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American Academy of Child and Adolescent Psychiatry

Suicides among young people continue to be a serious problem. Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds.

Teenagers experience strong feelings of stress, confusion, self-doubt, pressure to succeed, financial uncertainty, and other fears while growing up. For some teenagers, divorce, the formation of a new family with step-parents and step-siblings, or moving to a new community can be very unsettling and can intensify self-doubts. For some teens, suicide may appear to be a solution to their problems and stress.

Depression and suicidal feelings are treatable mental disorders. The child or adolescent needs to have his or her illness recognized and diagnosed, and appropriate treatment plans developed. When parents are in doubt whether their child has a serious problem, a psychiatric examination can be very helpful.

Many of the signs and symptoms of suicidal feelings are similar to those of depression.

Parents should be aware of the following signs of adolescents who may try to kill themselves:

  • change in eating and sleeping habits
  • withdrawal from friends, family, and regular activities
  • violent actions, rebellious behavior, or running away
  • drug and alcohol use
  • unusual neglect of personal appearance
  • marked personality change
  • persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork
  • frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • loss of interest in pleasurable activities
  • not tolerating praise or rewards

A teenager who is planning to commit suicide may also:

  • complain of being a bad person or feeling rotten inside
  • give verbal hints with statements such as: I won't be a problem for you much longer, Nothing matters, It's no use, and I won't see you again
  • put his or her affairs in order, for example, give away favorite possessions, clean his or her room, throw away important belongings, etc.
  • become suddenly cheerful after a period of depression
  • have signs of psychosis (hallucinations or bizarre thoughts)

If a child or adolescent says, I want to kill myself, or I'm going to commit suicide, always take the statement seriously and immediately seek assistance from a qualified mental health professional. People often feel uncomfortable talking about death. However, asking the child or adolescent whether he or she is depressed or thinking about suicide can be helpful. Rather than putting thoughts in the child's head, such a question will provide assurance that somebody cares and will give the young person the chance to talk about problems.

If one or more of these signs occurs, parents need to talk to their child about their concerns and seek professional help from a physician or a qualified mental health professional. With support from family and appropriate treatment, children and teenagers who are suicidal can heal and return to a more healthy path of development.


Teen Suicide is Preventable
Teen suicide is a growing health concern. It is the third-leading cause of death for young people ages 15 to 24.
What the Research Shows

Teen suicide is a growing health concern. It is the third-leading cause of death for young people ages 15 to 24, surpassed only by homicide and accidents, according to the U.S. Center for Disease Control and Prevention.

According to experts Michelle Moskos, Jennifer Achilles, and Doug Gray, causes of suicidal distress can be caused by psychological, environmental and social factors. Mental illness is the leading risk factor for suicide. Suicide risk-factors vary with age, gender, ethnic group, family dynamics and stressful life events. According to a 2004 report distributed by the National Institute of Mental Health, research shows that risk factors for suicide include depression and other mental disorders, and substance-abuse disorders (often in combination with other mental disorders). More than 90 percent of people who die by suicide have these risk factors. The risk for suicide frequently occurs in combination with external circumstances that seem to overwhelm at-risk teens who are unable to cope with the challenges of adolescence because of predisposing vulnerabilities such as mental disorders. Examples of stressors are disciplinary problems, interpersonal losses, family violence, sexual orientation confusion, physical and sexual abuse and being the victim of bullying.

National suicide prevention efforts have focused on school education programs, crisis center hotlines, screening programs that seek to identify at-risk adolescents, media guidelines (suicide prevention strategies that involve educating media professionals about the prevalence of copy-cat suicides among adolescents, in an effort to minimize the impact of news stories reporting suicide) and efforts to limit firearm access.

Screening programs have proven to be helpful because research has shown that suicidal people show signs of depression or emotional distress. Referrals can be made for treatment, and effective treatment can be employed when signs are observed in time. Intervention efforts for at-risk youth can put them in contact with mental health services that can save their lives.

Suicide is a relatively rare event and it is difficult to accurately predict which persons with these risk factors will ultimately commit suicide. However, there are some possible warning signs such as:

    Talking About Dying -- any mention of dying, disappearing, jumping, shooting oneself, or other types of self harm

    Recent Loss -- through death, divorce, separation, broken relationship, self-confidence, self-esteem, loss of interest in friends, hobbies, activities previously enjoyed

    Change in Personality -- sad, withdrawn, irritable, anxious, tired, indecisive, apathetic

    Change in Behavior -- can't concentrate on school, work, routine tasks

    Change in Sleep Patterns -- insomnia, often with early waking or oversleeping, nightmares

    Change in Eating Habits -- loss of appetite and weight, or overeating

    Fear of losing control - acting erratically, harming self or others

    Low self esteem -- feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me"

    No hope for the future -- believing things will never get better; that nothing will ever change

What the Research Means
One in five teenagers in the U.S. seriously considers suicide annually, according to data collected by the CDC. In 2003, 8 percent of adolescents attempted suicide, representing approximately 1 million teenagers, of whom nearly 300,000 receive medical attention for their attempt; and approximately 1,700 teenagers died by suicide each year. Currently, the most effective suicide prevention programs equip mental health professionals and other community educators and leaders with sufficient resources to recognize who is at risk and who has access to mental health care.

How We Use the Research
The Teen Screen® Program is a community-based mental health screening program for young people that accurately identifies youth who are suffering from mental illness or are at risk of suicide. The program's primary objective is to help young people and their parents through the early identification of mental health problems, such as depression. Parents of youth found to be at possible risk are notified and helped with identifying and connecting to local mental health services where they can obtain further evaluation. Most importantly, mental health screening detect youth with depression and other emotional disorders before they fall behind in school and end up in serious trouble, or worst of all end their lives.
Stop a Suicide Today! is a school-based suicide prevention program that has experienced success with a documented reduction in self-reported suicide attempts. Developed by Harvard psychiatrist Douglas Jacobs, MD, Stop a Suicide, Today! teaches people how to recognize the signs of suicide in family members, friends and co-workers, and empowers people to make a difference in the lives of their loved ones. It emphasizes the relationship between suicide and mental illness and the notion that a key step in reducing suicide is to get those in need into mental health treatment.
National Suicide Prevention Lifeline 1-800-273-TALK or visit their Web site.
The National Suicide Prevention Lifeline's mission is to provide immediate assistance to individuals in suicidal crisis by connecting them to the nearest available suicide prevention and mental health service provider through a toll-free telephone number: 1-800-273-TALK (8255). It is the only national suicide prevention and intervention telephone resource funded by the Federal Government.
Berman, A., Jobes, D., & Silverman, M., (2006) Adolescent suicide: Assessment and intervention (2nd ed.) Washington, DC: American Psychological Association, 456 pp.
National Suicide Prevention Lifeline or 1-800-273-TALK
Suicide Awareness Voices of Education (SAVE) or call: (800) SUICIDE
Cited Research
Center for Disease Control
Suicide Fact Sheet
Gould, M., Greenberg, T., Velting, D., Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry. 42(4):386-405.
Achilles, J., Gray, D., Moskos, M. (2004). Adolescent Suicide Myths in the United States. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 25(4):176-182.
Beautrais, A. (2005). National strategies for the reduction and prevention of suicide. Crisis: The Journal of Crisis Intervention and Suicide Prevention.26(1);1-3



Youth Suicide in Australia

Facts & figures

  • Suicide is a leading cause of death among young people, second only to motor vehicle accidents.
  • Suicide rates among 15-24 year old males have trebled between 1960 and 1990.
  • In remote rural Australia suicide rates for young males are nearly twice those of males living in capital cities.
  • Suicide is rare in childhood (<14 years) but becomes much more common during adolescence. The rise in suicide is most rapid between the ages of 15 to 19 years but there is a further increase between the age of 20 to 24 years.
  • Rates of suicide in Indigenous communities have been increasing since the 1970's. The majority of Aboriginal people who suicide are under the age of 29. Overall, the suicide rate in Indigenous communities may be 40% higher than the rate of non-Indigenous suicide.

Suicide attempts and self-harming behaviours

Surveys conducted at the Centre for Adolescent Health indicate that approximately 5% of young people engage in self harming behaviour.
Females are more likely than males to engage in self-harming behaviours, and young people have higher rates of deliberate self-harm than adults.
Australian studies have found that between 23.5% and 49% of teenagers have thoughts of suicide at some time.

Prevention of Youth Suicide

Research indicates that the scope for the prevention of youth suicide is broad, should occur within a developmental context and should take into account not just individual characteristics of a young person such as emotional well being but also risk factors which derive from important social environments such as school, the family and the community. There is a need for a continuum of interventions. Some risk factors for youth suicide such as antisocial behaviour, poor family cohesion and parental mental health issues are evident from early childhood. Others including academic failure, school drop-out, depressive symptoms and substance abuse become manifest in later childhood and adolescence. However, some risk factors are even more proximal eg suicidal behaviour and stressful life events. If you think a young person is suicidal, you should inform the person's parents, guardians or school counsellor and they should act immediately to ensure his or her safety. The management of an acutely suicidal person is an emergency.


  • Burns J, Sanci, L. Youth Suicide: A risk factor based approach to prevention. Medical Observer. Continuing Medical Education Program (invited paper, 7 August 1998).
  • Burns JM, Patton GC. Preventive Interventions for Youth Suicide: a risk factor based approach. Australian and New Zealand Journal of Psychiatry, 2000: 34:388-407
  • Harrison, J. Moller, J. Bordeauz, S. Youth Suicide and Self-Injury in Australia. Australian Institute of Health and Welfare, 1997.

Relevant research projects

Suicide Prevention Australia (SPA) in collaboration with the University of New England has published a groundbreaking research report on Understanding the Exposure and Impact of Suicide in Australia. This national research project highlights the far-reaching impact of suicide as a public health issue in Australia. The research is based on the input of more than 3,000 respondents from across the country who have been affected by suicide. This valuable information allows us to better understand how individuals are impacted by suicide and to inform where funds and expertise are directed in suicide prevention. The full report is now available for download

National suicide prevention strategy

The National Suicide Prevention Strategy (NSPS) provides the platform for Australia's national policy on suicide prevention with an emphasis on promotion, prevention and early intervention.

Page last updated: 25 May 2016

In November 2015, as part of its response to the National Mental Health Commission Review of mental health programs, the Government announced a renewed approach to suicide prevention through the establishment of a new National Suicide Prevention Strategy. The new Strategy involves:

  1. a systems-based regional approach to suicide prevention led by Primary Health Networks (PHNs) in partnership with Local Hospital Networks, states and territories, and other local organisations with funding available through a flexible funding pool;
  2. national leadership and support activity, including whole of population activity and crisis support services;
  3. refocussed efforts to prevent suicide in Aboriginal and Torres Strait Islander communities, taking into account the recommendations of the Aboriginal and Torres Strait Islander Suicide Prevention Strategy; and
  4. joint commitment by the Australian Government and states and territories, including in the context of the Fifth National Mental Health Plan, to prevent suicide and ensure that people who have self-harmed or attempted suicide are given effective follow-up support.

Painful conditions always pass, both mental and physical. Life always changes, and better times will come back inevitably.

Do not decide to harm yourself for a problem that will pass.

If you need help right now and want to speak to a friendly voice without judgment, call one of the available Australian suicide helplines

Are you worried about a friend?
Here are some questions to ask and how to provide support for someone who is in crisis.
Please do not make major decisions about your life when you are depressed, or have taken alcohol or drugs.

You would never advise a friend to die because of their problems. Tell yourself what you would tell a friend.

You would always tell a friend to Hold On

Helpful Articles

Youth suicide rate remains unacceptably high

New data on causes of death from the Australian Bureau of Statistics shows that youth suicide rates remain unacceptably high.

In 2013, 348 young people aged 15 to 24 years died by suicide – more than any other cause, including road accidents, cancer, and assault. Concerningly, the new data shows an upward trend in the rate of suicide among young people aged 15–19, and the overall rate of suicide among young people aged 20–24 remains stubbornly stable. 

Nearly three times as many young men died by suicide than young women, with young men aged 20–24 exhibiting the highest rate of suicide among all young people aged 15–24. The previously observed upward trend in the overall rate of suicide by young women aged 15–19 remained high but reduced year-on-year.

“Addressing youth suicide is one of the greatest challenges of our time. Given the strong link between poor mental health and suicide, these findings reconfirm the need to intervene as early as possible, focusing on the prevention of mental illness and, in turn, suicide,” said ReachOut CEO Jono Nicholas.

The National Mental Health Commission’s Review of Programs and Services is anticipated to be released soon, providing an opportunity to rebalance the mental health system making it more efficient and effective, enabling more people to access help.

“We’re encouraged by the Federal Government’s deep consideration of the Commission’s review, and look forward to working together with the sector on reforming the mental health system,” said Nicholas.

“Large-scale reform of the system is greatly needed, but it will take time to implement. We must consider what can be done right now to expand the reach of existing, effective interventions, as we cannot afford to allow another generation to experience the devastating effects of mental illness and suicide,” he added. 

Online interventions have been found to be highly effective in engaging young people vulnerable to mental illness and suicide. Twenty per cent of young visitors say they’ve come to ReachOut specifically for information on self harm and/or suicide, and more than 75 per cent of young visitors are in high or very high psychological distress.1

E-mental health services such as ReachOut enable self-care and peer support that helps a young person deal with what they’re going through. ReachOut also motivates young people to seek further professional help, with 46 per cent of visitors saying they’re more likely to do so after using the service.2

“Online services can be expanded right now, and to great scale – connecting any person with internet access to the help they need,” said Nicholas.

“70 per cent of young Australians experiencing a mental health difficulty aren’t getting the help they need. We must invest in prevention and early intervention, and better integrate face-to-face and e-mental health services in order to get the right help to those who need it.” 3

ReachOut Australia and Ernst & Young will soon release A Way Forward: Equipping Australia’s Mental Health System for the Next Generation, a new report exploring how the system can cost-effectively connect more young people to the help they need as quickly as possible.



In 2009, in Canada, there were 145 male suicides (and a 12.6 per 100,000 suicide rate) in the 15-19 age range. For females, there were a total of 57 deaths (and a corresponding suicide rate of 5.2 per 100,000).These numbers rise sharply (especially for males) when they reach their twenties and beyond. Males reach a peak rate of 27 per 100,000 in the 40-44age range with a recorded number of 337 deaths in 2009. See Statistics Canada for recent figures: http://bit.ly/LgmTuO


Approach to adolescent suicide prevention

    Marcia Kostenuik, MD CCFP

    Family and emergency physician at the Royal Victoria Hospital in Barrie, Ont, and a volunteer for and co-founder of No Youth Left Behind, Simcoe County

 Correspondence: Dr Marcia A. Kostenuik, Royal Victoria Hospital, Emergency Medicine, 201 Georgian Dr, Barrie, ON L4M 4S2; telephone 705 728-9090; e-mail marciek2001@hotmail.com

 Mohana Ratnapalan

Author Affiliations    Master’s degree candidate in the Department of Health Policy, Management and Evaluation at the University of Toronto in Ontario


OBJECTIVE To provide family physicians with an approach to suicide prevention in youth.

SOURCES OF INFORMATION A literature review was performed using Ovid MEDLINE with the key words suicide, attempted suicide, and evaluation studies or program evaluation, adolescent.

MAIN MESSAGE Youth suicide might be prevented by earlier recognition and treatment of mental illness. Family physicians can and should screen for mental illness in youth; there are many diagnostic and treatment resources available to assist with this.

CONCLUSION Earlier detection and treatment of mental illness are the most important ways family physicians can reduce morbidity and mortality for youth who are contemplating suicide.



Youth suicide in Canada: Prevention strategies by province

The Alberta Mental Health Board's 2005 A Call to Action: The Alberta Suicide Prevention Strategy can be found here

British Columbia's Suicide Prevention, Intervention and Postvention Initiative for B.C. from 2009 can be found here

Manitoba's Framework for Suicide Prevention Planning in Manitoba can be found here and from Manitoba Healthy Living (2008), Reclaiming Hope: Manitoba’s Youth Suicide Prevention Strategy can be found here.

New Brunswick's stragegy from 2007, called Connecting to Life: Provincial Suicide Prevention Program, can be found here

Nova Scotia's Strategic Framework to Address Suicide can be found here.

Nunavut's Suicide Prevention Strategy can be found here

Québec, from 1998, Help for Life: Québec’s Strategy for Preventing Suicide found here.

Newfoundland, Northwest Territories, Ontario, Prince Edward Island, Yukon Territory, Saskatchewan: No strategy at this time,

The Nation-wide, there is the Canadian Association for Suicide Prevention strategy, from 2009, found here.

This is Not a Crisis Centre

CASP provides educational material and resources.
The Canadian Association for Suicide Prevention (CASP) provides information and resources to reduce the suicide rate and minimize the harmful consequences of suicidal behaviour.

To find your local Crisis Centre, please click the button below.

I’m Having Thoughts of Suicide

Home » Need Help » I’m Having Thoughts of Suicide

The last thing that most people expect is that they will run out of reasons to live. But if you are experiencing suicidal thoughts, you need to know that you’re not alone. By some estimates, as many as one in six people will become seriously suicidal at some point in their lives.

Some Important Facts We Would Like to Share with You

Suicidal thinking is usually associated with problems that can be treated.

Clinical depression, anxiety disorders, chemical dependency, and other disorders produce profound emotional distress. They also interfere with effective problem-solving. But you need to know that studies show that the vast majority of people who receive appropriate treatment improve or recover completely. Even if you have received treatment before, you should know that different treatments work better for different people in different situations. Several tries are sometimes necessary before the right combination is found.

If you are unable to think of solutions other than suicide, it is not that solutions don’t exist, only that you are currently unable to see them.

Therapists and counselors (and sometimes friends) can help you to see solutions that otherwise are not apparent to you.

Suicidal crises are almost always temporary.

Although it might seem as if your unhappiness will never end, it is important to realize that crises are usually time-limited. Solutions are found, feelings change, unexpected positive events occur. Suicide is sometimes referred to as “a permanent solution to a temporary problem.” Don’t let suicide rob you of better times that will come your way when you allow more time to pass.

Problems are seldom as great as they appear at first glance.

Job loss, financial problems, loss of important people in our lives – all such stressful events can seem catastrophic at the time they are happening. Then, months or years later, they usually look smaller and more manageable. Sometimes, imagining ourselves “five years down the road” can help us to see that a problem that currently seems catastrophic will pass and that we will survive.

Reasons for living can help sustain a person in pain.

A famous psychologist once conducted a study of Nazi concentration camp survivors, and found that those who survived almost always reported strong beliefs about what was important in life. You, too, might be able to strengthen your connection with life if you consider what has sustained you through hard times in the past. Family ties, religion, love of art or nature, and dreams for the future are just a few of the many aspects of life that provide meaning and gratification, but which we can lose sight of due to emotional distress.

Do not keep suicidal thoughts to yourself!

Help is available for you, whether through a friend, therapist, or member of the clergy. Find someone you trust and let them know how bad things are. This can be your first step on the road to healing. Contact a crisis centre.

Source: American Association for Suicidology, www.suicidology.org

Having Hope

What is it?  Is it curse or blessing or both?  The sense of having no hope deepens our despair. One of the worst things we say to another human being is that they are hopeless.

We speak of being hopeful… of feeling hopeless.  We cannot give another person hope.  Reality teaches us that what is hope to one may be a burden to another.  In other words, my hope is not your hope.  The challenge is to find a definition of hope that is truly our own.

The key to this illusive concept of hope is finding our own definition of what it means in the midst of life.

As we struggle with darkness, fear, despair and apathy we can feel that there is no hope.  Perhaps that feeling comes from our understanding of what hope has been in the past.  Perhaps what we experience in the extremity of struggle is a whole new definition of hope.

Victor Havel writes, “Hope is not the conviction that something will turn out well, but the certainty that something makes sense regardless of how it turns out.”

Experience teaches us that our understanding of hope changes throughout our life time.  When we are children hope is what makes us happy.  As we age, hope is a goal, a vision, a dream.  It is far less immediate.  Something we might attain, rather than a state we can dwell in, right her and right now.

Hope, at the darkest moments in our life, is not a comprehensive commitment to faith and belief.  At those times hope can be as simple and as profound as the voice of another human being who appears to hear our fear; hope can be the knowledge that the sun will rise tomorrow, hope can be the smell of fresh spring rain, or the first snow flake, or the photo of someone we love.  When despair seems to overcome us we feel disconnected, isolated, lost.  What we need most in those moments is a means of re-connection, relationship and belonging.  This “means” can be surprisingly simple or deeply complex.  What matters at the moment is that we find this path of meaning in this life, here and now.

As someone who studied the science of hope, Ronna Jevne writes, “Hope; we ridicule those who have too much of it.  We hospitalize those who have too little.  It is dependent on so many things yet indisputably necessary to most.  Those who have it live longer.  Words cannot destroy it.  Science has overlooked it.  A day without it is dreadful.  A day with an abundance of it guarantees little.”

If you are reading these words; you have hope.  Try not to compare it with anyone else’s expression of hope.  Try not to get caught in the dualism of good – bad, hopeful and hopeless, worthwhile and worthless… the only kind of hope that will succeed is one that melts all the need of competition and comparison.  When we can come to this understanding we experience a sense of peace, both within and beyond ourselves.  In this state we trust life to be a journey of adventure, meaning and worth.

Imagine hope as an energy that melts the difference between life and death.  Life then is no longer either/or, it becomes more than we can even imagine.  Ending life then is not the option for the end of struggle because life is not an endurance test of endless struggle.  It is rather a mixture of struggle and strength.  This is radical hope because it is often born in a sense of hopelessness.  It is a new definition of the meaning of hope, which is not about happiness – rather it is about fullness, meaning and connection.  It is being constantly reshaped and redefined, and it is constantly inviting us to the never-ending story of life’s meaning.

This is how hope becomes energy for whatever we have to face in life.  It is not optimism, rather it is strength of seeking and realism.

Hope irks many professionals.  Professionals are trained to know.  Yet the choice is ours to make in relation to hope.  We can open ourselves to the mystery or stay with the illusion of certainty.

Books abound on the topic of hope, but before you begin reading take some time to read from the book of your own life.  Here some questions that may help you define your meaning of hope:

  • Who are the most hopeful people you have known in your life?
  • Who would you call to help with your hope right now?
  • What images do you have of hope:  music, smells, objects, colors, etc.?
  • How do you nurture and care for your hope?  What do you do to increase and strengthen it?
  • What most threatens your hope?
  • What do you think false hope is?
  • Where do you look for hope when you feel hopeless?
  • Can you remember a story of hope from your own life?
  • When you close your eyes and try to imagine a picture of hope what do you see?
  • What most threatens your hope?
  • If a child asked you right now, “What is hope?” how would you respond?
  • Do you have a practice of hope?  What if you began each day asking, what do I hope for in this day?  What if you ended each day with the reflective question, “Where did I find hope today?”

If you would like to know more about the study of the science of hope, and resources connected to a deeper understanding of hope you can contact:

Systematic Review A Youth Suicide Prevention Plan for Canada: A Systematic Review of Reviews
Kathryn Bennett, PhD; Anne E Rhodes, PhD; Stephanie Duda, BSc; Amy H Cheung, MD, MSc4; Katharina Manassis, MD; Paul Links, MD, MSc; Christopher Mushquash, PhD; Peter Braunberger, MD; Amanda S Newton, PhD, RN; Stanley Kutcher, MD; Jeffrey A Bridge, Ph; Robert G Santos, PhD; Ian G Manion, PhD, CPsych; John D McLennan, MD, PhD; Alexa Bagnell, MD;  Ellen Lipman, MD, MSc; Maureen Rice, MA, MLIS; Peter Szatmari, MD, MSc.

CanJPsychiatry 2015;60(6):245–257


Guía de Práctica Clínica sobre la Depresión Mayor en la Infancia y en la Adolescencia

El suicidio en niños y adolescentes problema creciente de salud púb





Protocolo Uniforme para la Prevención del Suicidio


Suicidio e prevenzione del suicidio in Svizzera  Rapporto in esecuzione del postulato Widmer