Suicide has become much more common in children than it used to be. For children under age 15, about 1-2 out of every 100,000 children will commit suicide. For those 15-19, about 11 out of 100,000 will commit suicide. These are statistics for children in the USA. Suicide is the fourth leading cause of death for children ages 10-14 and the third leading cause of death for teenagers 15-19. Recent evidence suggests it is the lack of substance abuse, guns, and relationship problems in younger children which accounts for the lower suicide rates in this group.
The main way children kill themselves depends on what lethal means are available and their age. In countries where guns are readily available, such as the USA, that is the usual cause of suicide. Other causes are strangling and poisoning.
Suicide attempts that do not result in death are more common. In any one year, 2-6% of children will try to kill themselves. About 1% of children who try to kill themselves actually die of suicide on the first attempt. On the other hand, of those who have tried to kill themselves repeatedly, 4% succeed. About 15-50% of children who are attempting suicide have tried it before. That means that for every 300 suicide attempts, there is one completed suicide.
What makes a child more likely to attempt suicide?
If a child has major depressive disorder, he or she is seven times more likely to try suicide. About 22% of depressed children will try suicide. Looking at it another way, children and teenagers who attempt suicide are 8 times more likely to have a mood disorder, three times more likely to have an anxiety disorder, and 6 times more likely to have a substance abuse problem. A family history of suicidal behavior and guns that are available also increase the risk. The vast majority (almost 90%) of children and adolescents who attempt suicide have psychiatric disorders. Over 75% have had some psychiatric contact in the last year. If a number of these are present, suicide risk needs to be carefully assessed regularly. If children are constantly dwelling on death and think being dead would be kind of nice, they are more likely to make a serious attempt.
Many people have thought that the main reason that children and adolescents try to kill themselves is to manipulate others or get attention or as a "cry for help". However, when children and adolescents are actually asked right after their suicide attempts, their reasons for trying suicide are more like adults. For a third, their main reason for trying to kill themselves is they wanted to die. Another third wanted to escape from a hopeless situation or a horrible state of mind. Only about 10% were trying to get attention. Only 2% saw getting help as the chief reason for trying suicide. The children who truly wanted to die were more depressed, more angry, and were more perfectionistic.
Predicting suicide is very difficult. It is even more difficult in children and adolescents. When we discuss suicide, there are three different levels of concern.
This means a person is thinking about suicide but has no plan. This is not uncommon. About 3-4% of adolescents will have considered suicide in the last two weeks. However, these thoughts are much more likely, and more likely to be serious, if the child has previously made a suicide attempt is depressed, or is pessimistic. Children who are still depressed and have made previous suicide attempts are extremely likely to be thinking seriously about suicide.
Example: Jenna is 13. She is quite depressed. She has most of the depression symptoms mentioned. She sleeps poorly, she has no energy, can't concentrate on her work and is super cranky. She thinks about running away or how nice it would be to out of this horrible life. She thinks sometimes about killing herself, but she doesn't think about how she might do it. At the moment, she says she is too scared to actually do something. This is suicidal thinking.
This means that you are thinking about suicide and have a way to do it in mind.
Examples: Allan is 12. From what he can see, life gets worse every year. He can not imagine living like this for 50 more years. He is very irritable, is always getting in fights with his parents, and mostly says and thinks that "Life sucks!". He goes out for walks and thinks about two things. First, jumping in front of a truck. He doesn't do this because he is afraid it won't work. That is, he will end up hurt but not dead. Second, he thinks about going down to the wharf and jumping off. He is not exactly sure how to do this to make sure no one saves him.
Tina is 15. She is also very depressed. She is waiting until Friday night. Her parents are going out and leaving her home. She has been collecting Tylenol and her Grandmother's heart pills for the last two weeks. She has almost 100 pills. She has been working on a suicide note. She is scared that she will "blow it" and tell someone.
Ryan is 15. He is depressed, but has not been thinking about suicide. In fact, he told his mother this a few days ago. He told the doctor the week before that he wasn't thinking about suicide. But now, at 10:15 at night, he has had it. His mom will not let him go and see his girlfriend. That is, his ex-girlfriend. She told him on the phone this evening that she just wants to be friends. Ryan can't take it anymore. He has decided to break a light bulb and cut his wrists and just see what happens. If he dies, fine. That's okay with him.
These are all suicidal plans. Some suicide plans are well thought out, like Tina's. Others are very impulsive, like Ryan. Others are not that serious yet, like Allan's.