SIEC Alert

Children and Suicide

Incidence of Child Suicide and Suicidal Behaviours

Motivations For Suicidal Behaviours

Risk Factors For Child Suicide

Strategies For Preventing Child Suicide

Children and Suicide

It is widely believed that childhood is a time which confers a relative immunity from the risk of suicidal behaviours. This belief is based on two notions: childhood is in large measure free of problems and stress, and children do not have the developmental maturity to think of or act upon suicidal thoughts (Pfeffer, 1993: 175). However, recent research has found that by grade 3 children (age 8-9) have a thorough understanding of suicide, and that younger children understand the concept of "killing oneself" (Mishara, 1999: 105, 114). Statistics also verify that children do act upon suicidal thoughts.

Incidence of Child Suicide and Suicidal Behaviours

Data from Statistics Canada indicates that during the period 1993-1997, 229 Canadian children ages 5-14 completed suicide.

• 2 of these suicides were by boys under the age of 10

• Of the remaining 227 children, 155 were male and 72 were female

• Highly lethal methods were common. For both males and females, hanging and firearms accounted for over 90% of deaths.

Even though suicide is also very rare among Americans under age 14, studies have shown high rates of nonfatal suicidal behaviours and ideation among children, especially those who are psychiatric patients (Pfeffer et al, 1993: 106; Milling et al, 1994: 228; Marciano & Kazdin, 1994: 151). In 1997, it was estimated that nearly 1% of school-aged children attempted to harm themselves and even more contemplated self-harm (Goldman & Beardslee, 199: 417). In addition, an undetermined number of traumatic injuries and "accidental" self-poisonings are believed to be suicidal in their intent.

Motivations For Suicidal Behaviours

It is much easier to believe that the suicidal thoughts or behaviours displayed by a child are trivial or are ploys to get attention (Greene, 1994: 231). However, childrens' suicidal behaviours are rarely impulsive and their motives, particularly ones which are interpersonal, can be similar to those of adults. Some reasons that children may engage in suicidal behaviours are (Goldman & Beardslee, 429):

• An attempt to regain control in their lives

• Retaliation or revenge against real or perceived wrongs

• Reunion fantasies

• Relief or escape from unbearable pain

• They see themselves as the family scapegoat

• To distract the family from other issues, e.g. divorce

• Acting out a covert or overt desire of the parent to be rid of the child

Risk Factors For Child Suicide

Factors which may place children at increased risk for suicide and suicidal behaviours can also be similar to those which place other age groups at risk and include:

• Depression and hopelessness

• Psychiatric disorders

• Poor social adjustment

• Emotional, sexual and/or physical abuse

• Change in the child's role in the family

• Family problems or familial suicide

• Chronic health problems

• History of suicidal behaviours

• Poor coping strategies

Strategies For Preventing Child Suicide

There is a tendency in our society to deny suicide and especially the possibility of child suicide. Greene asserts that there are at least two reasons for this: the desire of families to avoid stigma and the small number of suicides among children (Greene, 230). In order to prevent child suicide, we must first acknowledge that children do have suicidal thoughts and that they might act upon these.

Some strategies for preventing child suicide include:

• Strengthening family relationships. Prevention needs to start within the home with parents actively involving themselves in their childrens' lives (Workman & Prior, 1997: 131).

• Greater public awareness of risk indicators and intervention techniques (Tousignant & Hanigan, 1993: 113).

• Education programs for students, community workers and school personnel which teach children how to ask for help for themselves or a friend and which give gatekeepers skills in identifying children at risk and sources of help (workman & Prior, 131; Goldman & Beardslee, 441).

• Early intervention programs which address and treat known risk factors for suicide, e.g. family dysfunction, depression (Goldman & Beardslee, 441).

SIEC thanks Brian Tanney, MD, FRCPC for reviewing this issue of Alert