Youth Suicide: What Every Parent Needs to Know


Paul Quinnett, Ph.D.


What do you know about youth suicide and how to prevent it? If you are like most parents, you know very little. And, if you are like most parents, you believe your child would never end his or her own life.


But each year roughly 10,000 American parents must deal with the loss of one of their children to suicide. It is an unbearable tragedy and, sadly, in the majority of cases the death was preventable.


Most parents do not believe their child would ever think about suicide, plan it, or attempt it. Yet, according the American Association of Suicidology and Centers for Disease Control thousands upon thousands of young people do just these things each year. It is estimated that 25 percent of high school students give suicide serious consideration, and nearly 4,000 young people between 15 and 24 die each year by their own hand.


While suicide is the 3 rd leading cause of death for teenagers, according to the National Mental Health Association, "suicide is the second leading cause of death among college-age students, with an estimated 1,088 occurring on campuses each year." Young people are one of the highest at-risk populations for suicide in America and around the world.


Not my child, you say?


A study by the Centers for Disease Control published in the Journal of Consulting and Clinical Psychology in 1995 found 10 percent of college students admitted to having suicidal thoughts during the 12 months preceding the survey, and more than twice that number of high school students admit to such thoughts.


Based upon this published scientific research, the odds are that your child will contemplate suicide in the next 12 months is at least one-in-ten.


No loving parent is willing to accept a 10 percent chance their child will think seriously about suicide in the next 12 months and do nothing about it. Yet most parents do not know the warning signs of suicide or the symptoms of depression that drive the feelings of despair and hopelessness that cause suicidal thoughts and feelings, or what to do about them.


Parents should know they are not alone in helping to prevent their child from becoming so distressed he or she contemplates or attempts suicide. The new National Strategy for Suicide Prevention 2001 specifically targets suicide prevention education and training for youth in middle and high schools, as well as young people at colleges and universities, and the U.S. Senate recently passed the Lee Garret Smith Memorial Act (Senator Gordon Smith, R Oregon lost his college-aged son to suicide) that is now funding youth suicide prevention programs across the nation.


Here's why the country is initiating suicide prevention programs:


Young people have the highest incidence of reported suicide ideation (thinking about suicide)
We are losing some of our brightest and most able young people to a preventable death
A large proportion of this at-risk population could be reached through school and campus-based suicide prevention efforts
Parents who lose their children to suicide say that if they had known 30 days before the suicide what they knew 30 days after t he suicide, the life of their child may have been saved
Knowing what to look for and what to do can prevent a tragedy


Depression and other problems


Evidence suggests that over 90 percent of young people who die by suicide have a mental disorder. The most common disorders that predispose young people to suicide are mood disorders, e.g., major depressive disorder. Competent diagnosis and treatment of these disorders saves lives, and treatment is highly effective.


Most youth in crisis send warning signs they are in trouble, e.g., statements of hopelessness, saying goodbye, giving away prized possessions. This is our opportunity to act. If you think you have seen any of these warning sings, take action immediately. Be bold, and don't wait or talk yourself out of your fear. Fear is a trustworthy emotion and should be honored by action.


Watch for symptoms of depression or other problems, for example, not sleeping, failing classes, having trouble with concentration, attention, irritability, relationships, or feeling down, out of sorts, or bored. Most young people have never experienced depression and may not describe the symptoms well. You will learn more about depression in this program.


What can I do now?


Learn QPR and become a suicide prevention gatekeeper. With suicide the 3 rd leading cause of death of young people, all parents, teachers and youth leaders should learn QPR. QPR is the most widely taught emergency response to a youth crisis in America . It is taught by more than 2,000 Certified Instructors and more than 250,000 adults have been trained to help prevent suicide.


What is QPR?


QPR stands for Question, Persuade and Refer, an emergency mental health intervention that teaches lay and professional gatekeepers to recognize and respond positively to someone who may be exhibiting suicide warning signs and behaviors.


What is a Gatekeeper?


According to the Surgeon General's National Strategy for Suicide Prevention (2001), "key gatekeepers" are "people who regularly come into contact with individuals or families in distress" and gatekeeper training has been identified as one of a number of promising prevention strategies. Key gatekeepers include a variety of professionals who are in a position to recognize a crisis and the warning signs that someone may be contemplating suicide, including, "teachers, school personnel, clergy, police officers, primary health care providers, mental health care providers, correctional personnel, and emergency health care personnel." Among others, gatekeepers can also include parents, coaches and religious leaders. Gatekeeper training is seen as a promising approach to preventing youth suicide.


How is QPR like CPR?


CPR stands for cardio pulmonary resuscitation, an emergency medical intervention created by Peter Safar in 1957. CPR is part of the "Chain of Survival" model of emergency cardiac care. The likelihood that a victim will survive a cardiac arrest increases when each of the following four links is connected:
* Early recognition of warning signs
* Early CPR .
* External defibrillator
* Early Advanced Life Support and access to medical treatment


QPR is designed to work like CPR. QPR teaches potential gatekeepers how to recognize, intervene, and refer at-risk youth for professional evaluation and help. For QPR to be effective the following four links in a chain of survival must also be in place:
* Early recognition of suicide warning signs . The sooner warning signs are detected, the sooner an intervention can be initiated.
* Early QPR . Directly asking someone emitting suicide warning signs opens a potentially life-saving, caring dialogue which may a) immediately reduce anxiety and distress and b) enhance protective factors to decrease risk factors, e.g., restore hope, decrease isolation, and increase social and spiritual support while removing the means of suicide.
* Early referral . Linking the at-risk person to local resources or calling 1-800-SUICIDE or 1-800-273-TALK for evaluation is essential to reducing immediate risk.
* Early professional assessment and treatment. As with any life-threatening crisis or illness, early detection, assessment and treatment result in reduced morbidity and mortality.


The goal of QPR training is to enhance the probability that a potentially suicidal youth is identified and referred for assessment and care before a suicide attempt or completion occurs. Based on self-reported student survey information in one large school system, an estimated 6 percent all students report "harboring significant thoughts and/or plans about suicide" over a 12-month period, but no more than 5 percent of these suicidal children were actually identified and referred for care by school staff. Thus, most youth at risk for suicide suffer in silence and go undetected and untreated.


When QPR is applied as it is taught, it delivers a strong and positive response to someone showing warning signs of a pending suicide event. Just as the prompt recognition of the scream of a smoke detector can eliminate the need to suppress a raging fire, so too can the early recognition of suicide warning signs, confirming their presence, and opening a supportive, caring dialogue with a suicidal youth prevent the need for an emergency room visit or a psychiatric hospitalization. The interaction between a trained and caring adult gatekeeper and an at-risk youth may lead to improving protective factors, enhancing knowledge and decision making, and building resiliency to deal with conflicts and challenges in healthier ways.


QPR is currently being investigated for effectiveness in a wide variety of settings and in several major research projects funded by the U.S. Government. The potential of gatekeeper training programs has been documented as a promising tool in school settings to enhance intervention for youth at elevated risk for suicide. Research findings are encouraging with regard to enhanced knowledge, improved attitudes, preparation for coping with a crisis, and referral practices.


How can I get QPR training?


QPR is taught by Certified Instructors in classroom settings and takes approximately 60 to 90 minutes. It is also offered in CD-ROM format and via an online, interactive, multi-media and video program delivered by the QPR Institute and its educational partner, Eastern Washington University . The QPR Institute trains and certifies QPR instructors in face-to-face training formats, or using distance learning technologies. The training to become a certified instructor requires eight to 10 hours of work.


Eastern Washington University and the QPR Institute also offer advanced training programs targeted toward professionals who have responsibility for the health and safety of those they serve. To learn more about these college credits, CEU or non-credit online courses and programs, or to learn QPR online, please visit or


This is an exciting time in youth suicide prevention. Social policy is changing. New funding is available from the federal government. Leadership is emerging at the local, state and federal levels and new jobs in suicide prevention are being created. Lives are being saved, and youth suicide rates are trending downward. As an informed, educated parent, you can help make all the difference, if not in the life of your own child, perhaps in the life one of your child friends, or a youth you know through religious settings.


A new career?


If you are interested in a career in suicide prevention, a new 100-hour special certificate in suicide prevention is now offered on campus by the School of Social Work and Human Services at Eastern Washington University . It is the only certificate program of its kind in the United States .


Thank you,
Paul Quinnett, Ph.D.


As a thank you, SMILE wishes to make you aware of a free best-selling e-book about suicide written to those thinking about suicide and those who know, love and counsel them. It is available as free download and may be copied or printed and given to anyone you like.