Mental Health and Foster Care Series: Preventing Suicide in Foster Youth

SUICIDE…the very term conjures gory pictures of young desolate individuals with no hope ending lives not yet lived.  Families are torn apart by suicide as the self-blame, recriminations are met with silence as to the question Why? Every single day we lose 12 youth to suicide, and there is an average of 25 suicide attempts for each completed suicide.  Youth between 10-24 years of age are at the involved in suicide, the risk factors, protective factors, warning signs, the case studies I was involved with, and how we can prevent suicide in foster youth.involved in suicide, the risk factors, protective factors, warning signs, the case studies I was involved with, and how we can prevent suicide in foster youth.

Foster youth are 3-5 times more likely to commit suicide than same age peers, two and a half times more likely to think about possibly committing suicide, and four times more likely to make a suicide attempt (source: National Center for Prevention of Youth Suicide).

Q. How do you recognize that someone is likely to commit suicide?

A.  Early warning signs of suicide include the following subtle signs:

  • Withdrawal and isolation, and alienation, i.e., inability to reach out for help due to poor coping skills
  • Saying that life has no value or this earthly existence is meaningless
  • Odd behaviors and sudden changes in behaviors that are high risk or dangerous
  • Personality changes, social relationship changes, sleep disturbances, nightmares, lack of social acceptance, self-loathing
  • Obsessions with thoughts of death and dying, focus on music that is violent or reflecting death themes
  • Loss or death of loved one, such as an idolized parental figure

4/5 suicides are usually preceded by warnings by the person who is planning to commit suicide and often these are not taken seriously.

A.  There are multiple risk factors.  These can be classified as: major, minor, idiosyncratic, synergistic, dynamic and/or culturally relevant. The most cited ones are:

  • Previous suicide attempt
  • Strong family history of suicide
  • Strong family history of severe depression/severe mental illness
  • Bullying
  • History of child sexual abuse
  • Lack of access to help, isolation
  • LGBT youth (bullying and discrimination)
  • Access to lethal weapons
  • Engaging in high-risk behaviors
  • Substance abuse/dependence
  • Loss of family contact, support and connection
  • Poor impulse control and low frustration tolerance
  • Feeling stuck, trapped, or caged with no hope of escape
  • Communicating about suicide: Journaling about suicide or writing about it, or talking to friends

Q.  What are the protective factors?

A. Protective factors include dimensions of personality, resilience, life experiences, and genetics.  Within these categories major protective factors for foster youth include:

  • Determination to succeed
  • Refusal to accept the norm
  • Positive self-esteem
  • Strong support system: family, friends, biological connection
  • Willingness to accept society
  • Academic achievement
  • Sense of optimism
  • Involvement in sports and other activities
  • Peer support and acceptance
  • Limited access to lethal weapons
  • Religion and spiritual practice
  • Sense of having personal control
  • Support through mental health and other services

Q. What are the ways in which foster parents and families can prevent suicide in youth?

A. The main areas of intervention by foster/adoptive/biological families lay in those of making the child feel wanted, feel they belong and feel they are important to your family.  Ways in which this can be achieved are:

  • Use I statements and say how glad you are that they are around
  • Express love and emotion about having the youth in your family
  • Ask for their opinion, views, and even if you disagree, allow independence of spirit and opinion
  • Be watchful and mindful of access to alcohol, drugs and illicit activities: often these are ways to escape from traumatic memories
  • If the youth seems “out of control” try to find the cause – in foster care, it is more often about escaping from pain and grief than about wanting to be defiant or being mentally ill
  • Talk, talk and be there for your young person
  • Talk to teachers, peers and welcome friends into your home so that you get to know whom they are hanging out with
  • Promote school activities, sports, drama, art, and community activities. The more youth are involved in positive activities the less likely they are to engage in negative self-talk
  • Increase importance in the family system by providing positive roles and realistic expectations, and giving leadership opportunities.
  • Involve youth in family decision making, helping in improving communication amongst family members and openly talking about suicide, depression and feelings of isolation and alienation from society

Above all, accept the youth for whom and what they are; you cannot take away their memories, but you can provide happier events that leave positive memories for the future. Each positive memory is a mental health bank for healthier self-esteem and self-worth.