Introduction/Demographic Data – Teens and Suicide
The National Institute of Mental Health (NIMH) defines suicide as, “death caused by self-directed injurious behavior with intent to die as a result of the behavior” (2018). Death by suicide varies by country, suicide is a worldwide health crisis. In 2013 there were 804,000 deaths worldwide at approximately one death by suicide every 40 seconds (Linde, Treml, Steinig, Nagl & Kersting, 2017). According to NIMH, suicide was the tenth leading cause of death in the United States for Americans, but the second leading cause of death for those between the ages of 10-34 following second only to accidents. Suicide rate for males of any age are significantly higher than females, in 2016 for those between the ages of 15-24 females suicide rate were 5.4 for every 1,000 and male suicide rates were 20.1 per every 1,000 nearly four times higher than their female peers (CDC, 2018).
Some risk factors that contribute to suicide ideation or suicide are: mental illness (depression being the highest), previous suicide attempt, low family/peer support, physical/sexual abuse, victimization/bullying, exposure to violence, same sex orientation, impulsivity, having a family member who had attempted suicide, and access to firearms. Some of the somatic symptoms experienced by teens who have suicide ideation are: changes in eating/sleep habits, deep sadness, withdrawal, stomach aches/headaches, fatigue, decline in academic achievement, and interest with the concept of death and dying (Pirruccello, 2010).
Grief Experiences of Parents/Caregivers who lost Their Children Due to Suicide
Suicide loss survivor, is the term for those left behind after a loved one ends their life by means of suicide. The individual role they play in their loved one’s life gravely affects their outcome when it comes to grieving (traumatic grief), complicated grief, bereavement, mourning process and feelings of guilt. For the purpose of this paper, grief will be defined as deep distress, traumatic grief will be defined as a sudden and unexpected loss and bereavement will be defined as the period after a death that is spent grieving (Cadence Hospice, 2018). Complicated grief is described as, “intense longing, intrusive preoccupation with the circumstances of the loss, self-blame, avoidance of thoughts or memories of the deceased, avoidance of previously shared activities, and inadequate adaptation to the loss” (Linde et al., 2017 p. 2-3). After a loss the loss survivors frequently alternate between addressing the loss and avoidance as a coping mechanism and experience the sense of shock, disbelief, and numbness (Dyregrov & Dyregrov, 2008). Parents who lose children to suicide and experience intense bereavement are twice as likely to experience complicated grief within a month of their loss.
Suicide for those who have survived the loss of a child or loved one becomes more tangible and sparks interest in suicidal behavior or ideation based on the normalization that someone else’s death by suicide presents. Although there are significant effects associated with grief and bereavement, “It is the psychological and behavioral reaction to the loss of a significant other… not a disease” (Andriessen, Draper, Dudley & Mitchell, 2015). Furthermore, regardless of the life changing impact that follows a loss by suicide the behaviors experienced proceeding that loss are directly connected to that significant life event. For some, the loss of a child or loved one can lead to post-traumatic stress disorder (PTSD) but it is also believed that following the PTSD comes post-traumatic personal growth (Feigelmen, Jordan, & Gorman, 2009). According to Pitman et al., (2017) studies show a direct link associated with suicide bereavement and the carrying out of a suicide attempt (p. 6).
Reactions from the Communities and/or Religious Institutes, and Coping Strategies for the Families
Mental health carries a huge barrier of being stigmatized among all different types of communities, working in conjunction with faith-based community partners supports the efforts to provide suicide prevention while being culturally sensitive making it a more acceptable practice. An example of a successful multifaceted approach is, “Western Athabaskan suicide prevention program had multiple components including a network of natural helpers, community education, suicide risk screening, postvention following suicidal behavior (e.g., support for individuals or families who have lost loved ones due to suicide), and adoption of guidelines for preventing suicide clusters” (Goldston et al., 2008). Although it is widely recognized that religion prohibits against suicide, the spiritual faith creates a bond between the individual and other worshipers but also establishes a connection with a higher power.
The reinforcement of protective factors through cultural strengths that include religion and/or spirituality, to those who disproportionately experience intersectionality either in their home country or in the United States, helps empower groups that are often underserved (Goldston et al., 2008). Spiritual faith also has a significant effect on the manners on how youth cope with daily stressors and equipping them with tools such as increased coping skills, religious beliefs, social support, and connections (Saroglou, 2011; Bakhiyi, Calati, Guillaume, & Courtet, 2016). ******
Personal growth as a coping strategy for families who had lost a loved one to suicide, and giving back to their communities and using their grief as a platform to change who they are thus becoming more compassionate, caring and a help giving individual. Community involvement helps mitigate and reestablish a sense of purpose in survivors and helps promote inner healing. A common trend among families who are suicide loss survivors help bring awareness to the cause, help change public perception and help raise funds for future research on suicide and suicide prevention (Feigelman, Jordan & Gorman, 2009).
Interventions for Families, focusing on Parents – Include Helpful Resources
Survivor groups that are specific for parents who lost a child to suicide differ from other loss groups due to the stigma attached to death by suicide. One intervention is a peer supported program, this intervention consists of personal meetings and/or telephone conversations. Another common option is psychotherapy either individual or in a group setting that promotes the principles of socialization, recreation, and leisure (Linde et al., 2017). A common and more convenient option for those experiencing bereavement and loss is an online forum such as, suicidegrief.com, with the purpose to provide comfort and support to individuals whose life has been affected by a suicide loss.
An online community listed on the suicide grief support forum is Parents of Suicides – Friends and Families of Suicides, directly linked from The American Foundation for Suicide Prevention website (2018). Through this online platform parents experiencing grief or bereavement are able to establish connections with others who have experienced similar situations from the comfort of their own home. A local resource group for suicide loss survivors is a cost-free group at Venice Church called SOLACE-support group for suicide loss. Venice church hosts the group on h Saturdays between 2-3:30 for adults to possibly help alleviate loneliness and feel more understood in a safe and supportive environment (ASFP, 2018).
Conclusion/Roles of Social Workers, and Possible Issues for Future Practice and Questions for Further Discussion
Teen suicide continues to be a growing trend, as a social worker our responsibility is to be agents of change, advocate and ensure we have valid and sufficient research to address this growing public health concern. According to the NASW code of ethics, some of the social work foundational ethical principles are; recognize central importance of human relationships, and to help people in need and address social problems (National Association of Social Workers, 2018).
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