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Since the 1950s, suicide rates have increased dramatically among young people in the U.S. and Canada. Suicide is the third leading cause of death of young people between the ages of 15 and 24 in the U.S. (National Center for Health Statistics, 1989), and the second leading cause in Canada (Health and Welfare Canada, 1987). Although official suicide rates are much lower for children under 15, suicidal behavior has been reported even in very young children. It is generally accepted that many suicides are unreported or misreported as accidents or death due to undetermined causes (particularly for young children). It has been estimated that the actual number of suicides may be two to three times greater than official statistics indicate (American Psychiatric Association, 1985). The presence of a psychiatric disorder--particularly a mood disorder such as depression or bipolar illness, a conduct disorder, or a psychosis--contributes to the likelihood of suicide. Depression often exists in conjunction with other mental disorders or with other long-lasting social or behavioral problems. However, not all students with depression or other psychiatric disorders are suicidal. Very little information is available regarding the prevalence of depression or suicide in students who receive special education services, although relationships between cognitive deficits and depression and between diminished problem-solving abilities and suicidal behavior have been noted. Medical problems have also been associated with depression and suicide. Estimates of the prevalence of depression or symptoms of depression among children and youth with learning or behavior problems tend to be higher than those for the general population (e.g., Forness, 1988). Children with symptoms of depression, particularly gifted children or children who do not also exhibit symptoms of another disorder, may be overlooked in the school referral process for special education services (Guetzloe, 1989, 1991). What Factors Place Students at Risk of Suicide? Researchers have attempted to identify situations, experiences, or characteristics that contribute to the likelihood that a child will complete a suicide (e.g., Blumenthal, 1990; Davidson & Linnoila, 1991; Pfeffer, 1989). When a child has more than one of these factors, the risk of suicide is increased. In addition to mental illness and behavior disorders, suicide has been associated with demographic factors, such as being between the ages of 15 and 24, being white or male, or having a history of attempted suicide. Psychosocial conditions, such as parental loss, family disruption, exposure to suicide, unwanted pregnancy, and particularly, having a relative who has committed suicide are additional factors. Certain biological conditions have also been associated with suicide; these include perinatal factors, decreases in levels of serotonin, and decreases in the secretion of growth hormone, among others. The American Association of Suicidology has developed guidelines for the media, aimed at reducing the contagious effects of suicide reports. They recommend that the press avoid providing specific details of the method, romanticization of the suicide, descriptions of suicide as unexplainable, and simplistic reasons for the suicide. Further, news stories about suicide should not be printed on the front page, the word suicide should not be in the headline, and a picture of the person who committed suicide should not be printed. How Can a Student Who is Potentially Suicidal be Recognized? Suicidal ideas, threats, and attempts often precede a suicide. The most commonly cited warnings of potential suicide include (a) extreme changes in behavior, (b) a previous suicide attempt, (c) a suicidal threat or statement, and (d) signs of depression. Young children who have depression may have physical complaints, be agitated, or hear imaginary voices. Adolescents may have school difficulties, may withdraw from social activities, have negative or antisocial behavior, or may use alcohol or other drugs. They may display increased emotionality, and their moods may be restless, grouchy, aggressive, or sulky. They may not pay attention to their personal appearance. They may refuse to cooperate in family ventures or want to leave home. They may feel that they are not understood or that they are not approved of, or they may be very sensitive to rejection in love relationships.
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