Myths about teenage suicide get in the way of effective prevention programs, according to University of Utah researchers.
"Suicide, by its nature, is a complex problem," they wrote. "Many myths have developed about individuals who complete suicide, suicide risk factors, current prevention programs and the treatment of at-risk youth."
Misconceptions are found among parents, health professionals, school administrators, government officials and the media.
Researchers Michelle Moskos, Intermountain Injury Control Research Center; Jennifer Achilles, U. School of Medicine; and Doug Gray, U. Department of Psychiatry, conducted the study to separate fact from fiction and to offer recommendations for future prevention programs.
Their conclusions include the following:
Myth:Suicide is caused by family and social stress such as loss, rejection or discipline.
Fact: Those events are common in a teenager's life, and suicide is a rare outcome.
People often attribute suicide to breaking up with a boyfriend or girlfriend, arguments with parents or disciplinary action.
Teenagers who kill themselves do have more stress and family dysfunction, but at least 90 percent have a mental illness. Furthermore, mental illness runs in families.
Suicide "is caused" by an interplay of biological, psychological, environmental and social factors, according to the study.
Myth:Suicide attempters and completers are the same.
Fact: Males are four times as likely to die from suicide, but females are more likely to attempt it.
Current suicide prevention efforts do not focus on high-risk groups, the study shows. School programs that consist of a brief, one-time lecture are not effective. Females use crisis hotlines more than males, thus having little effect on those most at risk.
According to the Centers for Disease Control and Prevention, reduced access to guns may be one of the "most promising underused strategies" in suicide prevention.
"Unfortunately, a recent study demonstrated that only 25 percent of gun owners remove firearms from their home when repeatedly asked to do so by their teenager's mental health provider."
Myth:Current prevention programs work.
Fact: School education programs, teen suicide hotlines and efforts to limit firearms access have not significantly lowered teen suicide rates.
The majority of teens who kill themselves have never made a prior attempt, the researchers wrote. And boys are more likely than girls to die from suicide because they use lethal means such as guns. That and cultural influences that make it more acceptable for males to take their lives account for their higher suicide rates.
Myth:Suicide is not inherited.
Fact: Genetics has a critical role in mental illness and suicide. Some families have increased risk for depression over generations, while others have increased risk for depression and suicide. Future prevention programs need to focus on predispositions to suicide, the researchers say.
Myth:Teen suicide represents treatment failure.
Fact: Studies indicate few suicide completers were in treatment at the time of their deaths.
Government data showed that 1 percent of teenagers who took their lives were in public mental health treatment and 3 percent had psychotropic drugs in their systems.
The leveling off of youth suicide coincides with increased use of antidepressants and mood stabilizers. There is no proof of a causal link, but other known risk factor such as divorce or substance abuse were unchanged.
"Parents identified the stigma of mental illness and the denial of mental illness as the most significant barrier between teen suicide completers and treatment."
Myth:Teenagers have the highest suicide rate.
Fact: Elderly white males have always had the highest rate, but adolescent rates more than tripled between the 1960s and 1990s.
Suicide is one of the leading causes of death for teenagers. In addition, cluster suicides occur predominantly with teens. The researchers found that a lack of appropriate treatment or compliance with treatment for mental illness leads to suicide rather than the illness alone.
Moskos, Achilles and Gray say the six myths they identified show better research is needed to combat the high teenage suicide rate, and that too often suicide prevention programs aren't designed, implemented and evaluated with appropriate supporting research.
Psychiatric illnesses are often viewed differently from other medical problems. Public awareness, researchers said, could close the gap between the perception of mental and physical illness as separate issues.