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Recognise it, talk about it, prevent it!

What is it that motivates somebody to end their life out of their own will? What can be done to prevent this, to recognize it and to intervene immediately? I talked to Dr Adrienn Németh child psychologist about this.

In Hungary, how common is suicide compared to other countries?

Amongst teenagers, it is the second most frequent cause of death, with which we are leading the statistics all over Europe. According to the research of SEYLE, 12% of Hungarian youth have considered committing suicide in their lives, 10% of them are quite interested in suicide and 3% of them have already attempted to commit suicide. In the under-14 category, 1% of children have successfully committed suicide, while in the 14-19 age-group, suicide is responsible for 10% of deaths. Boys typically commit 4 times as many successful suicides as girls, but girls attempt suicide more often.

Who are most at risk when it comes to suicide?

According to research, most often, there is a psychological disease in the background. The most common one is depression. Amongst those who have already harmed themselves – who have cut themselves or have taken pills – the probability that they will do it again is two or three times higher that they will attempt it again.

What do you think, most young people who attempt to commit suicide really want to die or just want to call their environment’s attention to their problems?

The two things cannot be separated. Each case must be taken seriously, because we cannot know what was in the background. In my experience, most young people who attempt to kill themselves do not necessarily want to die. But we cannot ignore the fact that they are in such a difficult situation that they cannot find a way out of it.

According to the current scientific approach (based on the DSM – 5), there is a new category, which consists of self-harm without the wish to die. The acts that belong to this category are committed without the attempt of young people to kill themselves, but where the perpetrator only wishes to dissolve the tension and anxiety with their act.

Unfortunately, the exact opposite is characteristic as well. There are teenagers who consciously plan the whole process. They possess a concrete script about how they would like to die. They write a goodbye letter and account for their lives. It is important to mention that a lot of teenagers fantasize about who they are important for, who will miss them. I have even read a goodbye letter where the exact circumstances of the funeral were elaborated on in detail: what music will be playing, who will be there, who will be crying, who will admit that they made a mistake in their confronts… etc. With this, they probably wish to settle their personal conflicts. 

What is in the background of the suicide of teenagers?

Numerous studies have dealt with this. There can be a lot of reasons, but it can never be narrowed down to a single cause. Some kind of sensitivity is needed for this too. Puberty is the most potentially risky period as during this time, young people go through a lot of changes. They are facing identity crises, during which, if any complication or difficult situation comes up, some of them consider solutions like this the most efficient for erasing problems. Still, behind most suicides, there are problems caused by personal conflicts. Such problems might be the loss caused by the end of a relationship, conflicts with parents, teachers or peers.

More and more often, young people living in youth homes falls victims to bullying, which can be their reason to end their lives. Besides desperation and isolation, one of their main reasons is usually to cause remorse for the perpetrator.  

What can an expert and the immediate environment do to prevent this?

Prevention is the most important and that this topic stops being a taboo. If those living in the environment of the children – teachers, classmates, parents, experts – sense that the child has thoughts about suicide, they should create a situation where they can talk about it and they should not be scared to ask them directly about these problems. It used to be a wide-spread opinion of the public that by talking about it, young people are encouraged to go ahead with their attempts to kill themselves, but research shows that this is not true and it is nothing else but a protective factor. If they manage to put their thoughts into words and they find acceptance, they will be able to relax more and it helps decreasing the tension in them. However, if the danger of them harming themselves or their immediate environment is still present after such conversations, then an expert’s intervention must be sought.

The most important task of the expert is to reveal the causes that led to the act. To walk down the road that carried the young person there and deal with the arising problems adequately. This can be achieved by a long-term therapeutic process.

How can the school and peers be prepared for noticing the signs and for dealing with them?

The SEYLE (Saving and Empowering Young Lives in Europe) programme led by Dr. Judit Balázs child and youth psychologist is a good example of this. This study was carried out in 12 European countries (Austria, Estonia, France, Ireland, Israel, Hungary, Germany, Italy, Romania, Slovenia and Spain) with the help of the European Union. Teenagers between the ages of 14-16 were involved. The goal was to promote healthy lifestyle by reducing high risk behavior. The study’s primary focus was suicide rates, but it dealt with other harmful addictions as well and it tested some efficient programmes to do with the topic. Within the frames of the research, prevention classes were held at schools. These are extremely important, since, in a lot of cases, it is the peers that will notice if something is wrong with one of their classmates.  

The European Alliance Against Depression has created a variety of preventive programmes in order to recognize depression and through this to reduce the risk of suicide. Amongst those, I would like to recommend the psycho-educational website and online self-help tool produced by the PREDI-NU programme. On this site, which is unique in Hungary, well-researched and useful information can be accessed by young people and adults alike. The website is still undergoing development, but should be accessible for all within a few weeks’ time.

I would like to emphasize that prevention is indispensible and it would be extremely important for every school, teacher, student and parent to be well-informed in this field. Through this, they will find it easier to recognize the tell-tale signs, they can ask for a professional’s help and will be able to hinder a tragedy from happening.  

What are these tell-tale signs?

If we start from the above-mentioned depressive mood that might precede suicide, then we must take it into consideration that in a lot of cases, it comes out differently in young people and adults. With the latter group, it is easier to see that they are down, that they get tired easily and that they experience mood swings. Of course, these symptoms can be present in young people as well. They become lonely, therefore they do not socialize, their grades start getting worse. The difference, however, is that teenagers are peevish and irritable and consequently, their acts might be misinterpreted and therefore, depression might remain hidden.

 If somebody is pondering the thought of suicide, then that can often be understood through some of their comments or remarks. E.g.: “I wish I had never been born. It would be better if I died. Nobody cares about me.” They can make a reference to the fact that they are fantasizing about death and they deem their future dark and consider it a dead-end. In these cases, it is worth asking them if they had ever thought of ending their lives. In some cases, it is easy to understand how real these thoughts are or how seriously they think what they say. However, with those who have a ready plan, it is important to intervene.

It is important to mention that there are also non-specific suicidal thoughts. The young person might be interested in these things, but it is important to point out that for teenagers it is not rare to fantasize about such things. This can be a manifestation of abstract thoughts and ambivalent feelings that are extremely characteristic of this age group. However, if this does not change with the time, intervention is necessary. 

Written by: Zsófia Tupi

Tanslated by: Judit Molnár