Why aren’t we screening for suicide?


Many parents who lose a child by suicide have no idea their child has had thoughts of killing themselves.

Even more parents, 90% of them, are unaware their teen has attempted suicide*, according to Lisa M. Horowitz, PhD, MPH, a clinical psychologist from the National Institute of Mental Health with whom I spoke with recently.

That was true in our case.

Charles apparently did have a previous attempt and while in Wilderness, he was on suicide watch according to his music lyrics about Cal Riley, a young man that died by suicide 2 years before Charles.

“I hate myself. I quake. I hate this place. I shake. It’s hell.
Stay awake and blame myself ‘cause you were there for me when I wanted to take myself,
And I blame myself, even though I know, it’s not my fault at all,
But maybe if I was there I coulda stayed and helped,
You used to tell me to stay myself cause I ain’t like any body else” — Sometimes in my dreams, Cal’s song, Charles A. Rogers

Because of the stigma, adolescents keep it to themselves and the signs are not always typical. Google the “signs of depression” and I see so many signs left out.

Charles was unmotivated–simply could have given a rat’s ass about school. Didn’t turn in homework and often slept in class. You know why? He thought it was pointless to invest in something like high school when he wasn’t going to live long. That was his mindset. I read that in his lyrics, too.

You might expect to see sadness, when what you really see is a combative teen. But then teens and preteens are naturally that way right?

If they are starting to get in trouble with the law, having a difficult time with anger management, it may be that they are actually suffering from depression. It expresses itself in ways you wouldn’t expect. Acting out is one indication something is wrong. Our answer is usually discipline when what they need is a psychological assessment.

Binge eating can indicate depression. Cutting can indicate depression. Risky behavior and teen pregnancy are other indications.

It’s those parents whose kids are thinking about it but haven’t a clue their child is contemplating suicide I wish I could reach. But that’s hard because they don’t yet know they have a problem. They probably won’t know until an attempt is made.

So how do we reach those parents?

The answer is suicide screening of their kids. And the pediatric practices and ERs are where that needs to happen.

As Dr. Horowitz stated in our call, “Screen to intervene.”

You might think, “These kids will never answer direct questions about suicide at their doctor visit.”

And you would be wrong.

A pediatric practice in Richmond VA is screening kids 12 and up at wellness visits–the first practice in the country to do so. Many of you local readers know Dr. Ted Abernathy and Dr. Scott Keel from Pediatric Partners.

Over the last 12 months, 17 of 136 patients tested positive for suicide risk. That’s 12%. The test is called ASQ and it’s just 4 questions.

Seventeen parents who were luckier than me now have a child that is still alive and getting treatment because of suicide screening.

One child at this practice said, “Suicidal thoughts often occur at random times. It’s better to offend someone by asking them than not asking at all.”

I wish adults were that wise.

Like Dr. Abernathy said, “The one thing that motivated our group more than anything in the world when we started talking about doing this was NOT how many are we going to catch? It was how are we going to deal with the ones we DON’T catch. And how are we going to handle the death of one of our patients by suicide? And that we couldn’t live with.”

See all the ASQ posts on this website

*Journal of School Health Report

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AnneMoss Rogers

AnneMoss Rogers is a mental health and suicide education expert, mental health speaker, suicide prevention trainer and consultant. She is author of the Book, Diary of a Broken Mind and co-author of Emotionally Naked: A Teacher's Guide to Preventing Suicide and Recognizing Students at Risk with Kim O'Brien PhD, LICSW. She raised two boys, Richard and Charles, and lost her younger son, Charles to addiction and suicide on June 5, 2015. She is a motivational speaker who empowers by educating and provides life saving strategies and emotionally healthy coping skills. As talented and funny as Charles was, letting other people know they matter was his greatest gift. And now that's the legacy she carries forward in her son's memory. Mental Health Speakers Website.

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