Sunday, September 11, 2011

Suicidal teens and youth

Teenagers today are compulsive and impulsive. They live in the world that requires them to do things quickly. Ironically, when they can’t solve their problems, some of them want the easy way out: suicide.

SUICIDE is symptomatic of a very dysfunctional society,” says suicidologist Adnan Omar. He explains that even though today’s teens are “very techno-savvy”, they have become rather impulsive.

“They want solutions to life’s problems delivered quickly, like fast food delivery!” says Adnan, who is also manager of Counselling and Psychological Services Centre, Taylor’s University, in Petaling Jaya in an email interview.

He says in today’s society, technology thrives on speed. But the downside of technology is that it “shortens rationality and truncates emotionality”.

Adnan ... They (teens) want solutions to life’s problems delivered quickly, like fast food delivery!

In other words, he reckons that teenagers want “super quick” solutions to life’s problems. “As a result, they thrive on temporality, immediate gratification, and the now culture.”

But in terms of emotional intelligence, teenagers, he feels, have become impulsive.

“They are not able to control their emotions properly.

Hence, they explode in a destructive manner, including attempting suicide when things don’t turn out. They get frustrated easily over simple things, which results in many unhealthy doings!”

With Facebook and social media, he feels that human relationships have become more shallow and temporary.

Then, Adnan feels that a teenager’s life is further complicated by the way his parents live. It appears that there are NOT enough hours anymore in a day to work.

He concedes: “Parenting becomes a biological ritual. We contract our love and care to maids, money, and the Internet. Parents are no longer idols; they have apparently been replaced by singers and actors, who are also teenagers themselves!”

Teenagers, he feels, don’t have strong and responsible adults and role models who can guide and teach them about life, resilience and self-awareness. Schools and families still play tug of war; each blames the other.

“It’s time for the society to reflect, pause and analyse the way it’s breathing and living. It’s time for various parties such as schools and families to seriously restructure to accommodate the real needs of teenagers so that we can begin understand their pain, agony and happiness,” he emphasises.

School authorities need to develop protocols, processes and procedures on how to handle suicide emergencies and cases, says Adnan.

“They need to look into aspects like which school personnel should be the first responder, who should inform the parents, and who needs to handle the media and other authorities such as the police,” says Adnan in response to questions on how school authorities should handle suicide prevention and whether they are equipped to tackle such situation.

Schools also need to have a comprehensive programme for debriefing and counselling students and staff who are affected by suicide.

“An effective follow-up programme needs to be in place because people react differently to suicide and death,” he says.

Asked if talks about handling emotional crisis, boy-girl relationships and suicide prevention should be held in schools, colleges and tertiary education centres to create awareness, Adnan opines: “The more informed we are about things, the better we can manage situations.”

He says: “Awareness programmes (talks, seminars, campaigns and conferences) are critical. These programmes need to focus on prevention, intervention and collaboration amongst various school authorities.”

“Some important awareness issues are: What is suicide? How is suicide different from other forms of self-destructive behaviours such as cutting oneself? What causes suicide? What are the signs that a student is suicidal? How can we help?”

An important component of the awareness programme, Adnan says, is to teach the students and staff about stress and depression.

“It is generally believed that depression causes suicide and depression may be the result of chronic stress. Since stress is a real challenge in our modern life, schools should, if possible, include in the curriculum the topic about stress.”

The discussion should include issues related to building emotional resilience and handling various emotional challenges such as academic failure and relationship break-ups.

Another critical issue is the stigma of suicide.

“The awareness programme also needs to focus on removing stigma of suicide or mental illness. For example, if you are suicidal, then you are crazy; if you seek counselling or psychiatric help, then you are suffering from mental illness; people who are suicidal are forever suicidal; suicide is inherited,” he says.

Beyond the programme, schools can also train a few school personnel and student counsellors to specifically manage suicidal cases.

Handling suicide attempts

Adnan says if a teenager is suicidal, intervention must be properly handled, says Adnan.

“If a suicide attempt is detected at school, the student should immediately be referred to a trained counsellor. If an attempted suicide occurs at home, the student should be referred to a psychiatric facility or hospital,” he advises.

On handling suicidal cases, he advises to follow these immediate steps:

1. Assess suicidality. One way to do this is by asking, “On the scale 0 to 10, 0 means you are not feeling suicidal at all and 10 means you are absolutely suicidal, how do you feel now?” Talk directly about suicide.

2. Ask about the means and remove the means!

3. Do a quick history check – mental illness, depression, attempts, coping skills, etc.

4. Develop support groups. With the student, brainstorm people who can help – parents, friends, etc.

5. Consider medication, if necessary.

6. Allow free expressions of feelings; don’t be judgmental.

At the end of the initial session, a comprehensive plan must be in place to monitor suicidality once the student leaves the counseling office.

A plan addressing the cause of suicidal thoughts or attempts must also be drafted together with the student, as well as a timely implementation of the plan. A regular follow-up must be scheduled to assess progress, or lack it.

Finding closure

Whilst the suicidal person can end his suffering tragically, he forgets that others will continue to suffer from his folly.

Adnan says: “Sometimes, we forget that many lives are affected by one suicide. It is estimated that about six to 10 significant others are severely affected by one suicide. These loved ones need to grieve and mourn the loss of the person who committed suicide.”

It is believed that finding closure or “coming to terms” with a loss to suicide is the most difficult when compared to loss of life due to natural death or accidental death.

Sometimes, it takes over six years for the survivors to find the closure.

Adnan shares ways which may be helpful to “survivors” of suicide:

1. Know that you can survive. You may not think so, but you can.

2. Struggle with “why” it happened until you no longer need to know “why” or until you are satisfied with partial answers.

3. Know you may feel overwhelmed by the intensity of your feelings, but all your feelings are normal.

4. Anger, guilt, confusion, forgetfulness are common responses. You are not crazy, you are in mourning.

5. Be aware that you may feel appropriate anger at the person, at the world, at God, at yourself. It’s okay to express it.

6. You may feel guilty for what you think you did or did not do. Guilt can turn into regret, through forgiveness.

7. Having suicidal thoughts is common. It does not mean that you will act on those thoughts.

8. Remember to take one moment or one day at a time.

9. Find a good listener with whom to share. Call someone if you need to talk.

10. Don’t be afraid to cry. Tears are healing.

11. Give yourself time to heal.

12. Remember, the choice is not yours. No one is the sole influence on another’s life.

13. Expect setbacks. If emotions return like a tidal wave, you may only be experiencing a remnant of grief, an unfinished piece.

14. Try to put off major decisions.

15. Give yourself permission to get professional help.

16. Be aware of the pain of your family and friends.

17. Be patient with yourself and with others who may not understand.

18. Set your own limit and learn to say no.

19. Steer clear of the people who want to tell you what and how to feel.

20. Call on your personal faith to help you through.

21. It is common to experience physical reactions to your grief, such as headaches, loss of your appetite, inability to sleep.

22. The willingness to laugh with others and at yourself is healing.

23. Wear out your questions, anger, guilt, or other feelings until you can let them go. Letting go doesn’t mean forgetting.

24. Know that you will never be the same again, but you can survive and even go beyond surviving.