This article was originally published in Wilmington StarNews on March 30, 2015. The article is based on the 2013 N.C. Youth Risk Behavior Survey. According to the survey, “[t]he NCYRBS sample is drawn in such a manner that, if the overall response rate is above 60%, the results of the survey can be generalized to the entire population of middle school students in the state with a relatively high level of precision.” In 2013, 29 schools participated in the survey, and the overall response rate was 61%.
The number grabs you by the collar and demands attention. One of 10 middle-schoolers in North Carolina has attempted suicide.
Suicide survey results
- Percent of students who ever seriously thought about killing themselves: 19.1
- Percent of students who ever made a plan about how they would kill themselves: 14
- Percent of students who ever tried to kill themselves: 10.5
One in 10.
If you look around a lunchroom and see 150 kids eating spaghetti, gossiping with friends and roughhousing just under the radar of the teacher on duty, 15 of those kids might have attempted suicide.
They didn’t have a passing thought that was pushed out the brain’s back door as soon as it entered. They didn’t vent an angry outburst of words that can’t be unsaid.
The 2013 N.C. Youth Risk Behavior Survey asked a very specific question: Have you ever tried to end your own life?
One out of 10 kids – one at every table in that lunch room – answered yes, I’ve tried to kill myself. The number is even higher – 12.9 percent – for females.
The survey shows that the trend continues in high school. One in 20 high school students has needed medical treatment for a suicide attempt in the past 12 months.
Challenges of adolescence
The issue of suicide confronts social workers and counselors from high school all the way down to elementary school.
Meredith Lloyd, a school counselor specialist for Brunswick County Schools said young children might not understand their own mortality.
“They may have heard something on TV, but it might be something they don’t understand,” Lloyd said. “But they need to understand the severity. This is not like a video game where you’re going to get another life.”
Adolescence brings its own set of challenges.
“Middle school can be a pretty tough time for kids,” said Kevin Edwards, a call center clinician at CoastalCare, which oversees mental health care for a five-county region. “There are significant changes – mentally, emotionally and socially. They face pressures to perform academically and to act a certain way. A lot of kids don’t have the skills to deal with these pressures.”
At the first hint that a student might be preparing to harm himself or others, New Hanover County Schools employs its suicide protocol. The indication could be presented through verbal contact with a peer, the concern of a friend, visual evidence of cutting or even an art or writing project that conveys the student’s intent. The school employee (teacher, nurse, coach, etc.) then alerts a counselor or social worker.
In the 2014-15 school year, NHCS counselors and social workers have used the protocol more than 240 times for more than 210 students.
According to data provided by Lisa Burriss, lead counselor/social worker at NHCS, some elementary school counselors have not had to intervene at all, while one high school counselor initiated the protocol 15 times this year, each time with a different student.
“That doesn’t mean the student is suicidal,” Burriss said. “It just means that there is enough concern that we initiate the protocol.”
Once a student is identified as a risk, the student is not left alone until she is released to her parents, Burris said. The social worker or counselor forms a small team, which can include a school administrator, teacher, social worker, parents and the student. The team discusses the best option for the student.
Sometimes, students are not allowed to return to school until they have been cleared to return by a mental health professional. This sometimes leads other students to believe that a suspension has been enforced, but that’s not the case, Burriss said.
Looking for signs
If there is any good news to glean from the state statistics, it’s that successful suicide attempts among schoolchildren remain rare.
Joyce Hatem of the New Hanover County child fatality investigation team said no children in the county committed suicide in 2012 or 2013, the last year for which complete statistics are available. In 2013, 34 children in North Carolina killed themselves.
Lloyd said Brunswick County Schools might see about one suicide per year or every other year.
“Whenever that happens, we always look back and look for a sign,” she said. “The hard reality is that there is not always that sign.”
A child who becomes disconnected from his family and friends might be at risk, said Matthew Oelslager, integrated care specialist at CoastalCare.
When signs do appear, they should not be ignored, he said.
“If a child makes any statement about wishing he was not alive, the parent needs to take it very seriously,” Oelslager said. “This is not a passing phase that can be minimized.”
And if someone seems at risk, it’s OK to ask, whether you’re a parent or a friend.
“You’re not going to put that in someone’s head,” Edwards said. “If we wait for someone to ask us, they are going to go on dying.”
And what if the student says, “Yes, I was thinking about killing myself.”
“Chances are, if you are thinking of suicide, you’re going to feel that sense of relief,” Edwards said. “It will lower their anxiety and get them talking about it.”
Warning signs of suicide
Talking about wanting to die.
Looking for a way to kill oneself.
Talking about feeling hopeless or having no purpose.
Talking about feeling trapped or in unbearable pain.
Talking about being a burden to others.
Increasing the use of alcohol or drugs.
Acting anxious, agitated or recklessly.
Sleeping too little or too much.
Withdrawing or feeling isolated.
Showing rage or talking about seeking revenge.
Displaying extreme mood swings.
The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide, but may not be what causes a suicide.
What to do if someone you know exhibits warning signs of suicide:
Do not leave the person alone.
Take it seriously.
Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt.
Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) or the CoastalCare crisis line 866-875-1757.
Take the person to an emergency room or seek help from a medical or mental health professional.
Source: American Foundation for Suicide Prevention, CoastalCare