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On the news the other day they were discussing the suicide of a teenager when the announcer said suicide is now the second biggest cause of teen deaths in South Africa. Disturbing as this is, it did not surprise me. In 1986, when I was a psychology intern, I worked at a parasuicide clinic set up by Professor Anthony Pillay, the hospital’s head of psychology, who recognised this trend more than 20 years earlier and was determined to reverse it.

For many, suicide is not only a tragic act but also baffling. For the most part, all we can do is speculate as to the reason why someone would kill themselves. What we do know from research, however, is:

  • There is a suicide every 20 to 30 minutes in the US;
  • In industrialised nations suicide is among the top 10 causes of death;
  • Teen suicide is the 2nd/3rd leading cause of death;
  • The lowest rate of suicide is among married people and highest for those who are divorced;
  • Physicians, lawyers, law enforcement and dentists have higher than average rates of suicide;
  • Among medical practitioners, psychiatrists have the highest and paediatricians the lowest and;
  • In the US, the teen suicides jumped 200% between 1960 and 1990. The general population increase was 17%.

South Africa has the world’s 8th highest teen suicide rate. Research has revealed that:

  • Twenty teens attempt suicide every hour and one will succeed ;
  • Overdose is the most common (88%) followed by hanging, wrist-cutting and jumping from heights and in front of vehicles.

Research has identified the most prevalent reasons as:

  • Death of a parent;
  • Divorce;
  • Feeling like a ‘pawn’ between fighting divorced parents;
  • Struggling with a new step-parent or step-siblings;
  • Relationship breakups;
  • Not feeling accepted by peers;
  • Being ridiculed by classmates;
  • Any experience perceived as ‘humiliating’;
  • Alcohol abuse, particularly binge-drinking
  • Drunk abuse and;
  • Bullying

It can be seen that no single explanation is likely to be sufficient to account for all types of suicides. There are, however, some trends.

It has been noted that families of teen suicides were under greater economic stress than the average family. It is possible that parents preoccupied with economic concerns are less available to support their children in times of need. Given the current economic situation, this should raise alarms.

Families of suicide attempters also show higher rates of medical problems, psychiatric illnesses and parental suicide attempts than average. It was also found the parents of suicide attempters tended to abuse alcohol and drugs and provided poor role models for coping with stress.

An aspect not often discussed is “acculturation”. At the clinic, I worked in, because hospitals were still racially segregated we treated Indian and Coloured patients. The teens we saw were mostly struggling with the conflict between trying to maintain traditional cultural values and norms while being influenced strongly by western values.

Families were poorly equipped to cope with this (I’m not sure if they are any better at it now). Teens found themselves unable to cope with the demands placed on them from both sides of the system and therefore chose suicide as the solution.

Families are also the victims of the tragedy. When I see family members I am always struck by the bewilderment they experience as they struggle to understand the ‘why’, but mostly I see the immense guilt they feel. The common scenario is ‘if only I did this or that then he/she would be alive now’. Sometimes this guilt never goes away.

Some years ago when I taught at university, a colleague committed suicide. For many days thereafter we wondered in amazement at how, in a department filled with psychologists, we could have missed the signs.

How did we not see it coming and therefore prevent it? The helpful answer is he was not a patient and we were not looking for signs of distress. Had we been more alert, perhaps we would have noticed warning signals which, according to research, is the best way to prevent suicide – to recognise signs and intervene early.

With teenagers, this is especially pertinent because the majority don’t really want to kill themselves. Their self-destructive behaviour is a last-ditch attempt to ease the psychological pain they are experiencing.

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