Transcription:
Suicide Prevention

Melanie Cole (Host): Everyone can feel down at times. However, if your child suffers from clinical depression, without proper treatment; those feelings of despair can become so severe that they consider taking their own life.

There's no handbook for your child's health, but we do have a podcast featuring world-class clinical and research physicians covering everything from your child's allergies to zinc levels. Welcome to Kids Health Cast by Weill Cornell Medicine. I'm Melanie Cole and our topic today is suicide prevention.

Joining me is Dr. Cori Green. She's the Director of The Behavioral Health Education and Integration

 at Weill cornell Medicine and an Associate Professor of Clinical Pediatrics at Weill Cornell Medical Center, New York Presbyterian Hospital. Dr. Green, it's a pleasure to have you join us today. As we think about this horrific topic, tell us how common it really is. And what are the ages that kids are most likely to consider this as an option for severe depression?

Cori Green, MD, MS (Guest): Thank you so much for having me. Yes, this is a hard topic, especially because we're seeing more and more youth suicide. And actually it can be a result of severe depression. It also can be a result of anxiety and other mental health disorders. In fact, suicide is the second leading cause of death starting at age 10. Some of that is a result of depression, but anxiety or other risk factors.

Host: Well, tell us about some of those risk factors. Who is at the greatest risk of attempting to take their own life?

Dr. Green: Well, if there's a family history of suicide, if there's a prior attempt of suicide. Other risk factors include having a mental health problem, a diagnosed mental health problem, such as depression, anxiety, even ADHD with impulsivity can lead to suicide. Kids are also a little different than adults, where you have to think about things like trauma and bullying and gender dysphoria. There are other things that lead to suicide in kids that put you at risk for it.

Host: Since this is so horrific and we're talking about prevention, are there warning signs? Is it possible to predict, Dr. Green?

Dr. Green: Unfortunately, it is hard to predict. Researchers have been working on this for decades. There are things you can do, looking for suicide risk that can make a difference. Both parents can do this and primary care providers should do this. In fact, most youth suicide, is after someone had seen a primary care physician within the past few months.

Host: So tell us a little bit about how you talk to someone that you suspect is thinking about this. If you ask someone about suicide, does that put the idea into their head? Many people think this is the case, so they don't want to discuss it.

Dr. Green: That's a really good question. And I'm glad you brought it up because that is a myth that the more you talk about it, the idea will pop into their head. There are no data to support that. And in fact, kids have already heard about it, right? It's around the media. There are so many movies, so really opening the door to have the conversation can be protective. Having connections, where you can talk about serious things with your parents and friends, actually is a protective factor against suicide.

Host: What should you do Dr. Green, if someone tells you, because back in the day, when I was growing up, you know, if that word was mentioned, people were like, oh please, you know, you wouldn't do that or something along those lines, but nowadays we take those kinds of statements much more seriously. So, if someone tells you they're thinking about suicide, or if they post messages on social media, what should friends and family do?

Dr. Green: Posting on social media is common. And if you are a friend who sees it, or a parent who sees it, you want to reach out to the parents of that child immediately. Don't take a risk and then the parent can address it with the child.

If as a parent, you're suspecting that your child is down or you see your child withdrawing more, not acting themselves, open the conversation, ask how they're feeling. Don't ask yes and no questions. Make it an open-ended statement. Really encourage a conversation. Don't be judgemental with what they bring up.

It's really easy to say, how can you feel this way? I've given you everything. I hear a lot, but you know, this is part of a mental health problem in common. So, really opening the door for conversations and for connection. The more connected youth feel, the less likely they will attempt suicide.

Host: Well, you mentioned something earlier, if they withdraw, can you give us some more of those red flags, Dr. Green, that parents, friends and families should be on the lookout for whether it's for mental illness issues, mental health issues, depression, anxiety, ADHD, one of those that you mentioned, but the red flags that signal that there's a spiral going on and it could be very serious.

Dr. Green: Well, any behavior change. If your child used to always come down for dinner and they're not, that's a red flag, more isolation, not doing things you used to do, afterschool activities, hanging out with friends. If you're starting to withdraw, that's a really big red flag. Noticing mood changes, sadness, worrying, all of that. You should engage in a very open conversation and be there for your child.

Host: Well as someone, and I hope I don't cry during this, but as someone who's, one of my dearest friend's daughter did this. And I mean, it's just absolutely devastating. Probably one of the most devastating things that can happen in a family. What do we do? Can they be stopped if this is something that's entered their mind? If you've got these red flags, Dr. Green, do they call the pediatrician? Do they call 911? What do parents do? You mentioned opening those lines of communication. Is that enough? Or do they need to call in the professionals? And if so, when?

Dr. Green: That's a great question as well. And I'm so sorry about your friend's daughter. It is such a tragedy and yes, kids can get better. Although you can't predict suicide, we really believe it's preventable. You know, one day it'll be like wearing seatbelts where we all really know how to prevent this, or that's our hope.

I think if you're very worried about immediate safety, then you call 911, go to your pediatrician, your primary care doctor. Sometimes you do have to go to the emergency department, but at least reach out to someone and open the conversation. I know there's a lot of stigma around this, but this is something, unfortunately we're seeing more and more of, and your doctor wants to hear from you.

Host: There are things that make it easier though, in people's homes, having an unlocked gun, can make a child who had maybe not even that big of a deal, a breakup, something like that make a permanent decision or medications. Are there any things you want parents to know especially if their child has one of these spectrum disorders, things that you don't want them to keep around their house?

Dr. Green: That's a great question. And I'm glad you brought up guns. Guns need to be locked, ammunition separate from the gun. Cause you're right. What if it's an impulsive feeling and you have access, then you're doing something that's permanent that you didn't think through. Medication should be out of reach. Tylenol, ibuprofen, these are things, people overdose on and it can cause a lot of harm. Really you want to think about, you know, I'm in New York City, tall buildings, is there access to tall buildings or windows, making sure no one can kind of access and jump off something that's high. I usually give this advice for families of kiddos, who I know considering it, but gun safety is for everyone. And it's not a bad idea to just think of those things, regardless of what your child may be suffering from.

Host: Certainly true. So, as we wrap up, I want you to give us your best advice for parents about spotting those red flags and for friends, family, loved ones, if they have suspected, if they know that someone is considering this, to take it seriously. Can you just give us your best advice to hopefully prevent this in the first place?

Dr. Green: Always take it seriously for sure. That's key. It's not a cry for help. If it was a cry for help, then you have to wonder why does this child need help? Ask questions, you know, to even prevent it, have routine meals with your family, where there is open conversation about everything. If you suspect it, speak to your youth, make the house safe and call your doctor. There are also suicide hotline numbers that you can call or a youth can call. Have that number in your phone, just for emergency, if something's happening and you don't know what to do, you can call the National Suicide Prevention Lifeline.

Host: Such important information. And if you're having thoughts of taking your own life, or if a loved one is going through something very difficult and you suspect that they may be considering suicide. The National Suicide Prevention Lifeline is 1-800-273-TALK, that's 1-800-273-8255. Or you can text talk to 741741. Someone is always available to help you out. So, parents, really share this show with friends and family, discuss this with your children, because it's something that we all need to know about and keep those communication lines open. Talk to your pediatrician if you have any questions and Weill Cornell Medicine continues to see our patients in person, as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine. That concludes today's episode of Kids Health Cast. We'd like to invite our audience to download, subscribe, rate, and review Kids Health Cast on Apple podcast, Spotify and Google podcast. For more health tips, go to weillcornell.org and search podcasts. And don't forget to check out Back to Health. I'm Melanie Cole.

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