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By AnnaIlse Kempen
The combination between life stresses, such as South Africa's high crime rate, difficult financial times, political instability as well as dealing with adolescence, can simply be too much for some teenagers - even when we, as adults, think that teenagers should not worry or be too concerned about these issues, But these are not the only issues that teenagers have to deal with, and just like some adults, not all teenagers have the same ability to deal with their problems sometimes, the only solution these people consider is to end their lives.
According to statistics quoted by the South African Depression and Anxiety Group (SADAG), 9.5% of South Africa's youth consider suicide as the (only) solution to their problems. "Suicide is the fastest growing, and second leading cause of death in the 15 to 19 age group. The recent National Youth Risk Survey found (that) an alarming number of high school teens were depressed and suicidal - over 20% had considered suicide during the last month," reads a "Facebook Friday" post by SADAG dated 14 February 2013. During SADAG's Teen Suicide Prevention Week, which takes place each year during February, SADAG wants to raise as much awareness as possible, to prevent even just one more teen from thinking of taking his/her own life.
An article entitled "SA teens: high suicide risk", published on Health24.com, quotes a study claiming that "24.5% of attempted suicide cases among black South Africans have occurred in youths aged 17 and below. A total of 34% of black youths have considered suicide as an option in response to stressful life situations, such as divorce of their parents, conflict and love/relationship problems".
According to the World Health Organisation (WHO), around one million people commit suicide each year and it is predicted that by 2020, this figure will rise to 1.53 million. Hanging is the most frequently used method of suicide, followed by shooting, gassing and burning. The suicide rate for children aged ten to 14 years has more than doubled over the past 15 years. According to Prof Lourens Schlebusch, a South African authority on stress and suicide, recent research in the country shows that on average, suicide accounts for 9.5% of non-natural deaths in young people ( I I% in adults), while ten to 20 times more non-fatal suicidal behaviours occur per year. Weekends and year-end months are high risk periods. In South Africa, 8% of all deaths reported to academic hospitals are due to suicide, but the real figure is higher.
Nearly a quarter of Gr 10 pupils reported being bullied having made a suicide who have also reported attempt in the past 12 months, according to the Washington State Healthy Youth Survey in 2008.
What is suicidal behaviour' According to Prof Lou rens Schlebusch (2005), suicidal behaviour occurs in different forms. It involves a varying degree of severity that can range from a person wishing him-/herself dead to that person actually killing him-/herself. Suicidal behaviour denotes a wide range of self-destructive or self-damaging acts in which people engage, owing to varying degrees of levels of distress, psychopathology, motive, lethal intent, awareness and expectations of the deleterious (harmful) consequences or outcomes of the behaviour. Fatal suicide behaviour refers to self-committed, completed suicidal behaviour that embodies the victim's intent or aim to die, and occurs when that person has managed to achieve that predetermined goal. On the other hand, non-fatal suicidal behaviour refers to selfinflicted suicidal acts that did not succeed in ending the victims's life and which embody several manifestations, such as those seen in attempted suicide and parasuicide.
Contributing factor( Some families fail to communicate important matters affecting all the family members, both young and old. Some take the problems which the younger members of the family experience for granted while others simply don't pay any attention to their problems. A family's financial stresses can impact on all family members' lives, but some parents are ignorant of this fact. They do not recognise that some teenagers may in some way feel coresponsible for the family's situation.
Inability to deal with the death or serious illness of a parent or sibling may be another contributing factor leading to teenagers contemplating suicide, as they often find that they cannot talk to the adults in their lives about the tragedy and therefore have to find their own way of dealing with it.
Other issues which can increase a teenager's risk of committing suicide include: Mental illness, including depression and conduct disorders; Environmental risks such as having access to a firearm; substance abuse; and situational crises such as the traumatic/ unexpected death of a loved one, physical or sexual abuse, family violence etc.
Mike Hardcastle, who has been a foster parent for many a year, expresses the opinion that the three most common factors considered to account for the high suicide rate among teens are: an immortality complex in teens, meaning that they don't necessarily grasp the reality and finality of death; reactive immaturity, which means that the psyche is thought not to have developed enough maturity to control emotional reactivity to negative or hurtful occurrences and bouts of depression; and broad hormonal fluctuations that can lead to irrational thought processes and bouts of depression.
Another reason why people, and especially teenagers, commit suicide is clinical depression, although it is not a prerequisite. In some cases, it's more likely that teenagers may be reacting to social and environmental pressures when they become suicidal than that they are suffering from a true mental illness - this makes it harder for experts to predictsuicide in teens.
Girls versus boys and preferred methods According to Hardcastle, there is a difference in the ways that boys and girls handle thoughts about, and commit, suicide. Girls think about committing suicide twice as much as teenage boys, but boys are four times more likely than girls to actually die by killing themselves. The disparity is best explained by looking at the chosen methods: girls who attempt suicide are more likely to overdose on pills or to cut themselves - the latter attention-seeking behaviour is more common among girls. The former method of overdosing is a less violent way of meeting death as "it allows them time to 'stage' their appearance beforehand - some girls also view this method as 'more romantic'.
Boys, on the other hand, seem to choose quicker and more lethal methods, including using firearms, hanging themselves or jumping from heights. These preferred methods increase their chances of a successful attempt, and due to the nature of these attempts, by March 2014E1 enamus 15
Why is suicide so prevalent among teenagers? Teenagers otten experience a rollercoaster ride of emotions, including having thoughts about ending their lives for a variety of reasons, especially when peer pressure or pressure to perform becomes too much, However, when a teenager frequently feels or expresses real suicidal thoughts, it becomes a problem Peer pressure is one of the biggest influences in the lives of teenagers and when they can't cope with the added pressures, they fall victim to issues such as bullying or they are socially excluded by their peers, they might view suicide as the only way to 'opt out' Ironically, attempted suicide might also be viewed as a way of gaining attention from peers that would normally ignore them
Other issues Which teenagers also have to deal with include hormonal and bodily changes, the reality/uncertainty about awakening sexual feelings and developing their own identity, While attempting to be socially accepted and taking on more responsibilities as they transgress into the adult world, the variety of pressures can at times simply be too much to deal with for some teenagers the time someone discovers them, it is often too late.
Understanding the preferred methods of the different genders might help to prevent suicide. However, one must remember that suicide is not confined to any age, gender, social or economic group. It is indiscriminate, and a serious topic.
According to Prof Schlebusch's research, suicide methods differ across socio-demographic groups. Hanging accounts for between 34% and 43% of suicides, firearms for between 29% and 35%, ingestion of poison for between 9% and 14%, gassing for between 6% and 7%, burning for between 2% and 4%, and jumping off of buildings or other heights for between 2% and 4%. When referring to non-fatal suicidal behaviour, the overall method of choice in 90% of cases is drug overdose. Over-the-counter analgesics and prescription medications are commonly used, along with household utility products such as paraffin, cleaning agents, pesticides and various poisons.
Risk factors Some life events may act as a final "nail in the coffin" for teenagers and prompt them to go ahead with their suicide attempt. These include: III Bullying and cyberbullying In February 2012, a Grade 10 learner from the Lethabong Secondary School in Soshanguve, north of Pretoria, committed suicide in an apparent attempt to avoid further bullying by his fellow learners. David, a 16-year-old teenager, had been beaten, repeatedly called names and had, on occasion, had to run to the staff room to avoid the onslaught by his fellow learners. A day before his death, he returned home with a letter for his parents requesting that they visit the school urgently to discuss the bullying.
However, the next day, David pretended to leave for school but returned home ... and hanged himself. David's stepfather found him hanging from the rafters by an electrical wire, still breathing ... with his favourite gospel song playing in the background. Despite his stepfather taking immediate action by cutting the electric wire with a side cutter and arranging transport to take him to the clinic, the young 16-year-old David was declared dead on arrival. Apparently, one of the bullies had earlier been suspended for hitting a teacher.
In September 2013, a 12-year-old American girl jumped from a platform at an abandoned cement plant near her parents' home after she had suf16 Maart 2014 El ervamus
fered months of ruthless cyberbullying from other girls. At a news conference, the local sheriff said that more than a dozen girls have been identified as possibly being involved in the bullying. He said that she was "absolutely terrorised on social media". At one point, the mother had pulled her daughter out of school and transferred her to another school, closed down her Facebook page and took away her cellphone. However, the victim had apparently secretly signed on to new apps, such as a cellphone message application called Kik Messenger, and the bullying resumed.
However, mental health experts would argue that claiming that bullying is the only cause of suicide is much too simplistic. "Bullying aggravates depression and increases suicide risk and the seriousness of the issue shouldn't be minimised. Because bullying can be a catalyst for suicide, its significance should not be overlooked. When kids who are already at risk for suicide due to depression or other mental health issues are bullied, the results can be disastrous. Even relatively well-adjusted kids that are bullied can become depressed and contemplate suicide. So the possibility of suicide must be considered when a child is bullied" (Gordon).
Exam resulr, Teenagers' stress levels generally increase before and during the writing of exams, especially their matric exams. However, the same happens directly before and after receipt of their results.
Nomsa Mokone, a 17-year-old learner from Thabo Senior Secondary School in Naledi, Soweto committed suicide by hanging herself at her home in January 2010 after she couldn't find her name in the newspaper in which the matric results were published - she thought she had failed. However, she had passed five subjects and qualified to write supplementary exams in the two she had failed. Her distraught family wished at the time that she could have waited to see her statement/certificate. After her death, one of her friends recalled that Nomsa was so focused on her school work that she did not have time for a boyfriend or parties. "If you see her in the streets, she would be carrying her books to go and study. She never went to parties like other girls," she said.
Due to the fact that HIV/Aids is a highly stigmatised disease leading to discrimination against sufferers and their families, those infected and affected by the disease may consider suicide. Meel (2003) states that mental disorders are associated with more than 90% of all suicide cases and that depression affects approximately 25% of those with chronic illnesses, including HIV/Aids. "Depression may alter the course of HIV infection by impairing immune function or influencing behaviour. Many people with HIV suffer from depression and suicidal ideation, which responds to antidepressants, counselling, education and cognitive strategies ... There is a dramatic, sustained rise in depressive symptoms as Aids develops, beginning as early as 18 months before clinical Aids is diagnosed."
A study conducted by the University of KwaZulu-Natal aimed to examine the relationship between hopelessness, depression and suicidal ideation in HIV-infected persons. The adult volunteers attended a voluntary counselling and testing (VCT) HIV clinic at a university-affiliated state hospital during which suicidal ideation and depression were measured at two intervals, namely at 72 hours and six weeks after HIV diagnosis.An analysis of the results showed optimal sensitivity, indicating that the HIV-positive depressed patients were at risk of suicidal behaviour (Govender and Schlebusch, 2012).
II Other risk factor,. Alda Smit (2008),a clinical specialist at Lifeline Ekurhuleni, mentions that other stressful events associated with teen suicide include a disciplinary crisis or social failure, such as rejection by friends; an unsuccessful intimate relationship; or job failure. Often, suicidal teens have a close family member or friend who has committed suicide.
Research conducted by the students of the University of Cape Town, as One in five teens have considered suicide,
quoted in an article published by Mpumalanga News, summarised the most significant causes of suicidal behaviour in the country to be (among others) academic-related problems (including parental expectations around academic performance and career choices); relationship difficulties; peer-group difficulties, like bullying; social isolation and thus a lack of social support; family problems, such as disrupted family environments; broken family relationships; adverse parent-child interactions and violent abuse in the home (Mlangeni, 2014).
Dealing with attempted suicide Mike Hardcastle, a teen mentor who has written numerous articles about teenage behaviour, is of the opinion that there is no such a thing as a failed suicide attempt - an attempt is a desperate call for help and should not be ignored. "Often people think that somebody who tries to commit suicide but survives is only seeking attention, but in reality, suicide survivors are 12 times more likely to eventually die from suicide than teens who threaten suicide but do not ever act on the threat. People who have attempted suicide and survived are at a high risk to eventually take their own lives," says Hardcastle in an information sheet on suicide published on about.teenadvice.com.
By attempting suicide, teenagers signal that they feel overwhelmed with life and its stresses and, as they don't feel that there are solutions for the problems they face, they choose to end it all. It might be a dangerous statement to make, but substance abuse, including alcohol (which is a depressant), can create feelings of dependency, illness and depression. And, although a user will normally start using substances to escape life's
problems/challenges, users ultimately lose control over their lives due to their addiction, which can also lead to thoughts of or attempts to end their lives.
"Teen suicide is a preventable tragedy and through destigmatisation and education, teaching peers and teachers to recognise warning signs and intervene appropriately and timeously, can we save lives," says Cassey Chambers, SADAG's operation's director. It is important to never take warning signs lightly or to promise to keep them secret. If those involved in a school community, such as teachers and fellow learners, make suicide prevention a priority and are empowered to take the correct action, youth at risk can be helped before they take a decision/action with irreversible consequences (www.nasponline.org).
After all, we need to start caring about one another and ensuring that our children learn how to deal with their pressures, but even more importantly, creating an environment in which they can share their feelings, fears and questions about school, society and life without being judged. Nothing replaces a parent's love - make sure your child experiences it.
List of references AFP. "Girl, 12, commits suicide after cyber bullying." - Accessed at www.news24.com/ World/News/Gir1-12-commits-suicide-aftercyber-bullying-20130914 on 14 January 2014. Gordon, S."How strong is the link between bullying and suicide." - Accessed at http://bullying.about.com/od/Effects/a/HowStrong-ls-The-Link-Between-Bullying-AndSuicide.htm on 6 February 2014. Govender, R D and Schlebusch, L. 2012. "Hopelessness, depression and suicidal ideation in HIV-positive persons." The South African Journal of Psychiatry. Vol 18, no I. "Information sheet on suicide - ten things you need to know about suicide." - Accessed at teenadvice.about.com/of/factsheetsforteens/a/ 10 thingssuicide.htm accessed on 13 January 2014. Kwinana, N. 2013. "Teenage suicide: When all hope seem lost." 10 August. Accessed at www.voices-of-the-world.org/community/ teenager-suicide on 13 January 2014. Mlangeni, T. 2014. "Suicide increase among learners." Mpumalanga News. 7 January. Accessed at http://mpumalanganews.co.za/34515/suicideincreases-among-learners/ on 14 February 2014.
Maphumulo, S. 2010. "Suicide girl passed five matric exams." - Accessed at www.iol.co.za/ news/south-africa/suicide-girl-passed-five-matricexams- I.469840#.Uv4ENGKSyE4 on 14 January 2014. Meel, B L. 2003."Suicide and HIV/AIDS in Transkei, South Africa." Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology. January - June 2003: Vol 4, No I. Accessed at www.anilaggrawal.com/ij/vol_004_no_00 I /papers /paper00 I.html on 14 February 2014. Preventing youth suicide - tips for parents and educators. - Accessed at www.nasponline.org/ resources/crisis_safety/suicideprevention.aspx on 13 January 2014. SADAG Facebook Friday - Teen depression and suicide prevention 15 February 2013. SAPA. 2012. "Bullied teen commits suicide." Accessed at www.news24.com/SouthAfrica/ News/Bullied-teen-commits-suicide-20 120221 on 14 January 2014. "SA teens: high suicide risk." - Accessed at www.health24.com/Medical/Depression/Suicide/ SA-teens-High-suicide-risk-20120721 on 14 January 2014. Sapa. 2011. "Suicide in SA increasing." September Accessed at www.health24.com/ Medical/Depression/ News/Suicide-in-SA-increasing-20120721 Schlebusch, L. 2005. Suicidal behaviour in South Africa. Pietermaritzburg: University of KwaZulu-Natal. Smit, A. 2008. "Suicide amongst young people in South Africa." - Accessed at www.ngopulse.org/ article/suicide-amongst-young-people-southafrica on 13 January 2014. Talane,V. 2009. "Tackling teenage suicide in South Africa." Mail & Guardian. 18 November. "Teen suicide." - Accessed at www.sadag.org/ index. ph p ?o pti on = co m_co n te nt&v i ew = article &id=1840&Itemid=153 on 29 January 2014.
Editor's note. Refer to the Community Safety tips on page 3841 to learn how to deal with someone contemplating suicide.
SADAG Suicide crisis line: 0800 567 567 SADAG SMS service: 31393