Suicide is the third leading cause of death among 15- to 24-year-olds, according to the Centers for Disease Control and Prevention, and the phenomenon has lately been in the news. Cornell University is coping with a suicide cluster among students, two teenage girls killed themselves last month in Norwood, Pa., and four teens died by suicide last year in Palo Alto, Calif.
Scott Fritz, whose 15-year-old daughter took her life in 2003, says there are many things parents can do to prevent suicide.
"Educate yourself on the warning signs, risk factors, and very importantly, on protective factors," said Fritz, president and co-founder of the Society for the Prevention of Teen Suicide.
Like many parents, Fritz said "we had no idea teen suicide was even a problem" — until his daughter's death. Teen suicide rates in the U.S. have decreased since the 1970s, but a 2007 CDC survey still found 14 percent of high school students had "seriously considered suicide" in the previous 12 months.
Fritz's organization offers an intense but extremely informative 17-minute video on its Web site called "Not My Kid" — www.sptsnj.org/ — that can help parents identify warning signs of suicidal behavior.
These include feelings of hopelessness, anger, excessive worry or anxiety or other signs of depression; self-destructive or risky behavior, including excessive drug or alcohol abuse; extreme changes in moods, attitudes or behavior, or a withdrawal from activities or socializing; and verbal or written threats, innuendos or statements like "Life isn't worth living." In some cases there may be a family history of suicide.
Fritz added that death by gunshot is the leading method of youth suicide. "So if you are worried about your kid, make extra sure there is no access to guns," he said.
Another factor often present in suicides is a "triggering event," such as a disappointment that leads to despondency. The event might not seem like a big deal to adults, but remember that teenagers don't always have the skills to cope with stress related to school pressures, social situations or family conflicts. Or they may be struggling with a serious problem such as the loss of a loved one.
These "triggering events can push someone off the edge," said Maureen Underwood, a social worker who has written suicide prevention school curricula and who works with the Society for the Prevention of Teen Suicide.
The phenomenon of multiple suicides in one community or school raises a terrifying question for parents: Is adolescent suicide contagious?
"There is a contagion factor with kids," Fritz said. "It isn't any different than how they wear their hair or their clothes. They tend to copy each other."
"There is something about peer identification in that age group," agreed Underwood.
That doesn't mean parents should avoid raising the subject. The "Not My Kid" video stresses that there's no evidence that discussing suicide with kids in a responsible way leads them to do it. In fact, says Fritz, talking to teenagers about suicide helps prevent it.
But what exactly do you say?
Fritz says if there's been a suicide in your community or it's in the news, you might start like this: "'I just read in the paper that so-and-so died by suicide. What do you think about that?' ... Have you ever thought about suicide or what it means?'"
Just be careful not to glamorize or romanticize suicide; don't dilute the message that suicide is wrong. If your child knows of someone who committed suicide, you might say, "Johnny made a terrible mistake, and he can't take it back," Fritz said.
Many schools discourage tributes or other physical memorials in cases of suicide, and Fritz's organization asks that schools and parents refrain from dedicating events or places named for the deceased. The society also says there is evidence that publicizing the details of how suicides are carried out can encourage copycat behavior.
Fritz believes his daughter's suicide was triggered by antidepressant medication, and he testified at federal hearings that led to warning labels about suicidal behavior as a risk of certain drugs. So he also urges parents whose kids are taking medication to educate themselves about "what the side effects are and what to look for," he said.
But he noted that every suicide is unique, and multiple factors are usually involved, even if they may not be obvious beforehand.
"There is no typical profile," added Underwood. "There's never just one reason; there's always a more complicated story."
For parents, though, the message is simple: Talking about suicide with a teenager is not all that different from talking about drugs or sexual activity. Listen to what your child has to say and communicate your values.
The takeaway, Fritz said, should always be: "We value life, and no matter what problems you may have, there's nothing so bad that we can't work it through together."
Beth J. Harpaz is the author of several books including "13 Is the New 18."
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