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Teen suicide: Prevention is contagious, too.

Teen suicide in the US continues at high rates, but the stories of lives saved often don't make headlines – and prevention experts are encouraged about progress in that direction.

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Because adolescents tend to be highly influenced by peers, suicide contagion has been a longstanding concern. Being exposed to a suicide directly, or indirectly through news or social media, can increase their risk of attempting suicide, researchers say.

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By age 17, roughly 1 out of 4 students is aware of a schoolmate who has died by suicide, according to a major new contagion study out of Canada.

Rather than seeing it as a taboo subject, prevention experts say, parents and school staff need to be better equipped to talk with young people about suicide – and to listen. Bringing it up in a constructive conversation will not plant the idea in kids' minds, they say.

There's a growing understanding about both risk factors and protective factors – and one of the strongest protections against youth suicide is connection with a trusted adult.

"It isn't just the negative stuff that is contagious," says Mark LoMurray, who created Sources of Strength in North Dakota after working in crisis intervention and attending 30 teen funerals in less than three years – 15 because of suicide.

But for hope and strength to spread, teens have to know where that resiliency comes from. Youth groups "could usually fire off the warning signs of suicide," Mr. LoMurray says, but when he asked how people get better if they are depressed, addicted, or traumatized, "most were giving a shoulder shrug."

That's when he started developing the colorful "wheel" depicting eight sources of strength that peer leaders focus on in their schoolwide messaging.

Sources of Strength is a comprehensive approach that influences the whole student population – one of several prevention strategies available to schools through dozens of research-based programs.

It's also part of the upstreaming trend. "Historically, suicide prevention has been very strongly focused on identifying individuals who are suicidal or in some very-well-identified high-risk group, and seeing mental-health or substance-abuse services as the strategy for addressing needs.... It's really come out of a medical perspective," says Peter Wyman, a psychiatry professor at the University of Rochester School of Medicine who has studied various prevention efforts. Now, he says, there's an important shift toward "a greater recognition that reducing suicide rates is going to require a broader range of approaches ... to reduce the occurrence of distress ... and strengthen protective factors."

Suicide prevention strategies do make a dent

Nearly 16 percent of American high-schoolers who answered the Centers for Disease Control and Prevention 2011 National Youth Risk Behavior Survey said they had seriously considered suicide in the previous 12 months, and close to 8 percent had attempted it. More girls than boys think about, plan, and attempt suicide. But far more boys complete their attempts. (Boys tend to use means that are more immediately lethal, but it's not clear why, experts say.)

For 15-to-19-year-olds, suicide is the third most common cause of death. For native Americans ages 15 to 24, the suicide rates are about double the national average. Lesbian, gay, and bisexual youth are at least twice as likely to attempt suicide, according to various studies.

A unique and complex mix of factors underlies each suicide. More than 90 percent of youth suicides have involved at least one major psychiatric disorder, most commonly depression. Among other common risk factors: a family history of suicidal behavior, substance abuse, parental mental-health problems or addiction, and stressful events such as romantic problems, abuse, divorce, and bullying.

Theories about why the rate increased through the 1980s range from more exposure to drugs and alcohol to broader availability of firearms, but there's no consensus.


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