Teen Suicide: The Need for Concrete Reactive Intervention Strategies

Suicide has remained one of the top five leading causes of death for teenagers since the 1970s when statistical records were reliably validated by governmental organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). Today, suicide is the third leading cause of death nationwide for teenagers (WHO, 2023). In the United States, there has been a noted exponential increase in the rates of suicide and suicide attempts among teenagers since the COVID-19 pandemic (Curtin & Garnett, 2023). Data from the CDC and the National Center for Health Statistics (NCHS) suggest that the prevalence rates for suicide among teenagers have increased by as much as 56% in this postpandemic era compared to prevalence rates recorded in the early and mid-2000s (Curtin & Garnett, 2023).

The causality of this drastic increase in suicide rates is difficult to pinpoint. Numerous studies have examined the negative effects of various compounding factors on American teenagers, such as isolation during COVID-19 lockdowns, lack of social interaction with peers during school closures, lack of access to necessary mental health ­treatment during lockdowns, increased ­bullying and har­ass­ment on social media, increased prescription medication usage, increased economic stress on the family structure, decreased parental supervision in the home, and numerous other factors. Yet, despite the vigorous and thorough re­search on the causalities facilitating this expanding suicide epidemic, very little pragmatic data have emerged that has been effective in offering any concrete solutions to remediate the escalating issue.

As the rate of fatal suicide attempts among teenagers in the United Sates continues to increase, public health experts continue to scramble to seek effective solutions and offer effective interventions. Under such drastic current conditions, many public health experts are now advocating for a change in suicide response methodologies. The current prevailing mentality among many public health experts appears to have shifted from focusing on research-based and data-driven initiatives emphasizing proactive approaches to minimizing the prevalence rates of suicide, to advocating for more targeted reactive approaches that are centered on preparation for acute treatment during suicide, attempts (American Psy­cho­logical Association, 2021).

These targeted reactive intervention strategies appear to be plausible pragmatic approaches based on the current prevailing mechanisms through which teenagers attempt suicide. The overwhelming majority (approximately 90%) of intentional teenage suicide att­empts initiate with a form of consumed poison in tablet form in the home or school setting. Pharmaceuticals, both prescription and over the counter, account for approximately 95% of consumed poisons ingested during teenage intentional suicide attempts. Analgesics, such as acetaminophen, are the primary poison of choice during suicide attempts (40%), followed by antidepressants (20%), cold and allergy medicine (18%), sedatives (15%), and a variety of other options, including common street drugs, herbal supplements, household cleaning supplies, alcohol, and/or combinations of the aforementioned available home substances (5%; Overall et al., 2021). Because such poisons tend to offer a latency period before death, immediate first responder care, when implemented in a timely and accurate fashion, has the potential to save a life.

Therefore, many public health experts are currently advocating for acute response training interventions that prepare parents, guardians, teachers, coaches, siblings, peers, and other individuals as primary first responders for attempted suicide scenarios. Very similar to the trainings and certifications offered for cardiopulmonary resuscitation, such suicide prevention training interventions would focus on immediate care strategies required in self-inflicted poising scenarios to save an individual’s life. The Suicide Prevention Resource Center (SPRC) currently offers the most comprehensive, best-practice training materials (SPRC, 2020). However, the SPRC intervention materials still heavily favor proactive techniques focusing on identification of warning signs and minimizing prevalence rates through early intervention, not reactive strategies de­signed for first responders. Similarly, the majority of departments of Beha­vioral Health and Developmental Dis­abilities in various states currently offer proactive prevention strategies, with little focus on reactive strategies designed to provide immediate care during suicide attempts. Hence, though there appears to be an emerging shift among public health experts in best-practice response patterns to combat teenage suicide, there remains a serious lack of available resources and materials to advance the initiative.

Therefore, the current environment may be ideal for school-based organizations, such as the National Education Association or SHAPE America – Society of Health and Physical Edu­cators to take the initiative to advance the development of reactive strategies designed to provide immediate primary care for suspected suicide att­empts by poisoning among teenagers. An organization such as SHAPE America, with its extensive knowledge of health literacy, health education, and curriculum development, may very well be in the best position to take up this charge and develop and disseminate the necessary life-saving skills that ensure that a teenager’s darkest hour is not their last.

Disclosure Statement

No potential conflict of interest was reported by the authors.

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Notes on contributors

Kevin Hunt and

Kevin Hunt ([email protected]) is a professor and Helen Dupree is a lecturer in the School of Health & Human Performance at Georgia College & State University in Milledgeville, GA.