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Preventing Adolescent Suicide
What Are the Warning Signs

The ability to predict suicidal behavior is still relatively poor. It is difficult to distinguish those likely to attempt suicide from those who will complete suicide. However, in approximately 80% of cases, young people who complete suicide have communicated suicidal thoughts and feelings and their intent to kill themselves to someone prior to the suicidal act.

Although it is not possible to prevent every suicide, it is possible to recognize changes in behavior and the existence of common crises that may precipitate suicidal behavior. Those who are likely to come into contact with young people can help. Knowledge of the warning signs and risk factors may help people to intervene in the potentially destructive process in which a young person is enveloped and take action to alleviate it.

The more of the observable signs, the more stressful episodes and chronic life stresses that a young person shows, the more at risk of suicidal behavior they generally are. It is important to note the duration and intensity of these factors and to consider any changes in observable behavior in the light of the individual concerned rather than necessarily comparing one person with another. Depressed mood and drug or alcohol abuse is a particularly deadly combination.

Observable Signs of Suicide Risk

•Marked decline in school performance and levels achieved.
•Skipping classes and opting out of school activities generally.
•Poor concentration, sleepiness, inattentiveness
•Unusually disruptive or rebellious behavior.
•Death or suicide themes dominate written, artistic or creative work.
•Loss of interest in previously pleasurable activities.
•Inability to tolerate praise or rewards.

•Giving away prized possessions.
•Sudden changes in relationships, for example, exhibiting disruptive behavior.
•Withdrawing from friends and social involvements.
•Not wanting to be touched by others.

•Apathy about dress and appearance.
•Sudden change in weight.
•Running away from home.
•Risk-taking and careless behavior
•'Accident proneness'.
•Sudden and striking personality changes and changes in mood.
•Overt signs of mental illness (for example, hallucinations).
•Loss of sense of humor or sudden compulsive joking.
•Sleeping pattern changes.
•Self-mutilation behaviors.
•Noticeable increase in compulsive behavior.
•Development of extreme dependency.
•Sudden happiness after a prolonged period of depression.
•Impulsive tendencies.
•Depressive tendencies.
•Unrealistic expectations held of self

•Direct statements, for example/ 'I wish I were dead', 'I'm going to end it all'.
•Indirect statements, such as, 'No one cares if I live or die', 'Does it hurt to die?'

Episodic Stressful Precipitants (Stressful Episodes)

•In trouble with school authorities or police.
•Loss or disappointment in school.
•Change of school and/or address.
•Strong demands from adults for show of strength, competence and effectiveness.

•Loss of an important person through death or divorce.
•Recent suicide of friend or relative.
•Breaking up with boyfriend or girlfriend.
•Exposure to violence, incest, rape.
•Abusing drugs or alcohol.
•Feared pregnancy.
•Refusal by significant other to provide anticipated help, support or love.
•Major disappointment or humiliation
•Major family dysfunction.

Chronic Stressful Life Situations

•Chronic depression or mental illness in parent(s).
•Incest or child abuse.
•Severe parental conflict.
•Family involvement with drug or alcohol abuse.
•Poor communication with parents.
•Pressures for high achievement to gain parental approval or acceptance.
•Exposure to suicide, suicidal behavior or violent death of family member or friend.

•Involvement in physical violence.
•Inability to relate well to peers.
•Sexual promiscuity.
•Inability to enjoy or appreciate friendships or to express affection openly.
•Mood swings and occasional outbursts.
•Feelings of worthlessness, being a burden or having let parents or others down.
•Feelings of guilt, failure. having no control over their lives.

Mental Health Library
Royal Park Hospital
Parkville, Victoria 3052
Tel: (03) 9342 2574/5