Adolescence

Today there are 1.3 billion adolescents in the world, more than ever before, making up 16 per cent of the world’s population (UNICEF, 2018). Adolescence is defined by the United Nations as the period between the ages of 10 and 19.  Adolescents experience a transition period between ‘dependency’ in childhood, though to ‘independence’ to adulthood (Geldard et al., 2019) with significant growth and development. Adolescence face life-stressors including physiological, biological, cognitive, behavioural, social and environmental challenges. Additionally, some young people may face and be exposed to physical, mental, verbal, and sexual abuse that may lead to mental health challenges and risks, including anxiety, depression and suicide ideation that need to be recognized.

It’s normal to feel down or sad from time to time. For some people, feelings of sadness and unhappiness can outweigh happy and excited emotions.  Rates of suicide in Australia have caused a great deal of concern, as youth suicide is now the leading cause of death in young Australians aged from 15 to 24 years of age (Australian Institute of Health and Welfare, 2021c). Many more young people attempt suicide or consider taking their lives (Department of Education, 2022).  On occasions, adults often rub off adolescent depression symptoms simply as a phase, or a reaction to a situation or life-stressor that the young person has been exposed to, or simply could not handle. Unfortunately, all of these stressors can result in many young individuals experiencing some level of suicide ideation, attempt or suicide.

Suicidal Ideation

There are many factors that can contribute to someone experiencing suicidal thoughts (Headspace, 2022c). These thoughts can be related to a person’s ‘mood, past or current life circumstances’ (Headspace, 2022c), or as a part of a mental health condition, including anxiety and depression.

Many adolescents have thoughts of suicidal ideation when life seems unbearable and they want to end their pain. Most adolescents who have suicidal thoughts may not actually want to die, they just can’t imagine another way out of what they are going through. Families, schools and environments have a critical role and influence on the young person who is at risk of suicidal ideation as a “young person clearly has no control” over their family (Geldard et al., 2019). Suicide, suicide attempt and ideation are strongly linked to childhood and childhood abuse (Calder et al., 2010). Exposure to family problems including breakdowns and stability as well as serious impairment of communication between parents and the young person heighten the risks (Geldard et al., 2019). A youngster who has been predisposed to abuse during childhood is at a greater risk of suicide ideation, and if the abuse continues, including physical abuse this escalates greater risk factors for suicide and attempts (Kaplan et al., 1997).

School is a multi-dimensional context for a young person and plays a critical role in their individual lives that can have a lasting impact (Geldard et al., 2019). School is not just a place for learning. Schools offer a place where relationships and friendships are formed as well as direct pressures from parents, teachers and peers to perform academically, and additionally to conform to social and behavioural expectations. These expectations may be positive or negative to educational outcomes and wellbeing. Suicidal ideation can occur at school when the young person is unable to adaptively deal with life-stressors when confronted. Life-stressors include relationship or friendship breakdowns, exclusion from peers, bullying and experience of academic pressure and failure. These are factors that can contribute to someone experiencing suicidal thoughts and heighten to suicide when the young person is feeling isolated and alone to the point of it being unbearable.

The world is moving at such a rapid pace, and this predisposes today’s modern adolescent to the risk of media. Media is risk factor that adolescents are continually exposed to, as they are bombarded with pervasive, consumerism influences (Larson, 2002) through Tik-Tok, Facebook, Messenger Apps, Instagram and Snapchat, damaging an individual’s self-esteem, confidence and reputation and exposing them to cyberbullying on a scale that has never been seen before. The Australian Institute of Health and Wellbeing (2020a) identify one in four children have had unwanted contact online and almost half of adolescents have been bullied online, on at least one occasion.  The statistics are alarming, identifying risk factors that may impact on the individual young person’s mental health and heightens risks of suicidal ideation, attempts and suicide.

Evidence of Symptoms

Suicidal thoughts can happen as part of a metal health condition, like depression, personality disorder or other mood difficulties (Headspace, 2022c). The precursors and symptoms are increasing in Western society, resulting in suicidal ideation, attempted suicide and completed suicide (Dacey et al., 2006). For many young people who attempt or complete suicide they often have more stressful lives, fewer coping strategies and are often under-achieving, with poor school performance. Particularly “vulnerable to suicide are those young people who suffer from a depressive illness” (Geldard et al., 2019). They are more likely to commit to “suicide than young people with other psychiatric or medical illnesses” (World Health Organisation, 2016).

Suicide is complex. It’s unlikely to be the result of a single problem or event, but more likely a combination of stressors that result in a young person feeling overwhelmed and unable to cope (Headspace, 2015). Because teachers have day-to-day contact with many young people, a teacher is in a critical position to notice suicide warning signs.  Behavioural warning signs include self-harming, giving away their possessions, writing goodbye letters to people in their life, seeming to have less physical energy, feeling trapped and helpless, abusing drugs or alcohol and isolating themselves to the point that they feel alone or unsupported. When young people are demonstrating suicidal behaviours or advise that they will commit suicide, “it must always be taken seriously” and reported (Headspace, 2022c).

Suicidal ideation and suicide is a difficult topic for many people and young people who belong to an identified high‑risk group, including Australia’s Aboriginal and Torres Strait Islander peoples, so additional considerations are required. Young people are commonly bombarded by social life-stressors and expectations, as well as direct and indirect pressures from family, peers, school and community. Adolescents who are overwhelmed, or fail to perform to society social expectations, are identified high-risk of considering suicidal ideation, attempt or suicide.

Impact on the Individual and Interactions

Many young people consider or attempt suicide. A higher percent of males in this age group die by suicide, as compared to females (Headspace, 2015). According to Headspace (2015) many adolescents who die by suicide are experiencing mental health conditions such as depression at the time of their death. While it’s a rare phenomenon, ‘suicide contagion’, is when ‘one suicidal act’ within a school or community increases the likelihood that others ‘will attempt or die by suicide’ (Headspace, 2015).

Schools are in a critical position, if anyone is immediately affected by suicide ideation, attempt or suicide death. The individuals should be supported in a safe and secure place, where extra support including counselling can be provided and monitored. Family members also may need assistance to know how to support the affected person (Headspace, 2015). The role of the Guidance Officer is to provide immediate crisis support and ensuring a careful referral with client follow-up (Ivey et al., 2016).  The Guidance Officer will provide them with resources and contact details for support services in the local community.

Suggested Interventions      

Suicide and attempts have serious implications for school communities. Any suggestion of suicide should always be taken seriously and is to be brought to the immediate attention of the Guidance Officer (GO) and Principal. The suicide response plan will outline the critical response steps to be undertaken by the GO in this circumstance. This process is known as ‘suicide postvention’ (Headspace, 2019).

Responding to a student at risk of suicide can be very difficult and confronting, but there are strategies that can be implemented to support a student. The GO can utilise the GRIP Framework used in a  high school setting (Responseability, 2007). The GRIP framework has four elements, Gather, Respond, Involve and Promote that will be applied under the ‘close supervision’ of the Senior Guidance Officer (Geldard et al., 2019).  A care team is developed to analyse the case, develop an Individual Support Plan and involve the appropriate internal (school context) and external agency through a referral process. This process guides the best approach to circumstances and offers necessary support to the individual and their family, as well as identified school staff, including the student’s teachers on a strict confidential basis.

GO’s in schools are in are in a advantageous position to help drive positive change (Be You, 2022c) and stigmas surrounding mental health. Responding to “students’ wellbeing in a safe, supportive and inclusive environment assists children and young people to be resilient, confident and lifelong learners” (Commonwealth of Australia, 2008). The GO will take practical action and identify appropriate and necessary educational programs and training to support a school context at each level, student, educator, administration, family and community.  Research has indicated the most effective approaches to mental health are those that involve and are accessible to everyone.