has contributed to the serious and growing psychopathology in American youth.

Research by Penn State sociologist Paul Amato on the long-term damage to children from divorce demonstrated that, if the United States enjoyed the same level of family stability as it did in 1960, the nation would have 70,000 fewer suicide attempts in youth every year, about 600,000 fewer kids receiving therapy and 500,000 fewer acts of teenage delinquency.²

The million youth per year traumatized by the divorce plague deserve more from all of us, as do those adults who have been its victims. Divorce is killing our children, but we’re too drowned in PC to open our eyes. We must do so for the sake of our children.³

Parents who consider divorce should reflect upon the virtue of justice in regard to what is properly due to God, who placed the sacramental bond between them, to each other, and to their children. They have a serious responsibility to try to protect their children and their spouse from the life-long damage caused by divorce.⁴

Parents need to think in justice about what they owe to their children and to their spouse before making a decision to divorce and commit to uncover honestly their own psychological weaknesses and work on them for several years. Such work often helps to reduce marital conflict and increase marital trust. In our professional experience, most serious marital conflicts can be resolved, and divorce thereby prevented.⁵

Selfishness and Social Media

Dr. Twenge’s tentative answer is too much time on social media. “Compared with their predecessors,” she says, “teens today spend less time with their friends in person and more time communicating electronically, which study after study has found is associated with mental health issues.”

Obsession with social media and the subsequent neglect of personal interaction with peers is probably a major factor in the mental health crisis. I have long advised adolescent females, in particular, to call and not text their friends on a regular basis to protect themselves from loneliness, which is a major cause of depression and anxiety.

Dr Twenge has shown in her book The Narcissism Epidemic that there has been an increase of narcissism, anger, and poor impulse control. Yet, I was surprised that she did not clarify how social media use turns youth away from psychologically healthy ways of relating and fosters selfishness by minimizing the importance of self-giving in relationships.

As selfishness intensifies the heart becomes cold toward others and imprisons one within the self. Such an inner prison can lead to hopeless and a lack of meaning and mission in life.

Communication with others about adolescent life issues and stresses often results in a decrease in anxiety and worry. Without this, anxiety grows. Years of coping with anxiety can lead to depressive illness. The self becomes more and more turned in upon oneself with growth in solitary activities and withdrawal from family and other relationships.

Loneliness

God’s first advice to humanity was: “It is not good for man to be alone; I will make a helpmate suitable for him.” While this Bible verse is normally applied to marriage, it offers hope for those who struggle with intense loneliness at every life stage. Youth also need helpmates whom they see and with whom they communicate in person about their happiness and their struggles. Often this loneliness is completely denied — until it erupts under adolescent stresses.

We have worked with many youths who have reported a deep sadness because they did not have siblings or did not have a brother or a sister. In fact, the contraceptive mentality in parents has contributed to no small degree to loneliness in some youth.

Also, excessive use of pornography and marijuana over the course of many years turns youth in upon themselves and damages seriously their ability to relate in a healthy way to those of the opposite sex. This isolation can lead to fears of lifelong unhappiness and then suicidal thinking and impulses.

Parents have a serious responsibility to try to protect their children from loneliness as much as possible by communicating love and praise to them, by encouraging trust and self-giving in healthy friendships, by recommending respect and not control in family and peer relationships and by sharing and encouraging the numerous benefits of Faith and friendship with the Lord.

Excessive Anger

Numerous studies have shown that excessive anger/high irritability are associated with suicide in youth. A 2018 study found that high irritability and depressive/anxious mood profile is associated with a higher suicidal risk compared with the depressive/anxious mood only. Girls with the high irritability and high depressive/anxious mood profile had a higher risk for suicidality.⁶

Numerous other published studies found a that suicide attempters are more hostile and aggressive than community controls. These findings have led to recommendations that in the treatment of youngsters with a history of suicide attempts, aggressive impulses should be evaluated and treated.⁷

When excessive anger is identified, mental health professionals should recommend empirically proven forgiveness therapy as an aspect of the treatment plan since it is has been proven to diminish depression as well as irritability.

The marked increase in the prevalence of suicide and depressive illness in youth and its association to excessive anger indicates the urgent need for parents to teach their children the importance of the regular use of forgiveness beginning in childhood to resolve their anger with parents, siblings and peers and thereby protect their psychological health. Also, parents should also model forgiveness by not expressing anger in the home which is done by inwardly thinking of forgiving many times until the anger subsides.⁸

Low Self-Esteem

Healthy self-esteem is important in the development of psychological health in youth. Its development requires secure bonding first with the mother, then with the father, next with siblings and finally with peers/friends. Weaknesses in any of these relationships can contribute to insecurity that may cause both anxiety and depressive illness.

A psychological reality is that it is not possible to develop and maintain healthy self-esteem without friendships. The relationships with parents and siblings are not enough. Parental encouragement to grow in the virtue of gratitude for one’s God given gifts. gifts can build and protect self-esteem.

Mistrust and Anxiety

The development and protection of trust in relationships is essential to establishing and maintaining healthy friendships and later, loving relationships. Many youths have reported that it is increasingly difficult to maintain trusting friendships.

They explain that as friendships developed, they were blind-sided by the emergence of deep selfishness in the other person. This then destroyed their trust and created fears about being vulnerable and trusting again. As a busy psychiatrist, I often feel as though I am an army medic on a battlefield trying to help those traumatized by a culture that has given in to severe selfishness, excessive anger, lack of respect in treating others, the use of others as sexual objects, the contraceptive mentality and a retreat from, and failure to appreciate, the beauty and fulfillment found in marriage.

All of this profoundly wounds the tender, loving hearts of young women who have not been warned about the dangers of this narcissistic culture, nor properly protected by parents, siblings, friends, teachers and priests. It’s not too strong to say that they are suffering from post-traumatic stress syndrome (PTSD).

As with the healing of all emotional pain, forgiveness is essential to resolve the anger that encapsulates sadness, hopelessness, mistrust and low self-esteem. Both research studies and clinical experience demonstrate that when used daily forgiveness decreases these four types of emotional and mental pains, as well as making a young adult being less an emotional prisoner of his/her past.

Substance Abuse

The early risk factors that have contributed to the epidemics of deaths from heroin and opioid use in youth and young adults that often are the result hopelessness need to be identified and addressed. Like nearly all people with substance abuse problems, most heroin users initiated their drug use early in their teens, usually beginning with alcohol and marijuana. There is ample evidence that early initiation of drug use primes the brain for enhanced later responses to other drugs.

The first director of the National Institute of Drug Abuse, Robert L. Dupont, accurately identified marijuana as a gateway drug.⁹ The serious risks to youth from the use of high potency marijuana need to be identified and its legalization challenged.¹⁰

In this epidemic, it should be recognized that no progress was made in the treatment of alcoholism until a faith component was initiated in their treatment through what was initially the strong Faith component of the 12 steps of admitting powerlessness and turning it over to God. The explosion of opioid addictions and deaths related to hopelessness about life might diminish if there were a strong faith component as part of the treatment program and family therapy.

There is no reason why the theological virtues of Faith, Hope and Love could not be incorporated into the treatment programs of believing youth. Their benefits in protection for suicide and depression have been demonstrated. especially given the research findings that demonstrate their effectiveness. The most notable benefit was in the Harvard study of 5,000 adolescents who were 33% less likely to use illicit drugs as a result of regular attendance at religious services.

Contraceptives

A 2016 study of more than one million women in Denmark found that “use of hormonal contraceptives was associated with subsequent antidepressant use and diagnosis of depression at a psychiatric hospital. This research revealed that adolescents seemed most at risk.

A second study of nearly a half million Danish women found that those who used hormonal contraceptives had a greater risk of suicide than those who did not. Again, adolescents experienced the highest relative risks. The authors concluded, “Considering the severity of these little-recognized potential side effects of hormonal contraceptives, health professionals and women starting contraceptives should be informed about them.”

It is understandable that many young females no longer believe in romance and dreams of a faithful, loving husband and home with the children who will be born. In view of this sad reality, a young girl could be tempted to think about why one should live if there is nothing to dream of, idealize and look forward to.

Education in the virtue of hope and prudence in relationships, as well as in the Catholic marriage, by parents can protect their children from contraceptive-induced depressive illness and hopelessness.

Benefits of Faith

The knowledge of the benefits of faith to psychological health can assist parents in protecting and strengthening their children. For example, a study at Harvard University used a large sample of over 5,000 adolescents, followed them up for more than eight years, and controlled for many other variables to try to isolate the effect of religious upbringing. They found that, compared with never attendance, at least weekly service attendance and prayers was subsequently associated with greater life satisfaction and positive affect, greater volunteering, greater sense of mission, more forgiveness, and lower probabilities of drug use, early sexual initiation, STIs, and abnormal Pap test results; and fewer lifetime sexual partners.

For example, those who attended religious services regularly were subsequently:

• 12% less likely to have high depressive symptoms
• 33% less likely to use illicit drugs.

Those who prayed or meditated frequently were:

• 30% less likely to start having sex at a young age
• 40% less likely to subsequently have a sexually transmitted infection.

Moreover, a religious upbringing also contributed to a number of positive outcomes as well, such as greater happiness, more volunteering in the community, a greater sense of mission and purpose, and higher levels of forgiveness. For example, those who attended religious services were subsequently:

• 18% more likely to report high levels of happiness
• 87% more likely to have high levels of forgiveness.

Those who prayed or meditated frequently were subsequently:

• 38% more likely to volunteer in their community
• 47% more likely to have a high sense of mission and purpose.

These are relatively large effects across a variety of health and well-being outcomes. Religious practice and prayer or meditation can be important resources for adolescents navigating the challenges of life.

Another Harvard study published in JAMA Psychiatry found the benefits of regular attendance at religious services a factor in diminishing severe depressive illness. Compared with women who never attended services, women who attended once per week or more had a five times lower risk of subsequent suicide; Catholic or Protestant women who attended services more than once a week almost never committed suicide.

This study does not prove that fervent Christians never contemplate or attempt suicide — we know that they sometimes do — but it does indicate that practicing one’s faith strengthens hope for living.

The serious threats to the development of a healthy personality in their children and future psychological health should be identified by parents and communicated to them. These include; divorce, selfishness, controlling personality conflicts, excessive use of social media, loneliness, anger, mistrust, low self-esteem, the contraceptive mentality, hook-up culture and cohabitation that permeates the culture. For far too long the politically correct culture has failed to report the truth. This puts far too many youths at risk for serious challenges in their lives. It is time to see that the time-tested ways of faith, virtues, and living for others is a pathway to health.

An understanding that the habits that are needed for a healthy marriage are the same as those needed for psychological health in childhood and young adult life and can motivate parents to courageously teach them to their children.¹¹ Also, a major way in which Catholic parents can protect the psychological and spiritual health of their children is to model a loving, loyal relationship in their marriage. Also, they should not hold back offering correction for personality weaknesses or of societal views that are a threat to the health of their children.

Parents can build hope in their children by sharing their lived experiences of the benefits of virtues and grace from prayer and religious services that can protect their minds and hearts from the current epidemic of hopelessness and suicide.