The Suicide Epidemic

Jonathan B. Singer 0:03

Adolescence kind of almost by design are existential. They're asking themselves like, what is my place in the world? Like, what does it all mean? Right? And so when they have these thoughts about maybe this is not a world worth living in, maybe people would be better off if I were dead, right? Those kinds of thoughts are sort of developmentally outside of the norm for children in a way that they are less outside of the norm for adolescence.

Penny Williams 0:30

Welcome to the beautifully complex podcast, where I share insights and strategies on parenting neurodivergent kids, straight from the trenches. I'm your host, Penny Williams. I'm a parenting coach, author and mindset mama, honored to guide you on the journey of raising your a typical kid. Let's get started.

Welcome back to the beautifully complex podcast, I am thrilled to have Jonathan singer here with me, who is a social worker and an expert in suicide, among other things. And we're going to talk about suicide. And it's a really hard topic to talk about. It's a really hard topic to listen to people talk about in to think about, but it is so imperative now that we all have it on our radar. And we are all doing what we can to help with the crisis that we're really facing in this area. So I welcome you back. I know you've been on summons. I think you've been on the podcast at least once before. Always a pleasure to talk with you. But I want to start just by having you introduce yourself. Let everybody know who you are and what you do.

Jonathan B. Singer 1:41

Yeah, thanks, Penny, real honor to be back and talking with your folks. So I'm Jonathan singer. I'm a Professor of Social Work at Loyola University Chicago, past president of the American Association of Suicidology. I'm the co author of the book suicide in schools, at the end of 2023, we should have the second edition coming out of that. I'm also really interested in the intersection of technology, and social work, practice and education. And that includes the role of cyber bullying and suicide, right as those things have a connection. And so I co lead the Social Work Grand Challenge, harness technology for social good, my home, lots of things, you're doing lots of things, lots of good in the world, as well as the podcast, I forgot to mention the search word podcast.

Let's start our conversation, I think with some statistics, because I reached out to you to be on the podcast at this moment in time, after a public figure had taken his life by suicide. And I was completely shocked, and knocked off of my access, because it was someone who I have watched and has brought me great joy. And I have like, watched him and said, he has such a light in the world, he brings so much happiness. He's such a kind, amazing, joyful person. And it was a facade, you know, and it really just, it threw me for a loop for a few days, honestly, and, and I don't usually get into celebrity stuff and all this, but it was someone who really had brought me joy before. And I found it so sad that he felt like he needed to hide what was really going on from the world. And so I wanted to again, talk about this topic and what we can be doing. And first, I think we have to talk about the fact that it's a crisis, the numbers just keep going up and up, right?

Yeah. So if we look at the most recent stats from the Centers for Disease Control, and the most recent Final stats that we have are actually from 2021, which is a long time ago, feels like it. And so, you know, one of the issues is we don't have real time stats for suicide, or even for youth for suicide ideation or attempt at that makes it really difficult to respond in real time. So a lot of our programming, a lot of our planning is based on old data. But the old data that we have is that in 2021, the rates increased from 10.5 and 2020 to 11.3 per 100,000. And basically what that means is that if you have 100,000 kids, ages 10 to 24, about 11 of them would have died by suicide in 2021. And I will say the majority of those kids are 20 to 24. Right, so the number of suicide deaths increases in that age group. Now, just for some context, back in 2000, the suicide rate was seven per 100,000. Wow. And went up, it went down it went up it went down and then you know we have this most recent stat now, most of us thankfully are not confronting the reality of losing a child to suicide, it's what we call low base rate behavior.

Which just means that, you know, there are 80 million folks under the age of 24. In the United States, about 6000 of them die by suicide. And so each one of them is one to many. But when you look at 6000, compared to 80 million, it's a relatively small number, right. And so what we end up thinking about and sort of dealing with on a regular basis is kids who are having thoughts of suicide, were attempting and those numbers are much greater. So for example, in the Youth Risk Behavior Survey, which is again through the Centers for Disease Control, among high school students, in 2021, about 22% of high school students reported having at least one thought of killing themselves in the past year, and about 10% reported an attempt. And if you look at the stats broken down by various different buckets, right, if we look at heterosexual youth, it's about 15%, report thoughts of suicide and 6% report attempt. But if you look at LGBTQ youth, or rather, let me say LGBTQ youth, not including transgender or non binary youth, because those stats aren't included in the in the Youth Risk Behavior Survey, the stats are about 45% of lesbian, gay, bisexual questioning, youth report thoughts of suicide and about 22% report an attempt.

So you have the same percentage of sexual minority youth reporting an attempt, as you have the entire population of high school students in general reporting thoughts of suicide. And then when we look at, you know, gender binary males and females, females, it's about 30% of high school females reported thoughts of suicide in the past year, and about 13% reported and attempt as opposed to 14% of males that reported thoughts of suicide about 7% reporting attempt. And so what you see is you have differences based on categories. And I'm sharing this because I think it's really important for folks to know that kind of the generic stats that I started out with, like 22% reported thoughts of suicide 10% reported attempt, that's not across the board, right, right. That's not something that you can say, oh, in my high school, this is what's going on, you have to look at who's in the High School, for example, with American Indian Alaskan Native youth.

It's actually 27% report thoughts of suicide and 16% report attempts, which is the highest percentage of any ethno racial category. Now, if we then look at who dies by suicide, the numbers get a little bit flipped, in the sense that it's mostly male students who die by suicide. Rarely, yeah. And so you have a greater proportion of females who have thoughts of suicide and who attempt but male students die by suicide about three to four times as frequently, in part because they use the most lethal means, which are firearms and suffocation. Which brings me to a really important point, there's been a lot of controversy and debate over the years about firearms. And I will just say that, unequivocally, the research shows that youth who have access to firearms are significantly more likely to kill themselves than youth who do not. It's not a constitutional issue. It's not about second amendment come there's, there's there's nothing in the Constitution about a well armed militia will allow some kid to kill themselves. It's not like it's not an issue, right? Yeah. If you are concerned about your kids safety, remove the guns, that is the number one thing that I would say to any parent who has concerns about their child's well being.

Penny Williams 9:00

I'm glad you said that. I'm glad you brought it up. I want to talk for a second about the younger kids and that population, because I remember looking at statistics, maybe a year or so ago, and seeing that what I would consider very young kids to be thinking about or attempting or dying by suicide. The numbers are there, you know, I would have never thought like any child below younger than high school. And I was shocked to see that.

Jonathan B. Singer 9:30

Yeah. Now again, this is one of these areas where we don't have good data, right? Most of the data that we're seeing in the news is coming from emergency departments. Right? So there'll be reports of how many kids came in for a suicide risk assessment based on suicidal ideation or possibly an attempt and then they you know, they keep track of ages, which again, is not to diss those stats that are really important. But for example, there is no equivalent of the Youth Risk Behavior Survey for elementary schools. So we don't have a national database for that. But what we do know is that in any given year, there are about 50 Kids in the United States under the age of 10, that die by suicide, or 10. And under the die by suicide, and the majority of those are black youth. And so, again, this is one of the ways in which data are flipped, right? We are sort of stereotype of kids who die by suicide is white male, although these days because of the news reports, maybe it's white and female.

But when you're looking at children, it tends to be black, male youth. And when we think about suicide ideation and kind of the thoughts of suicide, what we do know is that when you have children, elementary age kids who have suicidal thoughts, that those thoughts tend to be much more distressing for children than when they show up for the first time in adolescence, right, which isn't to say that suicidal thoughts should be dismissed in adolescence, but adolescence, kind of almost by design are existential, right. They're asking themselves, like, what is my place in the world? Like, what does it all mean? Right? Yeah. Which is not what eight year olds are thinking. It's just not, you know, because they're more concrete. And so when they have these thoughts about, maybe this is not a world worth living in, maybe people would be better off if I were dead, right? Those kinds of thoughts are sort of developmentally outside of the norm for children in a way that they are less outside of the norm for adolescents.

Penny Williams 11:32

Right. Right. That makes sense. Can we talk a little bit about what's going on? Why are our rates increasing? So much? And so maybe not steadily? I want to say suddenly, but maybe it's not really. And maybe it's because we are on information overload. Now we have the news right away, we hear about everything right. And so maybe we're hearing it a little bit more. But I think also, it just is more, there's more of this going on, right?

Jonathan B. Singer 12:04

Yeah. And you know, what's true is that the death rates have gone up. So that is true. Like that is a fact. It's also true that suicide deaths amongst youth tend to 24 have been going up for a long time. And then they actually plateaued for about three years. And then there was a slight increase in 2020. And then this increase again in 2021. And I think that there was a pandemic effect, surely, right. And so it's unclear to what extent the pandemic influence suicide deaths. We know historically, that when there are disasters, or catastrophes that suicide deaths decrease in the early part of the disaster catastrophe. This is true for the Great Depression, even though obviously, there were lots of very highly publicized bankers jumping off Wall Street on October 29 kind of thing. But since Hurricane Katrina and 11 other disasters, including the pandemic, like if you look at number of youth suicide deaths in the first three months of the pandemic, so March, April, May, June, they actually dropped to historic lows, I would never have thought that I know, it's it's a shocking thing, right? So, so historically, there's kind of this bimodal distribution, where you have these, it's like a two humped camel, right.

So in the spring, there's an increase, it goes up until April, and then it goes down again, in the summer months are pretty low, and then it goes back up, again, peaking in October, and then it goes back down again, to December. And what we saw in the pandemic was that it just kept going down. In the spring, there was no April peak. In fact, may there were fewer suicide deaths amongst youth than there were in June and July, when kids started going back hybrid or full time in person, the number of suicide deaths went back up again. Now, there are lots of reasons that we can think about this, right? I mean, with a pandemic, in this first few months, everybody was like, sort of fighting the same Invisible Demon, right? Like, we literally had no idea why so many people were dying. We Yes, we called it COVID. But like we didn't know, like, was it on our counters? Right? We have to wash off our food. Like, we didn't even know how it was transmitted. And so there was this sense of like, we're all in the same storm, we're all fighting the same thing.

But after a while, you know, for some kids, the sense of isolation, the loss of milestone events, right graduations, proms, first kiss, you know, being able to go to college and kind of experience that or get a job, right, all of these things kind of caught up with us. Now, if we step back from the pandemic itself, there's some pretty strong data that there's a correlation between the rise of social media and sort of increased mental unwellness. Yeah, in youth, particularly with girls. Yeah, that doesn't translate as kind of cleanly into the Suicide. So and I want to make this very clear, right? So there's a lot of data in the news. There's a lot of stuff in the news about the role of social media and sort of this emotional crisis with youth. Right. But the data are not as clear when it comes to suicide risk. And so you can have kids that are anxious and depressed and traumatized, and they don't kill themselves. Right. Right. Right. So So you can't say that the more kids are anxious or depressed or traumatized, the more that they're going to die by suicide. There's more to it than that.

Penny Williams 15:36

Right? Interesting. As you were talking about that, I was kind of thinking, social nuance and difficulty for kids who struggle with social interaction, not having that for a while, put them at ease, probably, you know, and they weren't struggling with going to school and being picked on and feeling like they didn't fit or, you know, having to give a presentation in front of the class or whatever it is that stresses kids out socially. As someone with social anxiety myself, that's where my mind goes, like, yeah, oh, you know, and but then when we get back into the world, now, we've been out of practice. And so if social was hard for you, it's like doubly hard after the pandemic, it feels like for a lot of us to get back in the swing of that.

Jonathan B. Singer 16:23

Yeah, well, I think that, you know, to your point, I heard from a lot of parents of kids who had struggled in classroom, maybe behavioral issues, peer issues, that the first part of the pandemic was great. You know, because oftentimes, there was some sort of relationship between social disease and computer use, right. And I'm not saying that kids have behavioral issues, because of computers, but like, you know, playing video games, or sort of being fascinated by programming and things like that things that have traditionally been considered more sort of solitary. You had all these kids that, you know, we're sort of computer geeks, were suddenly like the people who knew how to use Zoom best, right? And we're the most responsive on camera, and sort of, we're doing the best. But, you know, the students that really relied on the social interaction, that sort of the teacher's pet, you know, all those sorts of things, found themselves struggling. Yeah, in those environments. And it's actually one of the things that I think that we missed the boat on, coming out of the pandemic, is that instead of saying, Oh, our school system is not set up to respond to students needs equally. We just said, Okay, pandemics over everybody back in the classroom, that's going to be what's best and huge mistake, in my humble opinion.

Penny Williams 17:42

Yeah. You know, we were so fortunate when my son was in high school that he was able to do part time in person. And he did a couple of classes online at home. And that's what he needed. He couldn't manage that environment all day, every day. And, you know, I think that the pandemic and having done online school should open that door for everyone who needs it, right. And I'm sure that there are many, many school systems that are inflexible on that, because we still hold on to that traditional idea of education and learning. I want to talk about two more things before we wrap up. One is, when our kids say to us, I shouldn't be here, I might as well die. And this is something that I think we see more in our neurodivergent population. And younger kids, they have trouble regulating their emotions, they don't quite see the nuance and degrees of emotion, right. So if I'm frustrated, I'm raging and I'm angry, or, you know, if something is going wrong, I might as well die. They just have kind of this really dramatic, emotional response to a lot of things. And it's really upsetting for parents, and I was in the same boat for a long time with my own son, you know, every time something it was super, super hard and terrible. Well, you know, I just shouldn't be here. I might as well die. And you wonder, are they at risk now for suicide? Is that you know, a signal? Or is it just a kid who's struggling with communicating their emotions? And I think parents in our population really need some help with teasing that apart, knowing what to do or knowing what to say to that. And then lastly, I just want to touch on like what we can all be doing to help with the suicide crisis. But yeah, let's talk about the other first.

Jonathan B. Singer 19:33

Yeah, so I think that, you know, we think about neuro divergence, you know, there there is this way in which the medical community, the medical, sort of the professional community has established this kind of one way of being as the norm, right, to sort of the the neurotypical and we think about how resources and training for providers has followed that path. All right, right? You know, when we think about kids with autism, we actually have seen that there's research that when autistic kids have performed better on certain tests than average, it has been pointed out as examples of their problematic way of thinking. Like, that's how far it has gone in sort of this kind of demand that everybody be one way or think one way, right. And so one of the ways that that has translated into addressing suicide risk is to have people be trained providers and asking questions in ways that might not actually translate well, with folks. So for example, I'll just give some examples. So like, yeah, instead of saying, like, how are you feeling today? You could say, are you okay? Right? It's a much more direct, concrete way, instead of saying, you know, I'm with you, I'm here for you, right, which is sort of kind of generic. Yeah, you can just say, I'm texting you right now. Tell me what you want. Being very concrete, not expecting kids to use effective phrases that are things that that you might expect.

So for example, you might say, Oh, well, if this kid is really upset, they will present as sad. And they will say things like, I'm feeling sad, right? You might get kids who will laugh, right? Or not use sad words at all. And it's not that they're hiding. It's not that they're trying to mask it. It's just not how their brain is processing the information. And so I think that this is one of the ways that it can be challenging, trying to translate sort of the professional guidance into working with neurodivergent kids. So what I would recommend is, when possible, right, start out more concrete in communication than abstract. So, you know, it doesn't mean that you shouldn't use emotion words, but if emotion words, don't work for your kid, right? If you know that when you say to your kids, it's like, are you feeling frustrated? And they like lose their mind? Like, they're just like, wow, right? Don't do that. Right? Like, you know, it's okay. You don't have to use the feeling words, when you're sort of speaking logically with somebody, right? So anyway, I just wanted to throw that out as like, not that it's up to me to give permission for folks to do things. But if you and your gut are like, you know, I heard that you should be like, Okay, I'm gonna identify your feeling. And then we're gonna go into your feelings. And I'm going to, you don't have to do that you can do what works for your kid. Now, when you have a kid that's saying, like, this isn't a world worth living in. Right. However, they say that, I think it's a reasonable thing to first acknowledge that that's where they are, and be acknowledged that there's probably a part of them that disagrees, right?

Part of them wants to live, there's part of them that wants to stick around. And it's really important to acknowledge both of those places. Because sometimes it can be hard for kids to hold both of those at once. And so if you say things like, you seem really sad right now, or, you know, things have been really hard lately. And I know that sometimes, when things are really hard people are like, is it ever going to get any better. And I also know that you have gotten through some really hard times before, and we've gotten through them before. And we're going to be able to do that again. Right? And then you know, that sort of speaking to the hope, and when when your kid is struggling, you holding space for the future can be really powerful. Yeah. Now, also using the actual words like, kill yourself, suicide, dad die, those are really important to be able to do. If your kid comes to you and says, you know, I don't really see a point in living. You might not jump in and say, Are you suicidal? Like, right away? Yeah. But at some point, it would be important to say, Hey, I'm just wondering if, you know, because of everything that you've said, if you've had thoughts of ending your life, and that can be a scary thing for parents to say, fairy fairy. I mean, terrifying, right? And yet, asking the question, in and of itself can be healing. Yeah. Because as we know, when you're able to put words on things, or when you're able to put things into words, it can sometimes take the power away from them. If your kid is like, I'm having these thoughts, and the worst thing that could possibly happen is if my mom knew I was thinking that yeah, and then their mom was like, hey, sometimes kids have these thoughts. Is that happened to you? Like actually did you're like, Okay, thank you for telling me that. What else are like wait, what? Like the world didn't end? Oh, my goodness, I can talk to my mom about this. So yeah, so yeah, so I think those are all really, really important. considerations.

Penny Williams 25:01

Yeah, I think we have to talk about it. Right? We have to have these conversations, when we ignore it as the adult in the room, it makes kids feel like it's something they can't talk about. So they're not going to share it, we're not going to get any signals, and necessarily be able to intervene and prevent it from happening. So, and I think we are slowly shifting as a culture, to kids talking more to their parents. I know when I was a kid, especially a teenager, you You did not talk to your parents about anything like, you hold all of that to yourself. And to we have to set that environment with our kids, we have to set up that relationship to say, you can come and talk to me about hard things, and it's okay, it's going to be okay, I'm going to listen, I'm not going to get mad, I'm not going to shut you down, you know, we have to set that expectation for our kids so that they will talk to us. So to wrap up, I just want to ask, like, what can we do? Not even just as parents, but just as human beings in this world? What can we do to help with this situation?

Jonathan B. Singer 26:09

Well, so it's important to know that there are many pathways that kids can take to becoming suicidal, right. And so you might get one kid who has experienced bullying and has a family history of depression, and there might have been trauma, and they never think about suicide, but they fail a series of tests, and their hopes of getting into a certain college are dashed. And suddenly, that's what sort of kicks it off. Right? And so what I'm about to say is that, you know, what we can do about it, is all of the things. Right? So when we think about schools, and we have affirming content in the curriculum, right, and that includes everything from stories with disabled kids, neurodivergent kids, LGBTQ kids, ethno racial minority kids, you know, as sort of the central figures and not just for the central figures for like, Johnny's having a bad day, and he's in a wheelchair, but like celebrating all of the amazing things that these kids can experience in their lives, in the same way that we've done for sort of sis had able bodied, you know, white middle class kids for the hundreds of years. That is important. That sets an important foundation to say, you matter, your life matters. And when we're able to celebrate you, it makes it easier to say and your pain matters, right? So that's really important. We can look at structural things, including access to health care, access to resources, thinking differently about where resources are being provided.

If we're thinking about where kids are, you know, he's talking about higher suicide rates for American Indian, Alaskan native, we know that for black youth, you know, childhood suicide attire. So the question is like, where are these kids? Well, so maybe for black youth, we're talking about suicide prevention in churches, right? So maybe for American Indian, Alaskan Native youth, we're talking about making sure that we're having culturally responsive services, not just on reservations, but actually outside of reservations, where the majority of American Indian Alaskan Native youth live, right, but having those be resources that can be accessed. And so all of these things can be useful in addressing suicide risk. I think there's some other things related to social media, that can be helpful. So for example, when we talk about the role of social media and the way that algorithms are used to feed people content, we need to make sure that we are identifying algorithms that are feeding kids content that either promotes suicide promotes lethal means promotes messages, that suggests that your life and the way you're living your life isn't particularly valued. Right. And so I think that's an important piece to play as well. And something that we absolutely can and should be doing.

Penny Williams 29:13

Yeah, just checking on each other. Right? Well, yes. And checking, caring about each other. I mean, I, you know, I struggle with the feeling at least of the lack of empathy or the decline of empathy in our culture. And, you know, people need to feel like they fit somewhere, when they don't feel like they fit somewhere. Their world falls apart. It is a human need to have connection and fit. And we have to be just checking in on people sometimes and making sure that they have that in their life or being that for someone I think is so important. Yeah. I love the idea of the inclusivity eto. But I hadn't, you know, I think that sort of dovetails into that. And we're starting to get there. But we're moving so slow, like, so very slow. And I want us to move so much faster in that direction.

Jonathan B. Singer 30:11

In some states, we're moving away. Right? Every time you have legislation that's passed, that says, We're not going to have books about this, or we're not gonna be able to talk about this, like that is moving in the wrong direction. The legislations that invisible eyes, groups of kids, particularly trans youth, literally will kill those kids. This is not a an opinion, this is a fact. Right? We know this is true. We know that in the 90s, when you had states that recognized what we used to call same sex marriage, before it was the law of the land, before the Supreme Court ruling that kids in those states that were LGBTQ had lower suicide rates than LGBTQ youth in states that did not recognize same sex marriage. Right. So we know that there is a function of legislation.

Penny Williams 30:57

So many things. Yes, yeah, we're on the same page, I'm sure. Well, thank you, oh, this, of course, it's a difficult thing to talk about. And you always bring some peace to the conversation somehow, and just really opening the door for us to understand it, and to be okay with talking about it. And I really appreciate that so much. And I appreciate all the time that you've given just to my audiences over the years and trying to help help parents and kids and teachers and everyone out there to feel better or so that we can, you know, help this population who considers or attempts. I would love to see those rates go down. Of course, all of us would, right? Yeah. Yeah, obviously, for everyone listening, I want to make sure that you know, how to connect with Jonathan, and also have the resources that we've mentioned, as we've had this discussion, and that's all at the show notes at parentingADHDandautism.com/221 for episode 221. And without we'll end and I'll see everybody next time. Take good care. Thanks so much. Thanks for joining me on the beautifully complex podcast. If you enjoyed this episode, please subscribe and share. And don't forget to check out my online courses and parent coaching at parentingADHDandautism.com and at thebehaviorrevolution.com

Transcribed by https://otter.ai