(dailyRx News) While adolescence tends to be a tough time for most people, the experience can become overwhelming when multiple pressures or problems are occurring at once.
Such is usually the case with teens who end up committing suicide.
So watching for the common warning signs can help parents, friends, teachers, clergy and others identify an adolescent who is in danger of harming themselves.
A preliminary report from the U.S. Centers for Disease Control and Prevention led by Katherine Fowler, PhD, investigated eight young adult suicide cases in two Delaware counties. The report identified common factors among the cases that can help with early warning and suicide prevention.
Public health authorities in the two counties, Kent and Sussex, requested the CDC's help in studying the cases because the number was so high.
All eight, involving young adults aged 13 to 21, occurred in the first three months of 2012, compared to just four suicide deaths a year in the previous three years.
Four of the suicides involved students who attended the same high school, and one involved a middle school student.
In looking at risk factors, the CDC determined that seven of the deceased young adults had mental health problems, five had legal problems and five had recently had problems with their parents.
Four were having problems with a boyfriend or girlfriend, four were using drugs or alcohol, three were having academic problems and three had left a note or called or texted someone about suicide. Two had recently had problems with a fellow student and two were gay, lesbian or bisexual.
Every one of the young adults studied who committed suicide had at least two of the above nine risk factors, and more than half of the suicide cases involved five or more of those risk factors.
The most commonly used method among the cases - which eventually included 11 suicides that the CDC identified in their investigation - was hanging, followed by a self-inflicted gunshot wound.
The CDC also identified 116 nonfatal suicide attempts during the first four months of 2012 among young adults aged 12 to 21 in these two counties, though this number could not include attempts that went unreported or did not involve medical attention.
Most of these unsuccessful attempts involved overdose, followed by cutting as the second method attempted. Both the fatal and the nonfatal suicide attempts' methods were consistent with the national patterns for the young adults age group.
"Youth who commit or attempt suicide typically have multiple risk factors for suicide before an attempt is made," Dr. Fowler wrote in the report. "A precipitating event then often triggers the attempt in an already vulnerable person. Therefore, it is possible to detect risk factors for suicide in youth, and prevent suicidal behaviors in vulnerable young persons."
LuAnn Pierce, a social worker in Colorado who works closely with adolescents, pointed out that simply knowing someone else who has committed suicide can be a risk factor in itself, and several of the young adults in this study who attempted or succeeded in killing themselves had known someone else who had committed suicide.
"The risk factors noted in this report are consistent with my experience," Pierce said. "It is always hard to know if trends are related to other influences, but there is certainly a rise in adolescent suicide. I spoke with a young person recently who has lost three significant people to suicide in two years. This young woman is now certainly at risk, as she is very depressed and has other risk factors."
Pierce said she hopes that further study into youth suicide will involve more thorough efforts to identify commonalities among them, even if those commonalities may not be readily obvious at first.
"Did they all play the same video game? Did they all live near chemical plants? Did they all have common experiences at school (bullying, failing PE or singing in the chorus)," she said, referring to the types of factors that might be uncovered when public health officials study cases more carefully.
"Based on any commonalities they may have shared, what can we infer?" she said. "Or better yet - is there anything we can do as a society to engage and identify young people to prevent their suffering?"
The CDC made several recommendations to step up prevention efforts, including periodic mental health and suicide awareness training for people working with youth, developing community partnerships for serving youth and reviewing existing resources on suicide awareness and prevention.
Pierce offers similar recommendations, including having mental health specialists in every school, every doctor's office and any other place where children and their parents spend time.
"Mental health screenings should be conducted annually, just like physical, dental and vision screenings," she said. "At some point, holding adults accountable for taking care of their children's mental health needs must become the standard - the same as taking them to see other care providers - and following up with recommended treatment."