Protect your life against suicidal ideation "Seek help before anguish blocks you, you are not alone"
Anxiety and depression The imprint of the pandemic on children's mental health
Behind that door of the health center was his
last hope
.
Clinging to the three pages in which he recounted the hell of his life, he went through the door, trusting that that pediatrician would help him get out of the pit of abuse into which his father had thrown him since childhood.
At the age of 13 and with immense courage, he asked for help, was treated and managed to get the social assistance protocol activated in order to get away from that devastating suffering that had already led him to plan his death.
As he left the office, the relief at having been
listened to and protected
was reflected on his face .
There are children who feel that they have already lost the game of life.
And there are more and more.
Always too many.
In the last decade, the cases treated at the ANAR Foundation (900 20 20 10) for suicidal ideation have multiplied by 23.7 and suicide attempts by 25.9.
Evolution of child suicides
In 2021,
22 minors
between the ages of 10 and 14 (14 boys and 8 girls) died trapped in that extreme pain and hopelessness that did not let them see any other way out.
It is the highest number of deaths in that age group in the last 30 years.
The previous year, 2020, 14 children (7 boys and 7 girls) had died and a child under 10 years of age was included in these black statistics for the first time since 2005. The latest INE report also notes an increase in suicides among young people between
15 and 19 years old: 53
in 2021, five more than the previous year.
'Eleven lives' series
Radiography of suicide in Spain.
More deaths, greater risk among young people and a growing but insufficient effort in prevention
Drafting: YAIZA PERERA
Writing: INFOGRAPHIC: GABRIELA GALARZA Madrid
More deaths, greater risk among young people and a growing but insufficient effort in prevention
Emergency equipment.
Words, gestures and listening against suicide: "To help well you have to touch the pain"
Drafting: SANTIAGO SAIZMADRID
Writing: DANIEL IZEDDIN (VIDEO)
Words, gestures and listening against suicide: "To help well you have to touch the pain"
They are lives cut short by a pain that became unbearable.
Behind the cases of preadolescents and adolescents with suicidal behavior are in most cases (60.9%) triggering
situations of violence
such as bullying, physical and/or psychological abuse, sexual assault or gender violence, according to a report published last December by this organization based on the 589,255 calls and messages made by minors in the last decade requesting help.
13% of them acknowledged having
self
-harmed .
Anxiety and sadness were present in the lives of many of them, but more than half (56%) had not received psychological treatment between 2019 and 2022. In the last three years, according to ANAR,
The pandemic has increased risks
such as "isolation, abuse of technology, intra-family aggression, barriers to mental health care or poverty."
Precipitants in adolescence
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Pedro Martín-Barrajón and Elisa Alfaro Ferreres.
Guide to help a person who has thought about taking their own life
The adolescent group is
especially vulnerable
due to factors such as their greater impulsiveness, the magnitude of some emotional responses to bad experiences, and their low tolerance for frustration.
Shouting, slamming doors, angry responses, defiance, and risky behaviors of a sexual or drug use nature could all be symptoms of depression.
Suffer physical or psychological harm.
Bullying is a frequent trigger.
The fact that our adolescent children pay less attention to their mobile phones or that they get nervous or moody every time they consult it, that frequent illnesses or illnesses appear that prevent them from attending class or that their school supplies deteriorate or appear wet with some frequency are signs that should alert us. about a possible case of bullying.
Discovery and/or non-acceptance of homosexuality
Unwanted premature pregnancy
Lack of group membership
school failure
Pressure from a suicidal environment
(viral challenges, web pages with explicit instructions, an app where adolescents share and encourage each other to escalate their self-harm or the use of certain phrases that denote suicidal risk and can be indecipherable for an adult like : "Tonight I had pasta for dinner", "My mother has prepared my favorite pasta recipe", or "I have run out of shampoo and conditioner at the same time").
"
Fear, emptiness, sadness, insecurity, sadness, disconnection, uncertainty, anger, shame, restlessness, hate, madness
and above all, no confidence in myself. I wanted to stop being a problem for myself and for the world."
María de Quesada is a journalist and the reality that she speaks to us about in these lines is that of her own inner world, in which many adolescents who suffer can see themselves reflected: "A mountain of disconnected emotions, up and down at frenetic speeds and driven by a sensation that stood out above the others: that of emptiness".
She tried to take her own life at the age of 15.
trapped in a pain that "she was not allowed to share".
Surrounded by love and with the help of medication, she "rose from the ashes" and today she offers her testimony to "embrace" those who suffer until they want to stop living and fight against stigma and silence.
She does it on every page of
La niña amarilla
, the
suicidal stories based on love
that she signs along with 21 other people who in adolescence and youth thought like them about "disappearing."
The book offers a helping hand to parents to help them understand and support their children and provides an opportunity for society to become aware of the importance of talking about suicide to save lives.
Evolution of adolescent suicides
Francisco Villar
sees the tear in the gaze of adolescents every day.
As a clinical psychologist, he coordinates the suicidal behavior care program for minors that was implemented in 2013 at the Hospital Sant Joan de Déu Barcelona.
He attends to the most serious cases, those of those who have already taken the step of trying to end their lives.
He has spent nearly a decade caring for young people suffering from profound emotional distress, and his experience confirms that increased risk.
"We had a significant increase, of 34%, in 2017 with the broadcast of the American series 'Thirteen Reasons Why'" [which addresses the suicide of a student]," he explains. After a few years without an alarming rise,
2021 doubled the number of visits to the emergency room for suicidal behavior
"We went from 400 to 1,041",
Villar, author of the book
Dying before suicide.
Prevention in adolescence
, he talks in depth with the young people admitted about the situations that "overflow" them.
"There are many conversations that I have with the boys that it seems incredible to me that they have to have them after a serious suicide attempt because many are daily," he explains.
We already had a problem before the pandemic and we worked with suffering, with harassment, mistreatment, abuse...
but with social networks it has skyrocketed
Francisco Villar, clinical psychologist.
What is it that usually affects adolescents so much that they end up trying to take their own life?: "The things that overwhelm them in the eyes of an adult seem nonsense and they feel even less understood and invalidated.
Many times it is the guilt for not being what they are supposed to be because they believe or feel that they are failing with their parents or with what life 'should' be.
They feel that their personal worth is conditioned by performance.
That overdemand sometimes leads them to the abyss.
In these extremely serious circumstances, a decrease in academic pressure on the student is "negotiated" with the school.
What to do if we think an adolescent is at risk of suicide
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1.
Be aware of warning signs
: changes in behavior, hopeless comments, increased isolation, irritability, abandonment of activities and relationships that were previously pleasant...
2.
Listen to them and not relativize
the situations that overwhelm them
3. If we have suspicions, we must
ask without fear,
directly, warmly and progressively,
raising suicidal ideation first
: "With all this that is happening to you, that I see you badly, have you ever thought that life is not worth it? live it?"
4.
If they answer that yes,
that they have thought about death, we have to resort to suicide prevention telephone numbers such as 024 where they will inform us at any time of what measures to take.
5. It is important that the boy or girl feel taken seriously and see that we act.
These are the next steps:
Start the process of contacting a professional
, which in many cases involves informing the pediatrician or family doctor of the situation our child is going through and what he has explained to you.
Make a safe home
(immediately remove
ALL
medications available at home. From that moment on, you will be able to use them but you will not be able to access them. The recommendation is to get rid of what we do not use on a regular basis, have a small amount of what essential and in a locked box, for at least one year.
Increase
the suicide prevention network (the people around you who know your moment of vulnerability)
in your environment.
Suicide risk is not a secret that can be kept.
Misunderstanding confidentiality can increase the danger of the person who suffers, leaving them alone and being left alone in their accompaniment.
The tutor and the director of the educational center must be informed so that they can adjust in the best way to the circumstances of your child.
Also, if possible, explain the situation to relatives or close friends who can support the minor.
The care of the caregiver is essential.
6.We must prevent the possibility of suicidal ideation appearing whether he says that he has thought about taking his own life or if he says no.
Intervene to reduce their pain
: showing understanding, alleviating the guilt they may feel for feeling bad.
It is not about fixing his problems, but about making him feel guilty and feeling accompanied in his difficulties.
You don't need to encourage him to fight or fight discouragement from him.
It is very important that you know that
your suffering is not going to destroy us
, that you will never be a burden to your family, that they want you to recover, but that accompanying you at that moment is one of the things that gives meaning to your life as parents. , never think that they will be better off without him.
7.
Strengthen the bond and make them feel capable
(remembering moments when they were capable, or simply acknowledging that if they can't now, it's not because they are not capable, but because they are not at their best moment and encouraging them to allow it, that they be pious and understanding with themselves).
Promote their autonomy to the extent that they can assume it.
Don't help someone who doesn't need help.
8.
Offer hope
.
Accompany and transmit the confidence that everything will improve, without excessive optimism.
Optimism sometimes translates into trying to stop the person from suffering at this moment by looking at things in a different way.
Hope is different, in it you recognize the harshness of your current moment and you are allowed to be bad, but it reminds us that, like so many times before, in the end it will dawn.
9. Prepare a
security plan
to avoid an attempt: identify situations that may upset you, activities or people that help distract you and write down trusted contacts or helplines.
10. Create a
community network
in which we are all participants that gives care, listens and supports a minor who is suffering.
The abusive use of technologies that has been established with the pandemic "has greatly complicated the situation," admits Villar.
"It has completely overwhelmed us. We already had a problem before the pandemic and we worked with suffering, with situations of bullying at school, abuse in the family, abuse...
but with social networks it has skyrocketed
," he says, defending the need for parents to be aware of the "harm" and limit their use.
In the unit, he prepares a safety plan
with adolescents who have tried to take their own life
: it helps them to identify what can upset them, their own strategies to overcome it (go for a walk, put on music), the people who can give them distraction supports (friends to have a drink with), who to call (trustworthy people or suicide prevention telephone numbers) and prepare a safe environment (withdrawal of drugs from their reach).
When the minor leaves the hospital, it is recommended that proactive follow-up be carried out for 18 months.
In Catalonia an attempt is being made to implement the program for minors (WHO-BIC):
the intervention lasts for a year and a half and is more intense in the first phase (appointments are made 72 hours a week at your health center). because the days after hospital discharge are the ones with the highest risk of dying by suicide because "you return the person to the same scenario where they made the attempt."
For a person at risk,
"you have to go look for her because she thinks she is a burden and she doesn't want to bother."
"You can tell quickly that something is wrong"
There are still parents who cling to the myth of believing that 'this does not happen' at home: "Many times we do detect the pain of our children but we do not think it will end like this and they can choose that (suicide).
It is a reality and it is slamming the door in the worst way
. We are no longer going to be able to turn a deaf ear... there are so many. It is the worst way to raise awareness, with the increase in suffering".
"Suicide is a situation of hopeless pain in a context of social disengagement," summarizes Villar.
There are certain
signs
that have to put us on alert
and take action immediately.
"The boys are very transparent, they can tell very quickly that something is not right. They have a change in their behavior, they make very hopeless comments like 'this is bullshit', 'you hate me', 'you are making my life miserable', they feel very trapped, they begin to lose social ties, to isolate themselves, they stop going with their friends, they stop going to extracurricular activities, they feel lonely, they are more irritable, they abandon things that were pleasant to them"... All these are elements " more than enough" to ask how you are and how we can help you.
It is true that they are behaviors that can be frequent in adolescence but you have to be very careful to observe the difference: "It is one thing to lock themselves in her room and another not to leave it."
If we notice intense emotional distress in an adolescent and we believe there is a risk of suicide,
we must ask them directly, with empathy and warmth
.
The WHO recommends that
it be done from the age of 10
(Beck's CDI child depression questionnaires incorporate the question and are administered from the age of 8).
However, before doing so, it is important to know how to proceed if the answer is what we fear: call a suicide prevention telephone number such as 024 ["I have seen my son in pain for a long time, what do I have to do?" ] or go to the pediatrician or family doctor without delay from the age of 15.
The suffering of minors is also a reason for medical consultation.
It is not easy to assume that a son or daughter is thinking about committing suicide, but not addressing it and remaining silent puts them at greater risk.
They will most likely talk about it and express their discomfort outside of adults, perhaps in places where they will not get adequate help such as online platforms.
Listening and addressing that pain is one of the key tools in suicide prevention, both by parents and by any other adult in their leisure or educational environment.
You have to ask them progressively, first raising suicidal ideation:
"With all this that is happening to you, that I see you badly, have you ever thought that life is not worth living?"
"They are very honest. If they don't, they will tell you no. If they do, you already have enough information," explains Villar.
The next step in that second case is to seek professional help immediately.
In some cases it is the adolescent himself who asks for the help of a psychologist and although he cannot explain the specific reasons, perhaps out of shame or because they do not know, it is necessary that he receive this attention.
In his work, this psychologist includes a very useful scale to assess the risk of suicide:
MINI SCALE
(in bold the score next to the question)
during the last month
1.
Have you thought that it would be better to die or have you wanted to die?
one
2.
Have you wanted to hurt yourself?
2
3.
Have you thought about suicide?
6
4.
Have you planned to commit suicide?
10
5.
Have you tried to commit suicide?
10
life history
6.
Have you ever tried to commit suicide?
4
Low risk 1-6 points |
Moderate risk 6-9 points |
High risk greater than or equal to 10 points
The confinement due to the pandemic, in his opinion, left a highly dangerous legacy: the
"excessive use of technology",
especially social networks.
These are, in his opinion, "a clear enemy" for the healthy development of adolescents and one more risk factor for suicide.
"They cause an absolute loss of self-esteem", he argues about this continuous comparison "from the ideal" to which adolescents, especially girls, are forced.
The life that they observe through the screens, the one in which it seems that "happiness can be achieved immediately at any moment", is "inaccessible" for them and makes them "miserable".
That world is not real but they still do not have the "critical capacity" to see it, so "they only have to feel
terribly guilty and humiliated"
for experiencing an adolescence crisis that is normal but they do not know it.
The family is recognized as the main protective factor in suicidal behavior by reinforcing the feeling of belonging.
The interventions that are carried out in the unit coordinated by Villar parents are present.
The objective is threefold: reduce pain, strengthen the bond and offer hope
.
"I don't explain to them how to relate to their son, but rather they see me in a dialogue with the adolescent," explains Villar, emphasizing the need to listen, to "tolerate the nonsense they may say," to accept their own frustration, " encourage participation", to "accompany and give the feeling that everything will improve" in that complicated stage of change that they go through at the age of 12 or 13 and in which they find themselves emotionally "overwhelmed" in a stage of important changes at a national level neurological and in which the demands (own and others) are intensified, the concerns about the need to fit in with their peers, to create links and satisfy their own needs.
In the task of helping minors transition to adult life, there is a key aspect for this Catalan psychologist:
autonomy
.
"We have to build people who feel capable of facing the world and when they find themselves every night in the darkest moment, they know that it is going to dawn and that is hope", emphasizes Villar for whom "boys are coming to death for what it's bad to talk about life".
Associations and telephone numbers that offer help
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-In the event of an imminent vital emergency, call the emergency telephone number
112
directly .
-If you have suicidal ideation
024
- Telephone of Hope: 717.003.717.
- Suicide Prevention Telephone (Barcelona): 900.92.55.55.
-Telephone/Chat ANAR to Help Children and Adolescents 900 20 20 10
- Telephone Against Suicide- La Barandilla Association (Madrid): 911.385.385.
-- RedAIPIS-FAeDS Association
- Papageno 633 169 129 supervivientes@papageno.es
-The Yellow Girl Association
-P81 Social Association
-APSAV.
Association for Suicide Prevention.
Green Hugs.
Asturias.
- AFASIB (Family and Friends Survivors per suïcidi of Les Illes Balears (Balearic Islands)
-AIDATU.
Basque Suicide Association
- APSAS: Association for the Prevention of Suicide and Aid to the Survivor.
(Gerona)
- APSU: Association for the prevention and support affected by suicide (Valencian City)
- ASAM: (Burgos).
- BESARKADA-Hug: Navarra.
- BIZIRAUN: Basque Country
-BIDEGUIN: Basque Country
- After the Suicide: (Barcelona)
- Alaia Foundation (Madrid)
- Metta-Hospice Foundation (Valencia)
- Goizargi: Navarre
- Group Survivors of León.
- There is Exit, Suicide and Duel: (Cantabria)
- Ubuntu (Seville)
- Light in the dark Association (Tenerife)
-Volver a Vivir Association (Tenerife)
It is about "accompanying the adolescent to solve a vital crisis", sums up this professional, who defends that this task of suicide prevention is not a task that is restricted to homes or health centers.
Francisco Villar advocates consolidating a 'network' in which "we can all participate"
. Al describirla transmite la confianza de alguien que cree firmemente en los resultados favorables de un esfuerzo colectivo. "Hay intervenciones que han reducido el suicidio que consisten en que un chico que hace un intento de suicidio señala en el hospital a tres adultos (por ejemplo, su padre, el profesor de gimnasia y un tío) que reciben orientación del psicólogo. Ese chaval sabe que ellos le podrán ayudar y éstos cuando tienen alguna duda hablan con el terapeuta. Se da apoyo a una red de soporte". Este experto asegura que cada vez se está dando una "atención más rápida" y aunque reconoce la necesidad de reforzar los recursos asistenciales hace también hincapié en la necesidad de "relanzar, conectar, coordinar con los que ya existen en la comunidad" porque "mucha gente está haciendo prevención del suicidio sin saber que lo está haciendo", por ejemplo, en los colegios o en espacios de orientación a menores como asociaciones de juventud. [Consulte aquí pautas para hablar con una persona que piensa en quitarse la vida]Cuando Villar montó la unidad en 2013 lo hizo con el convencimiento de que tenía que "acabar desapareciendo" porque ya no hubiera más intentos de suicidios. No renuncia a ese "ideal" pero se marca otro objetivo, que sus intervenciones sean "por alto riesgo de suicidio no por tentativas". Y ya comienza a ver avances. Actualmente son ingresados chicos y chicas durante 24 y 72 horas que no han dado el paso de tratar de acabar con su vida sino que se encuentran en crisis. Se ha logrado acompañarles antes y evitar que pasen al acto: "Los tratamientos psicológicos para la prevención del suicidio son buenísimos, tienen una eficacia altísima. Sabemos lo que tenemos que hacer".
He welcomes the boys and girls he cares for as his "own children" and his absolute commitment to avoid their suffering is perceived in his words.
"
The death by suicide of one of our minors is a failure of society
. It should be our shame and hurt us as much as their biological parents," he says, leaving a question for collective reflection: "How could he have died?" .
This report is part of the 'Once vidas' project promoted by EL MUNDO for the prevention of suicide and of which Santiago Saiz, Rebeca Yanke, Rafael Álvarez and Yaiza Perera are part.
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