Commitment to Living » child & adolescent

Possible contagion effect in Nantucket

Anthony Pisani — Tue, 18 Mar 2008 12:11:35 +0000

The small island of Nantucket, MA has seen 3 teen suicides in a short period of time, according to the New York Times. Very sad. Statistically, three suicides in a high school of 400 represents a meaningful cluster, and a possible contagion effect. Whether it is or it isn’t contagion in Nantucket (it is impossible to know for sure and the article suggests some disagreement in this case), the key thing for clinicians to know is that vulnerability to contagion has been documented in adolescents. Clinicians working with adolescents at risk at the time of a public or peer suicide should consider reassessing their clients’ risk for suicide when news of a peer death becomes public.

NY Times: Short but Troubled Life Ended in Shooting and Suicide

Anthony Pisani — Fri, 12 Oct 2007 15:05:14 +0000

This NYT article about 14 year-old boy who died on Wednesday after critically wounding a teacher and classmates, is a case study in risk for adolescent suicide. Abuse/neglect history, legal trouble, access to weapons, social misfit, recent disciplinary action at school. The temporal proximity of his older brother’s arrest is also striking…again pointing to the systemic properties of suicide.

Risk of suicide in young children

Anthony Pisani — Wed, 13 Jun 2007 02:05:26 +0000

There is a lot of material available about assessing for risk of suicide in adolescents, but much less that focuses on small children. Some cases are relatively (and I mean relatively) straightforward, like the child who says he is going to kill himself in anger when he doesn’t get his way. But I have seen a fair number of young children where it is more complicated. Some of them may express the suicidality in anger, but they also take actions like grabbing a kitchen knife or putting shoelace around their necks and pulling it.

Now, in all of the cases I have seen this action has been taken in full view of parents or other adults, which makes it somewhat less concerning (at least in terms of immediate risk for suicide), but nevertheless the child has taken an action which, if done at another time and in a slightly different way could be dangerous.

Our frameworks for assessing risk in adults fall short in these cases. I know I feel on less steady ground. If anyone knows of good resources–ones that not only provide risk factors, but ways of conceptualizing suicidal behavior in young children, I’d love to hear from you.

ChildTrends Report: Teen deaths by homiside, suicide, and firearms

Anthony Pisani — Wed, 25 Apr 2007 11:47:30 +0000

Apropos of my recent posts reflecting about suicide, guns and homicide, colleague Bob Hawkes sent me a link to this report: Teen Homicide, Suicide, and Firearm Deaths, compiled by the Child Trends Databank. There are some nice figures in the report, including one nicely demonstrating recent declines in teen suicide rates (for related post see Unintended Consequences of antidepressant black box warning re: Kelly Posner’s (and others’) argument that these gains are threatened) . You can click on the figures from the linked page or see all together in the .pdf, which is linked to at the top of the page.