Dr. Courtney Bagge on teenage suicides
In recent months, the Northside has experienced several tragedies involving youth suicides. To help fellow students, friends, family, school teachers and faculty, Sun Staff Writer Megan Phillips spoke with Dr. Courtney Bagge at the University Mississippi Medical Center. She was graduated from the University of Northern Iowa and attended the University of Missouri-Columbia, where she received her PhD in clinical psychology.
There have been several suicides lately. What’s the best resource teachers, parents and school counselors can give children and teens?
“I think the first thing is to let kids know that they can come talk to them as a resource. This is if they need help or just to talk about feelings, especially with teachers. It’s not just about academics… Just to really encourage kids to come talk with them and to normalize that adolescence can be a stressful period and that one time or another people struggle, and just invite them to talk.
“Know the myths… One of the most important myths out there is that talking about suicide or asking about it plants the idea. We know, actually, that asking someone about suicide doesn’t plant the idea. In fact, acknowledging it and talking about suicide can reduce suicide ideation and distress and lead to improvements in mental health.”
Even if adults are experienced, knowledgeable and approachable about the subject of suicide, aren’t some adolescents still afraid to confide in them?
“I think that there’s a huge stigma associated with mental health and suicide, specifically, and we know that kids are actually more likely to talk with their friends first. I think it’s incredibly important to educate our youth and tell them what to do if a friend talks with them. Mental health disorders are highly treatable, and they’re not given the same respect or coverage as (physical ailments). But there’s a physical, cognitive, emotional component to any mental health diagnosis, and we have excellent treatments for it.”
What can family members do together to ensure children know how to emotionally cope?
“When kids don’t go to adults, one thing that parents and adults can do is to model appropriate talking of emotions and coping behaviors. If they do that, then I think it’s beneficial to the youth but also for them going to their parents. For instance, ‘This made me sad, and I did (this),’ something as simple as that. Or for teachers to discuss how other students have had such feelings, and they did this to help and list adaptive coping strategies.
What about weapons in the home?
“Something to keep in mind, particularly for families, is safe storage. Over 50 percent of youth suicides involve a firearm, and most (firearm) deaths involve a gun that belongs to a family member, usually a parent. I think it’s just critical for parents to store unloaded guns in a locked place and then store ammunition separately in a locked place, where the youth is not aware of the combination or location of the key. I’m not saying get rid of the guns, by any means. I’m just advocating keeping them hidden and locked… With firearms, it’s instantly deadly, so there’re not a lot of chances for intervention, and that’s why I’m making a big deal of firearms. The same thing, if you’re worried about your youth, store your medications in a locked place.”
What are some of the signs both friends and adults can be aware of in adolescents suffering from mental health issues?
Some things that are also signs of depression, which we know untreated mental health issues are directly related to suicide as the leading factor. So, increased sadness, irritability or agitation, wanting to be by themselves more, withdrawal — maybe not doing things they would enjoy or partake in, changes in school or grade performance, changes in sleep and appetite. And then also alcohol or drug abuse and then having aggressive or impulsive behavior are things to watch out for. Most importantly, out of those, people talking about wanting to hurt themselves or kill themselves or looking for ways to do that. This might be on social media; this might not just be verbal. We kind of have to go where the youth are.”
How can they help if they do see signs?
“I think that it’s about changes in their personality and behavior, and to be able to talk with the youth if you notice any kind of changes. Everything is better in hindsight, but in the vast majority of cases, people have dropped hints or there having been warnings… We don’t know how people are feeling inside, so we need to talk about feelings and make that a part of everyday conversation… Instead of, ‘How was your day?,’ say, ‘What was the best part of your day?’ ‘What was something not so good that happened today?’ ‘Tell me about something that was not so good.’ Really getting that conversation going would be important.”
If adults have tried speaking with the adolescent, what’s the next step adults can take to healthily intervene?
“I think that it just depends on what signs they’re seeing. It might be immediately they have to intervene. Remember that studies show that a combination of antidepressants and medications and talk therapy, or talk therapy (psychotherapy) alone, are very beneficial. A lot of times, people have misconceptions about therapy. It’s not just where you lay on the couch. It’s giving your youth skills that they can use. It’s to help teens get professional help as early as possible, and you should talk about it. If you see the signs, people might say, ‘Are you OK?’ and that’s great. But people really need to be asking specific questions about suicide.”
How can someone bring that up?
“You might want to start the conversation (with), ‘Hey, you’ve seemed really down lately,’ or, ‘I’ve noticed changes in—’ and this is what I’m talking about more for adults. Ask something. You might start off with, ‘Do you sometimes wish you didn’t exist or just didn’t want to be here?’ ‘Do you ever wish that you were dead?’ One that is common that I’ve seen is, ‘Have you ever wanted to go to sleep and not wake up?’ These are ways of getting in, but it’s incredibly important, whatever someone says as a response to those answers, that you be direct: ‘Do you ever have thoughts of killing yourself?’ Sometimes youths have these thoughts — talk about it.”
If a youth answers positively to these answers, how should adults respond?
“With actions, it’s important to listen nonjudgmentally. Don’t tell the teen, ‘Well you shouldn’t be feeling that way,’ or ‘Things aren’t that bad.’ Take the person seriously. Assist them in getting evaluated either by their primary care physician, their mental health professional, contact a crisis line or, if they’re experiencing kind of those immediate warning signs that I talked about, take them to be evaluated at an emergency department or call 911…”
What’s a crisis number or hotline that would be beneficial to utilize?
“I recently went to the Mississippi Contact Crisis Line. It’s amazing. My expertise is in suicidology, and we are very fortunate to have them. People think that for a crisis or suicide hotline that they have to call if they’re suicidal or (their mental health) is really, really bad. But, that’s not true at all. The whole purpose of it is to help the youth, or an adult, move from a hot moment to a cool moment. We want people to call earlier… One thing I tell adults is to put those resources in your phone and your youth’s phone, because you never know when you need them. Have the numbers in your notes page with the different resources.”
What can we do to teach students how to respond if and when their friends confide in them?
“There’s something called ACT. So, if in their friend, they think something has changed or they might be suicidal, they need to Acknowledge what they’re experiencing and take it very seriously; Care, listen, and let their friend know that they care about them and want to help; and Tell, inform a trusted adult. There have been huge campaigns about breaking the silence, because sometimes youth feel they can’t break a secret, and they can’t keep this secret… I think we need to instruct teens to watch out for what’s being posted (on social media) and discussed, and to tell someone, because they are going to be the ones that are noticing these kinds of things. If someone is talking about a recent suicide on social media, also post resources.”
Does social media put extra pressure on today’s adolescents?
“Yeah. What we know is that around 2012, which was the year when iPhones became popular, research showed a sudden increase in teens’ depressive symptoms. Increased screen time, we know, is associated with higher levels of loneliness, alienation and depressive symptoms, which is counterintuitive. But it’s not the real-world interaction, that is what’s different. We know that teens are actually spending the same amount of time on homework and outside activities. What they’re doing differently is the other time — they’re spending it online instead of using in person contact…”
How can adults create awareness for other students, so they can see the signs in their peers?
“A lot of parents have no idea what the different social media platforms are, how they can monitor it and educate yourself, but that is going to be very important… The IGen is when you grew up, you had all this (technology and social media). You can’t get away… One of the things that I think is getting better is teens are stepping up, and I really encourage teens to do that. If they see bullying, say, ‘Hey, that’s not cool.’ ”
How can parents monitor their children’s screen time and social media?
“It sounds really difficult, but there’s actually a lot of resources that you can use. You can actually put things on the child’s or teen’s phone. You can have guidelines or passwords that you share, so it’s not about spying. It’s about knowing. Would you let your teen just roam the streets? It’s the same thing…”
Has there been an increase in adolescent and teenage suicides?
“Yes. Unfortunately, this is a national epidemic. For instance, from 1999 to 2014, suicide rates increased for both males and females for all age groups 10 to 74. The highest increase was for 10 to 14-year-old girls. I want to highlight that this is a group that has a low suicide rate, but they had the highest increase. We also know that teen depression rates are on the rise, and untreated mental health illnesses are one of the leading causes of suicide… In Mississippi, we know it’s the third leading cause of death between 15 and 24 and the second leading cause of death for ages 10 to 24. For instance, in 2006, we had about 58 young adults kill themselves in Mississippi… We know nationally that for every one death by suicide, there are usually about 25 suicide attempts…”
Is there too much access too early to things like tv and social media?
“It really depends on the maturity and cognitive development of the child. But, I would recommend that parents be educated on social media, so they can be an informed party in determining those kinds of decisions… One thing I would recommend parents do is decrease screen time. Experts recommend less than two hours a day and have no internet or phone at mealtimes or within an hour before bed or in bedrooms over night. Screen time can influence sleep, which is incredibly important for mental health. There’re also a lot of structured activities, and I think we need to increase unstructured playtime, and if someone’s bored, that’s OK. Allow kids to be creative and have friends over and have quality family time…”