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Responding to Violence, Suicide, Psychosis and Trauma

What’s it like to be a young person with mental health issues?

Three teenagers who have found it hard to forge their sense of identity as young people with mental health issues
guardian.co.uk, Wednesday 15 April 2009 00.05 BST

Rachel Haddon, 21, Preston, Lancashire

Who am I? A 21-year-old female? Student? Mental illness and eating disorder sufferer? Self-harmer? Vegetarian? Or an animal lover? I am all of these things, yet none of these things. I am just me. If diagnoses were put on the end of your surname, like qualifications, I would look rather qualified! But these labels don’t aid and benefit me like qualifications would. It is time professionals stopped treating people as disordered statistics, and instead saw us as people. Ordinary humans, who just happen to have problems. After all, everyone has problems, don’t they? Perhaps our problems just affect us a little more than normal. But what is normal? The only normal I know is the setting on a dishwasher. Over the years I have met many so-called “professionals” – doctors, nurses, social workers and psychiatrists who apparently excel in their field. But most have actually made me feel worse. I don’t doubt that on the majority of occasions their intentions have been good, but instead of helping me, they have just diagnosed, medicated and hospitalised me. Of course, that is often necessary and beneficial, but the most important and helpful “treatment” is to be listened to, and believed. Sadly, many professionals seemingly fail to do this. The attitude of these professionals and the general public is obviously influenced by the media to some extent. It’s not rare to see a headline such as “Prisoner with personality disorder attacks staff”. Is it any wonder that the majority of people think having a personality disorder indicates that you are a dangerous, reckless, violent criminal? Some could argue for freedom of speech, but for those like me who happen to be diagnosed with a personality disorder (regardless of my opinions on the use of this “label”), such statements and in­accurate beliefs only add to our problems. The hope of recovery sometimes seems impossible in a world that functions on stereotypes and stigma.

Saad Butt, 21, London

It has been six years since my father died of a heart attack. Being the eldest, I looked after my mum and my younger brother and sister, as well as myself. I was 15. My GCSEs were a pressurised time and things weren’t easy. I had to grow up fast. My father and I didn’t always have the best of times. Why was it that we were so close and yet so distant? Why is it we wait so long to tell those close to us the way we feel about them? To lose someone close and still live and breathe each day was a big struggle. I had attacks of depression, identity crises and suicidal thoughts. There didn’t seem to be anyone who could help and it didn’t feel like counselling services were available either. But I kept on going, suffering in silence, living in the hope that one day things would be better. Before my dad died, I was involved in my community with the local youth parliament. That kept me going, but when I found a mentor through my community work to talk things through with, things started to change. At 18, I found in him the dad I never had. He became my guardian, had a deep-rooted concern for me, and took an interest in my studies and my extracurricular life. My emotions started to become a positive driver in my life. I love him more than anything in the world. Now I never take anything for granted; I’ve become more focused, more concentrated on what I want in life. My relationship with my mother has become closer. I’m studying for a law degree and I’m still involved with local youth issues – for example, as a member of the British Transport Police youth board. I’m getting married in the summer and looking forward to that and the new life that comes with it. I’ve also learned that it’s important to get help and talk to someone you trust. Above all, have faith, stay positive and cool about life, and go with the flow – it isn’t always as bad as it may look.
Celeste Ingrams, 24, Southampton

The most difficult thing is how people have reacted to my mental health problems. It made me think I was dangerous due to what was going on inside my head. This perception became almost a sense of identity that made me feel secure and reaffirmed my belief that I was “crazy” and uncontrollable. It took me a long time to realise that my “craziness” was my mind coping with the emotions that were reactions to me feeling unsafe and anxious. It is hard to admit vulnerable emotions and this denial came out in my behaviour, which I’m not proud of, but I couldn’t communicate my feelings in any other way. I often kicked against everything, which was self-destructive and led to people being hurt. Although I feel guilty about this, if I’d not gone through this process then I wouldn’t have been able to learn from my mistakes. How I manage is I don’t get too caught up in what’s wrong with me or how others make sense of what I do, but I stay in touch with my emotions. I use coping skills to steady myself, and prevent things getting out of control, often by spending my time expressing myself in more creative ways with art and writing. My experience of living in institutions – NHS or local authority psychiatric units, or residential therapeutic communities – was about feeling controlled and not supported. I think this affected my ability to believe or trust in myself. I try now not to feel caged by stigmas and stereotypes. I know it can be extremely difficult to do this in our society.

• Rachel, Saad and Celeste are all members of mental health charity YoungMinds

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Filed under: Other Mental Health, self-harm, Suicide, , ,

Reducing Suicidal Behaviors Among Adolescents

ScienceDaily (Mar. 15, 2009) — Adolescent girls who view themselves as too fat may display more suicidal behaviors than those who are actually overweight, according to a study by Inas Rashad, an assistant professor of economics at Georgia State University.

Although studies have shown a link between obesity, depressive disorders and suicidal behaviors, Rashad and Dhaval Dave of Bentley University, analyze these indicators in conjunction with an individual’s perception of their weight. The study, which was accepted for publication in February, will be published in Social Science and Medicine.

“Both obesity and suicide have been highlighted by the Surgeon General as areas of focus for adolescents and areas of great concern,” Rashad said. “We find that the role perception has independently of actual overweight status is an important one, which has implications in terms of any solutions to the obesity epidemic that are put forth.”

The researchers utilized data from 1999 to 2007 from the Youth Risk Behavioral Surveillance System, which indicated that 17 percent of high school students have seriously considered committing suicide. The data were used to not only investigate whether overweight status or perception are causal factors affecting suicidal thoughts and attempts among high school students, but also to estimate the potential economic costs.

“If being overweight not only imposes the usual health care and labor market costs, but also increases the risk of suicide, we need to take these costs into account when offering solutions,” Rashad said.

The study revealed that body dissatisfaction had a strong impact on all suicidal behaviors for girls and was generally insignificant for males. For instance, any perception of being overweight by girls raised the probability of suicidal thoughts by 5.6 percent, the probability of a suicide attempts by 3.2 percent, and the probability of an injury causing suicide attempts by 0.6 percent. The researchers also state that the risk of suicide by adolescent females could potentially add about $280 to $350 million to the costs of adolescent obesity, which includes the direct cost of illnesses and associated health care and indirect costs such as productivity losses, reduced income and premature mortality.

Rashad hopes more research will be done on the topic, but she recommends efforts aimed at preventing youth suicides focus on educating youths and fostering healthy attitudes with regard to weight.

“The prevalence of body dissatisfaction, among special populations of youths such as non-black girls, is significantly higher than the general youth population, even when the underlying weight is in a healthy range,” Rashad said. “Interventions that identify and assist these youths and educate them regarding a healthy body image will succeed in lowering suicide attempts.”
Adapted from materials provided by Georgia State University, via EurekAlert!, a service of AAAS.

Filed under: Suicide, , , , ,

Risk Factors For Suicidal Events Found Among Adolescents With Treatment-Resistant Depression

19 Feb 2009
Family conflict, drug or alcohol use and pre-existing suicidal thoughts were the strongest predictors of suicidal events among adolescents whose depression treatment was changed after a lack of response to a previous medication.

The findings were reported today in the article “Predictors of Spontaneous and Systematically Assessed Suicidal Adverse Events in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) Study,” at AJP in Advance, the online advance edition of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association.

In the study, 334 adolescent patients who had not responded to a selective serotonin reuptake inhibitor (SSRI) were switched to a different SSRI or to venlafaxine, with or without cognitive-behavioral therapy. Forty-eight patients experienced a suicidal event-suicidal ideation (new or worsening), a suicidal threat or a suicide attempt. The median time from a suicidal threat to a suicidal event was three weeks. In the AJP article, lead author David Brent, M.D., and colleagues recommend careful monitoring of more severely depressed adolescent patients who have high levels of suicidal thoughts or family conflict.

Treatments that target family conflict and emotion regulation early may help reduce suicidal events. Likewise, since the predictors of suicidal events also predict poor treatment response, targeting family conflict, suicidal ideation and drug use may hasten response and help to reduce the incidence of these events. TORDIA is sponsored by the National Institute of Mental Health. Any other funding the authors may have received is disclosed in the article itself.

The American Journal of Psychiatry is the official journal of the American Psychiatric Association. Statements in this press release or the articles in the Journal are not official policy statements of the American Psychiatric Association.

About the American Psychiatric Association

The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at http://www.psych.org and http://www.HealthyMinds.org.

Filed under: Other Mental Health, Suicide, , , , ,

Werther Effect and Bridgend Suicides

By Jeremy Laurance, Health Editor, Independent Newspaper
Wednesday, 20 February 2008

One question considered by the special task force of police, health and social services set up in Bridgend to review the spate of suicides is whether they are examples of the “Werther effect”, the name given to suicide clusters after the title of a novel by Goethe.

The Sorrow of Young Werther is the story of a young artist who shoots himself after an ill-fated love affair. Following its publication in 1774 there was a series of reports of young men who took their own lives in the same way, which led to the book being banned.

The copycat element in suicide is a well recognised phenomenon. The victims tend to come from similar backgrounds and are at greatest risk if they know other victims. In Bridgend, the Werther effect is thought to have been amplified by messages posted on internet sites such as Bebo, intended as tributes to the victims but which have instead romanticised the manner of their deaths.

Professor David Gunnell, an expert on suicide at Bristol University, said: “Young people are more likely to see and read items concerning suicide on the internet than in the newspapers… A medium like Bebo will have an impact on suicidal behaviour.”

In some countries, such as Norway, reporting of suicide is virtually banned – its journalism code says it should “in general never be given any mention”. In the UK, the Press Complaints Commission amended its guidance in 2006 to editors to avoid “excessive detail about the method”.

The Samaritans, which provides support to people with suicidal feelings, says that to reduce the risk of copycat deaths, suicides should not be romanticised, permanent memorials should be discouraged, suicide notes should not be disclosed and excessive detail should be avoided.

Filed under: Suicide, , , ,

Young people’s gendered interpretations of suicide and attempted suicide

Jonathan Scourfield*, Nina Jacob, Nina Smalley, Lindsay Prior§ and Katy Greenland¶

*Senior Lecturer, PhD Student, ¶Lecturer, Cardiff School of Social Sciences, Cardiff, Freelance Researcher, and

§Professor of Sociology, Queen’s University, Belfast, UK

Child and Family Social Work 2007, 12, pp 248–257

ABSTRACT

This paper aims to uncover gendered interpretations of various kinds

of suicidal behaviour. Its empirical basis is focus group discussions

with a range of young people, including users of social work services.

In support of Canetto’s research, the authors found some of the young

people to be associating ‘successful’ suicides with masculinity and

‘failed’ suicide attempts with femininity. These feminized suicide

attempts were subject to some fairly pejorative interpretations, such

as being motivated by revenge or manipulation. There was no particular

pattern of viewpoints in terms of the sex of respondents. The

implications of these findings for social work are discussed.

Filed under: Suicide, , , , ,