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WHY ARE ADOLESCENTS AT HIGH� RISK FOR�SUICIDE?

JUDITH R. MATHEWS, PhD, MPH

Retired Child Psychologist

Presented to TRIVALLEY NAMI February 2025

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�WHY ARE ADOLESCENTS AT RISK FOR SUICIDE?

  • JUDITH R. MATHEWS, PhD, MPH
  • Retired Child Psychologist
  • Presented to TRIVALLEY NAMI February 2025

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BUT…….

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WHY???

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Adolescence = Time of Explosive Changes

BECAUSE THEY ARE STILL DEVELOPING

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OUTLINE OF TALK

  • THE DEVELOPMENT OF THE ADOLESCENT BRAIN
  • STAGES OF ADOLESCENT DEVELOPMENT
  • TASKS OF ADOLESCENCE
  • WHAT MAKES THEM AT RISK FOR SUICIDE?
  • IMPACT OF COVID19
  • WHAT CAN YOU DO?

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STAGES OF ADOLESCENT DEVELOPMENT

EARLY ADOLESCENCE (10-13 YRS)

    • Onset of puberty (2-3 years earlier for girls)
    • Concrete black-and-white thinking
    • Need for privacy
    • Some begin to question gender identity

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https://www.healthychildren.org/English/ages-stages/teen/Pages/Stages-of-Adolescence.aspx

Onset of puberty (10-13) until mid-20’s

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STAGES OF ADOLESCENT DEVELOPMENT

MIDDLE ADOLECENCE (14-17 YRS)

    • Continued development of puberty (boys voice begins to crack)
    • Increased interest in sexuality and sexual relationships
    • More arguments with parents
    • Moving towards more independence
    • More abstract thinking, but may not be able to apply in the moment
    • Strong emotions and risk-taking behavior

https://www.healthychildren.org/English/ages-stages/teen/Pages/Stages-of-Adolescence.aspx

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STAGES OF ADOLESCENT DEVELOPMENT

LATE ADOLESCENCE (18-25 YRS)

    • Physically full grown
    • Better impulse control
    • Better able to weigh risks vs. benefits
    • Developing individuality and own values
    • Physically and emotionally separating from family

https://www.healthychildren.org/English/ages-stages/teen/Pages/Stages-of-Adolescence.aspx

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Adolescence = Time of Explosive Changes

PHYSICAL

SOCIAL

BEHAVIORAL

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Adolescence = Time of Explosive Changes

PHYSICAL

BRAIN

DEVELOPMENT

PUBERTY

(Raging Hormones!)

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Adolescence = Time of Explosive Changes

PHYSICAL

BRAIN

DEVELOPMENT

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THE ADOLESCENT BRAIN

FATHER OF 7 ADOLESCENTS AT ONCE:

“Adolescents’ brains go to mush and only re-emerge when they are 25”

https://misskiserela.wordpress.com/2018/02/14/my-brain-is-mush/

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THE PREFRONTAL CORTEX IS NOT FULLY DEVELOPED UNTIL THE AGE OF 25

https://www.ezmedlearning.com/blog/cerebral-cortex-lobe-anatomy

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SLEEP PATTERNS CHANGE

  • NEED FOR MORE SLEEP
    • 1 HOUR LONGER = 9-9 ½ HOURS

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  • BODY TIME CLOCK SHIFTS FORWARD 1-2 HOURS
    • FALL ASLEEP LATER
    • WAKE LATER

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OTHER IMPACTS ON SLEEP

  • SCHOOL START SCHEDULES TEND TO BE TOO EARLY
  • BLUE LIGHT OF SCREENS DISTURBS SLEEP

(stops production of Melatonin)

    • Delayed onset of sleep
    • Less sleep
    • Poorer quality of sleep

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Adolescence = Time of Explosive Changes

PHYSICAL

PUBERTY

(Raging Hormones!)

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RAGING HORMONES CAUSE FAST CHANGES IN EMOTION

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Adolescence = Time of Explosive Changes

LESS ABLE TO:

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    • Inhibit impulses
    • Weigh consequences of decision
    • Prioritize
    • Strategize
    • Plan ahead

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Giedd, J. N. (2004). "Structural magnetic resonance imaging of the adolescent brain." Adolescent Brain Development: Vulnerabilities and Opportunities : 77 - 85.

BEHAVIORAL

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IN GENERAL, �IMMATURE DECISION-MAKING

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  • Be influenced by peers, who are also making immature decisions

  • Think they are invulnerable (“It won’t happen to ME!”)

MORE LIKELY TO:

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Adolescence = Time of Explosive Changes

SOCIAL

PEERS BECOME MORE IMPORTANT THAN FAMILY

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Social Media’s influence on teens

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  • Are sensitive to social feedback, vulnerable to
      • personalized feedback:
      • AI-recommended feedback
      • Number of likes and followers

NOTE: AD CONTENT IS TAILORED TO YOUTH

  • Feel a Need to build friendships
  • Are susceptible to harmful content

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NOTE: SOCIAL MEDIA DO NOT HAVE CLEAR AND TRANSPARENT PROCESSES FOR ADDRESSING REPORTS OF MISUSE

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  • https://www.apa.org/topics/social-media-internet/youth-social-media-2024

WHY CAN SOCIAL MEDIA BE HARMFUL TO TEENS

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  • Have underdeveloped impulse control
    • lack of time limits
    • Push notifications capitalize on youths’ sensitivity to distraction
    • NOTE: USE OF YOUTHS’ DATA IS OFTEN WITHOUT PARENTAL CONSENT u

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  • Are vulnerable to malicious actors
    • Connection and direct messaging with adult strangers

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  • https://www.apa.org/topics/social-media-internet/youth-social-media-20

WHY CAN SOCIAL MEDIA BE HARMFUL TO TEENS

(CONTINUED)

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NORMAL ADOLESCENT TASKS

  • INDEPENDENCE
    • REBELLING AGAINST RULES
    • INDEPENDENT LIVING SKILLS
    • RENEGOTIATE ROLES WITH PARENTS
  • BODY IMAGE
    • SEXUAL FEELINGS
    • CHANGING BODY THROUGH PUBERTY

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https://hr.mit.edu/static/worklife/raising-teens/ten-tasks.html

https://www.utmb.edu/pedi_ed/CoreV2/Adolescent/Adolescent5.html

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  • PEER RELATIONSHIPS
    • Shift from friendships based on ACTIVITIES to ones based on TRUST, SHARED IDEAS & FEELING
    • PEERS become more important than family
  • IDENTITY
    • VALUES
    • SEXUALITY
    • MORALS
    • JUSTICE

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https://hr.mit.edu/static/worklife/raising-teens/ten-tasks.html

https://www.utmb.edu/pedi_ed/CoreV2/Adolescent/Adolescent5.html

NORMAL ADOLESCENT TASKS

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THEY ARE ALSO �DEVELOPING WONDERUL NEW SKILLS

  • THINK FOR THEMSELVES
  • BETTER UNDERSTAND OTHER PEOPLE’S FEELINGS
  • PROBLEM-SOLVE in more sophisticated ways
  • Determine their own VALUES & PRIORITIES in life
  • PURSUE THEIR INTERESTS in more depth
  • Develop MATURE RELATIONSHIPS
  • Begin to SET LONG-TERM LIFE GOALS for themselves

HOW TO:

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WITH SUCH HUGE CHANGES AND TASKS, �IT IS NO WONDER �THEY SOMETIMES MAKE MISTAKES!!

https://makeameme.org/meme/oops-sorry-bf5f96e164#google_vignette

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SUICIDAL BEHAVIOR IN ADOLESCENTS

“SUICIDE IS NOT ABOUT DEATH.

IT IS ABOUT ENDING PAIN”

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https://books.google.com/books?hl=en&lr=&id=KpQDEQAAQBAJ&oi=fnd&pg=PT4&dq=SUICIDE+PREVENTION+STRATEGIES+FOR+FAMILIES+USA&ots=bCXUQDcJ4B&sig=qxIf3aYcB3zw03fUS1l9ZQAooYc#v=onepage&q=SUICIDE%20PREVENTION%20STRATEGIES%20FOR%20FAMILIES%20USA&f=false

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DEFINITIONS

SUICIDE =

causes own death on purpose

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SUICIDAL IDEATION =

has thoughts of wanting to die

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SUICIDAL BEHAVIOR =

is focused on doing things that cause their own death.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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SELF-HARMING

= the intentional destruction of body tissue in the absence of any intent to die

(Cutting with a sharp object, burning, insering object un skin)

  • IS A STRESS RELEASE, NOT A SUICIDE ATTEMPT

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  • 17% OF ADOLESCENTS SELF-HARM

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  • SUSCEPTIBLE TO CONTAGION

https://www.health.harvard.edu/blog/cutting-and-self-harm-why-it-happens-and-what-to-do-202305312940

https://sbtreatment.com/program/adolescent/self-harm/

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IMPACT OF COVID-19 ON CHILDREN & ADOLESCENTS

  • Increased fear and anxiety
  • Disruption to daily routine
  • BUT showed resilience with the right support.
  • https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/camh.12453

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CHANGE IN ADOLESCENT SUICIDAL BEHAVIOR AFTER PANDEMIC (2025)

 

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OVERALL

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HISTORY OF MENTAL HEALTH CONCERNS

SUICIDE IDEATION

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4 - 7 %

29 %

SUICIDE ATTEMPTS

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22 %

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https://onlinelibrary.wiley.com/doi/abs/10.1111/sltb.13156

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BUT SUICIDAL BEHAVIOR �BOUNCED BACK �TO PRE-PANDEMIC LEVELS �IN 2022

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ADOLESCENTS AT RISK FOR �SUICIDE

  • Boys are 4 times more likely to die from suicide than girls.

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  • Girls are more likely to attempt suicide than boys.

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  • LGBTQ+ youth are at higher risk

  • Guns are used in more than half of all youth suicides

https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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ADOLESCENT SUICIDAL BEHAVIOR �IN TEENS AGED 10-14�(2011-2021)

  • The second leading cause of death

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  • 36% increase in African-American youth

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  • Adolescent Black girls, compared with other demographics, have the highest increase in suicide attempts

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WHY ARE TEENS AT HIGHER RISK FOR SUICIDE?

THEY ARE MORE LIKELY TO:

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    • Be IMPULSIVE

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    • Not consider the LONG-TERM CONSEQUENCES of their actions

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    • Have difficulty coming up with ALTERNATIVES to whatever is causing them to consider suicide
  • t

https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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FACTORS THAT MAKE A TEEN ESPECIALLY AT RISK�

  • Changes in their family
    • Divorce, moving

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  • Changes in friendships
    • Bullying, peer rejection

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  • Stress from social media
    • Cyberbullying

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  • Problems in school

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  • Other losses

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https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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Highest Risk�Adolescents

  • Mental health problems
  • Substance abuse problems
  • Past suicide attempts
  • Stressful life events

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https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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Highest Risk�Adolescents�(continued)�

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  • Family:
    • history of mental or substance abuse problems
    • history of suicide
    • violence
  • Easy access to methods:
    • guns
    • prescription medicines
  • Imprisonment

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https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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Highest Risk�Adolescents�(continued)

  • Exposure to the suicidal behavior of others:
      • family or peers
      • in the news
      • in fiction stories
  • Contagion
  • Social media

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https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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CONTAGION CLUSTERS

= When the exposure to the suicide or suicidal behavior of one or more persons influences others to attempt suicide 

        • Personal exposure
        • Media exposure

1%–2% OF TEENAGE SUICIDES ARE PART OF CLUSTERS (2024)

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https://www.cdc.gov/mmwr/volumes/73/su/su7302a1.htm?s_cid=su7302a1_w

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PREVENTION STRATEGIES

  • Get your child help for any mental or substance abuse problems.
  • Help your child understand that asking for help is not showing weakness.
  • Listen to your child.
  • Show interest. Stay connected.

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https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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Talking to your child about suicide does NOT start suicidal thinking or increase the chance of suicidal behavior

https://www.childrensmercy.org/departments-and-clinics/developmental-and-behavioral-health/mental-health-in-children-and-adolescents/suicide-prevention-in-children-and-adolescents/

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PREVENTION STRATEGIES

  • Keep medicines and guns locked and away
  • Become informed about youth suicide.
  • Know the warning signs for depression

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https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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https://www.who.int/activities/promoting-adolescent-well-being

WHO

Model of

Adolescent

Well-being

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MOST OF ALL:

WHILE SETTING LIMITS, FOCUS ON THE POSITIVES AND LET THEM KNOW YOU APPRECIATE THE THINGS THEY DO RIGHT

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https://www.bbc.com/news/health-42000702

REMEMBER THEY ARE STILL LEARNING AND GROWING

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WHEN IN CRISIS��

CALL OR TEXT 988

OR

TAKE IMMEDIATELY TO EMERGENCY ROOM

DO NOT ASSUME IT IS JUST

ATTENTION-SEEKING BEHAVIOR!!!

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RESOURCES ON ADOLESCENT SUICIDE

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  • JOHNS HOPKINS GUIDE

https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide

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  • PARENT AND YOUTH HOTLINE

https://caparentyouthhelpline.org/

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RESOURCES ON ADOLESCENT SUICIDE

ADOLESCENT DEVELOPMENT

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GENERAL PARENTING OF TEENS

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SOCIAL MEDIA

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RESOURCES ON ADOLESCENT SUICIDE

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SUICIDE PREVENTION

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FAMILY SUPPORT

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