Rethinking youth suicide prevention during COVID

June 26, 2020 – As the leading cause of adolescent death, suicide is a constant focus among researchers and clinicians in mental health. But the coronavirus, in a way, may have made it harder for young people to get the help they need.

A recent comment in the Journal of Adolescent Health discusses what the pandemic could mean for individual teenagers. Moving away from the usual social environments can help or harm your mental health, depending on the security and support of the home, say the authors. Distance education, the economic crisis and potential illnesses also play a role in stress and risk levels.

Author Hannah Szlyk, a postdoctoral researcher at the Brown School of Social Service at the University of Washington in St. Louis, says mental health professionals should be sensitive to these things. The bottom line, she says, is “if there were problems at home to start with, they will definitely be increased during that time”.

A 2019 study in the European Child & Adolescent Psychiatry magazine found three main things that increase the risk of suicide among young people: psychological factors, such as depression, anxiety and drug abuse; stressful life events, such as family problems and conflicts between peers; and personality traits, including neuroticism and impulse problems. All of these stressors may be at play during the pandemic.

“In children and adolescents, the life events that precede suicidal behavior are generally family conflicts, academic stressors (including bullying or exam stress), trauma and other stressful live events,” wrote the authors.

How, then, can doctors continue to treat suicidal adolescents when dealing with public and personal health crises?

Telehealth Therapy

Szlyk says that remote resources are not new for suicide prevention, since mental health hotlines have been in use since the 1950s. The rise of the Internet and smart devices has given way to online content, modules and applications related to suicide intervention.

Individual, group and family psychotherapy remains the main outpatient treatment for adolescents. These services are now adapting to the use of virtual doctor-patient communication, commonly called “telehealth”.

“You need to think about the implementation of putting things in this different way,” says Szlyk. “The use of technology will not be a panacea for the problems that we already see in mental health services.”

The Journal of Adolescent Health article explains that the disparities in telehealth services “can reflect or overcome the racial and socioeconomic disparities” seen in face-to-face services. Things like insurance coverage, telephone and internet access, language barriers and privacy complicate access to remote treatment for many teenagers.

“The question becomes ‘do we have the infrastructure to support this for everyone?'” Says Szlyk.

The researchers remain confident that “mental health service providers, regardless of their current comfort with virtual care, have years of experience in supporting people in crisis. We have the tools to weather this storm. “

For parents and caregivers, however, the challenge may not be familiar.

Parental Support

Szlyk and his colleagues say that as “the frontline of youth suicide prevention”, parents play a key role in their children’s suicide risk.

A simple way to support adolescents at risk during and after the pandemic is to practice an open and authentic expression at home, through casual communication. “Create spaces for dialogue, even when the teenager is not involved in the conversation.”

The Child Mind Institute, an organization dedicated to the mental health of young people, reinforces this idea in its tips for “Supporting teenagers and young adults during the coronavirus crisis”.

“Give them space to share their feelings and listen without judgment (or without reassuring them that everything will be fine),” says the text.

The institute also encourages parents to help teenagers create healthy habits, such as a consistent sleep schedule and a balanced diet.

Like most parts of the coronavirus pandemic, the relationship of the outbreak to the teen suicide rate is unclear. But what is known is that by actively listening to teenagers, parents and doctors can help to relieve the stress of their new reality.

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