Study: Teen Suicide Prevention Needs to Be More Specialized, Improved

Teen suicide is even more complicated than previously thought. According to a new study in JAMA Psychiatry, simply providing adolescents some mental health treatment is not an effective form of suicide prevention.

The study explored the prevalence of suicide, and the prevalence and treatment of suicidal behaviors including ideation, plans and attempts.

The study found that a majority of suicidal teens did receive at least some type of mental health treatment, and often the treatment started before suicidal behaviors began. However, despite early treatment, the suicidal behaviors still happened.

These results showed the need for major changes in treatments for suicidal teens and prevention efforts, since current treatments and prevention efforts are not always effective in helping suicidal teens.

Study conclusions suggested that instead of providing general mental health treatment for suicidal behaviors and general suicide prevention efforts, both aspects need to be more specialized.

Researchers behind the study proposed that suicidal behaviors are somewhat common for U.S teens, and many of these teens have preexisting mental disorders.

However, the type of mental disorder that suicidal teens have seems to be associated with the type of suicidal behavior they experience (ideation, plans or unplanned/planned attempts).

Because of the different mental disorders being paired up with different types of suicidal behaviors, more specified treatment and prevention efforts are needed.

Experts shared their opinions on what can be done to make teen suicide prevention efforts and treatment more effective.

Carl Grody, a licensed independent social worker, said in an email that although the study at first may appear to suggest that mental health treatments are ineffective for suicidal teens, there are a lot of complex factors to consider.

Regardless, he does agree improvements need to be made in treatment, prevention and generally in how suicidal teens are dealt with.

“We need to include families in the treatment,” Grody said.

“Too often, families drop teens in a clinician's office and say, ‘Fix them.’ More often than not, the family system plays a big role in the teen's thoughts and behaviors, and family therapy is necessary to help the entire family tackle those issues instead of just targeting the teen for treatment.”

Audrey Cleary, a licensed psychologist, said in an email that more consistent treatment is needed to actually help suicidal teens.

“When it comes to psychotherapy, the number and regularity of sessions is important in predicting whether treatment will be effective (8 or more weekly sessions is more meaningful than single sessions occurring sporadically),” Cleary said.

More structured therapy could also be beneficial to suicidal teens.

Dr. Mark Edelstein, a board-certified child and adolescent psychiatrist, said in an email that although teens do have access to mental health treatment, it’s not necessarily the most effective kind of treatment available, which needs to be changed.

“ In most cases, evidence-based treatments – that is, the types of therapy with the greatest scientific evidence – are not what most therapists in the community provide,” Edelstein said.

“As in the rest of health care, there is a serious lag between research [and] what is available to people seeking treatment the real world.”

He added that the study makes it pretty clear that “suicidality is complicated.”

“It can be the result of any of a number of things – any of a variety of mental health conditions, behavior difficulties, personality and coping style, alcohol and substance abuse, and situational stress,” Edelstein said.

“This is a reminder that assessment and treatment planning must consider multiple domains in a child’s life, including health, school, family and social life.”

Isaiah Pickens, a clinical psychologist, said in an email that treatments need to be tailored specifically toward adolescents in order to be effective, and certain treatments like cognitive behavioral therapy and dialectical behavior therapy tend to be more effective for suicidal teens.

Elizabeth Lombardo, a psychologist, physical therapist and author, said in an email that there are a lot of life skills teens can be helped with as part of an overall suicide prevention.

“Higher self-confidence, resilience, sense of purpose and happiness are all buffers to suicidal intentions,” Lombardo said.

“They are also all very teachable. If we taught our teens (and those even younger) how to deal with the stresses of life, how to have healthy self-confidence, how to have a sense of purpose that is independent of others, then suicidal ideations and attempts would plummet.”

Sources:

Green, Jennifer Greif and Nock, Matthew K., et al. JAMA Psychiatry. Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents. Results From the National Comorbidity Survey Replication Adolescent Supplement. Web. Jan. 23, 2013.
http://archpsyc.jamanetwork.com/article.aspx?articleid=1555602#RESULTS

Grody, Carl. Email interview. Jan. 23, 2013.

Cleary, Audrey. Email interview. Jan. 22, 2013.

Edelstein, Mark. Email interview. Jan. 23, 2013.

Pickens, Isaiah. Email interview. Jan. 23, 2013.

Lombardo, Elizabeth. Email interview. Jan. 22, 2013.

Reviewed January 24, 2013
by Michele Blacksberg RN
Edited by Jody Smith

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Tags:

• Depression
• Mental Health
• Psychiatric Illness
• Emotional Health
• Parenting