Psychiatric News December 21, 2001
Volume 36 Number 24
© 2001 American Psychiatric Association
p. 22
Adults Often in Dark About Suicide Risk in Teens
Eve Kupersanin
Suicide and mental illness among teens barely register a blip on adult radar screens, a survey shows.
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Adults participating in a recent survey were asked to cite what they thought were the two most important problems facing teenagers today. Suicide was ranked low, despite its being the third-leading cause of death among teens aged 15 to 19.
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Although suicide is the third-leading cause of death among teens aged 15 to 19, many Americans underestimate the seriousness of this problem, a new survey finds.
Adults rank drug and alcohol abuse as "the most important problem facing teenagers today," according to survey findings from the National Mental Health Awareness Campaign, a nationwide, anti-stigma, public education campaign announced jointly by President Clinton and Tipper Gore in June 1999 as part of the White House Conference on Mental Health.
The campaign used a private research firm, Greenberg Quinlan Research Inc., to conduct a survey with a random sample of adults (18 years and older) by phone in late September and early October of this year; 1,010 individuals responded.
When asked to cite the most important problems facing U.S. teens today, 61 percent of adults rated drug and alcohol abuse as number one, while only 8 percent thought suicide was a major problem for teens. Adults surveyed ranked mental illness last, with only 3 percent rating it the most important problem facing teens.
Even respondents related to a teenager who has been or is suicidal didn’t rank suicide above other problems for the most part—only 14 percent of those adults identified the issue as the most important problem facing teens.
Other important issues facing teens, according to respondents, are school violence (25 percent), sexual pressures (21 percent), and teen pregnancy (19 percent).
Researchers also questioned adults about their knowledge of the signs of depression and indications of suicide risk, and notably 33 percent said they know little or nothing about these signs and indications.
Parents of teens and young adults were the most informed of all respondents; 72 percent said they know "some" or "a great deal" about the symptoms of depression and 59 percent about the warning signs of suicide.
A higher percentage of respondents who were parents of teenaged girls (62 percent) knew about the signs of suicidal behavior in teens than did parents of teenaged boys (52 percent). Surgeon General David Satcher, M.D., in his 1999 report, the Surgeon General’s Call to Action to Prevent Suicide, emphasized that men were four times as likely as women to die by suicide.
Overall, findings revealed a contrast between the percentage of respondents who downplayed the importance of suicide as a national problem (8 percent) and the percentage who actually knew someone who had attempted or committed suicide (36 percent). That is, a significant number of respondents had a close connection to someone who attempted or committed suicide but they still did not acknowledge how significant a problem it is in this country.
Furthermore, fewer than 4 in 10 parents of teenagers surveyed said they had discussed suicide with their children.
Harold Koplewicz, M.D., who is founder and director of the New York University Child Study Center and a former member of APA’s Committee on Psychiatry and Mental Health in the Schools, told Psychiatric News that stigma is an issue for parents who don’t discuss suicide with their teens.
"Teen substance abuse, violence, and pregnancy are very visible, widespread acts and behaviors that often impinge on the character of schools and communities," he said. "Teen suicide is a relatively rare event, and parents and others often attempt to hide it because of stigma."
Koplewicz acknowledged that depression in teens often goes unrecognized because many believe that teens are supposed to be "moody."
On the whole, respondents knew about the most acute symptoms of depression and suicide. Most, however, missed the early warning signs of depression and suicide.
For instance, 81 percent of those surveyed recognize a previous suicide attempt as a serious indication that a teenager is experiencing severe depression. However, respondents did not identify changes in eating habits and sleep patterns as serious symptoms of depression, nor did declining performance in school set off alarm bells.
The failure of adults to recognize early warning signs of depression in teens concerns Koplewicz. "The onset of a depressive illness is insidious and not easily recognized," he said. "It can be seen as moodiness or ‘just a phase’ the teen is going through."
The impact of such a "phase," according to Koplewicz, is that it can "arrest the course of normal development and cause lasting social and educational difficulties even after the episode is over."
He suggested that educational campaigns targeted toward parents, health professionals, and school guidance counselors could topple stigma and misperceptions about depression and suicide, which could mean the difference between life and death for many teens.
"The successful recognition and treatment of major depressive disorder can reduce the potential for suicide attempts and the deadly sequelae of suicide," he added.
More information about the National Mental Health Awareness Campaign can be found at www.nostigma.org. 
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