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c economist suntribune july 221987 c3 teens in crisis help for suicidebound youths editors note this is the third article in a series on teens in crisis in this final story reporter maxine share covers the places where help is available for teens contemplating or attempting suicide by maxine share all the danger signals are flashing red you think your teenager may be considering suicide hes become quiet and with drawn and no longer spends time with his friends once an a stu dent hes been failing his classes your next move could save his life mdhs guidance counsellor carol drake says parents must put aside the notion that everything must be handled from inside the family which is easier she asks telling someone about your problem or dealing with the death of your kid recognize youve got a prob lem on your hands then decide to do something about it recom mends dr bob simmons coordi nator of psychiatric emergency services at the hospital for sick children in toronto but what professionals agree the most important step is getting profes sional help for the adolescent this is sometimes a difficult thing for parents to do says carol drake a guidance counsellor at markham district high school she says parents must put aside the notion that everything must be handled from inside the family which is easier she asks telling someone about your problem or dealing with the death of your kid power of love other parents may feel they can handle the problem themselves with the power of love she says if you really care about this kid its the best tool- youve got- sometimes the only tool youve got but she cautions if you just love them and dont know what youre doing youre going to mess them up too to determine what type of help an adolescent requires begin by assessing the risk of a suicide attempt if there is a plan and lethal means are available it may be time to take your teenager to a legal points by maxine share it may be easier to help a younger teen survive a suicidal crisis than older adolescents says an expert on teenager suicide dr bob simmons coordina tor of psychiatric emergency service at sick childrens hos pital in toronto say if the childs under 16 then the pa rents have the power to do something about it but if the teenager is over 16 parents cannot force their child to go to an emergency ward for help unless you can get someone to certify them as selfdestructive your hands are tied says dr simmons parents call and say can you do something for my suicidal child and we say no we cant unless the young per son is ready to cooperate the triangle which was on its apex re turns to normal and the teen reaches out of her situation to accept help janine strom local emergency ward says one expert advanced crisis ifthere is a gun in the house and his plan is to shoot himself then the crisis situation is very advanced says brian cunning- ton a counsellor with the mar- khamstouffville family life centre and if a male is talking in these terms the likelihood of it being lethal is very high they he says teenagers show their ambivalence in terms of a crisis call a note or planning the suicide so there is a likelihood of a family member finding out when they call to say goodbye that is an expression of that ambivalence he says furthermore all suicide has a communicative aspect he says- caring relationship at one extreme its saying life is just not worth living the way it then the possibilities for that family are great he says id find some other job if that werent so he said he said he believes there would be less suicide attempts if more people were aware of the in tervention services available the more that kids are aware of other supports such as gui dance councellors hotlines and people in the community the more they are able to help the if there is a gun in the house and his plan is to shoot himself then the crisis situation is very advanced says brian cunnington a counsellor with the markhamstouftyille family life centre and if a male is talking in these terms the likelihood of it being lethal is very high boys tend to use more violent means such as jumping or hanging as opposed to taking a handful of aspirins as many teenage girls do he says tend to use more violent means such as jumping or hanging as opposed to taking a handful of aspirins as many teenage girls do he says while girls attempt suicide twice as often as boys the males complete suicide twice as often as their female counterparts but even in an advanced crisis where the likelihood of an attempt is high professional intervention can help says mr cunnington some ambivalence anyone who is working in the health care profession cannot see a decision as being 100 per cent he says because even in a very advanced suicidal crisis there is always some ambivalance some indecision some yes and no voices j it is the task of the profession al to get in touch with the part inside that wants to hold on he says is right now if thats the case then the therapist responds to that form of communication as a professional mr cunning ton says he tries to establish a caring relationship where theres listening understanding and valuing of that individual i also try to expand their hope for the future he says in an advanced crisis they have very narrow tunnel vision they think things are bad now and there will never be a change but in fact i show them theyve exercised a choice by coming in for help and we con tinue by asking can we set an appointment for tomorrow already you are expanding their alternatives he says healing process he says he tries to involve the family in the healing process they may want to change but not know how to go about making that change if that is the case suicidal adolescent through the decision hotline helps in terms of practical advice mr cunnington recommends if a person is significantly advanced in the suicidal crisis a hotline or hospital emergency ward can be helpful in getting them through one emergency ward that handles hundreds of suicidal teens each year is the crisis unit at toronto east general hospital the program treats about 2000 patients a year and 60 per cent of those have made a suicide attempt or are thinking of it according to spokesman allison licht although the hospital deals mainly with adults ms licht works primarily with adoles cents in crisis everyone has a will to live but when the pain is great the will to live is not at the forefront we want to help them establish their will to live show alternatives what you have to do is hang onto them by showing them some of the alternatives they have other than suicide she says one aspect of therapy at the hospital involves teaching kids problem solving skills you help them through the problem of the moment then you equip them with new skills she says adults often tell adolescents i dont care what you do with you life as long as youre happy these kids have to know that its normal for them to feel unhappy at times says allison licht spokesman for the crisis unit at toronto east general hospital after several months of ther apy she says her patients find it difficult to believe they felt suicidal when theyre able to look at things differently in addition to assisting teens in crisis ms licht is also coordina tor of the hospitals school out reach program this unique program is designed to help schools cope when a suicide has occured and to assist teens who have a suicidal friend says ms licht she says there has been re search to suggest 90 per cent of students if they were feeling suicidal would tell a friend so if they are going to tell a friend she says the friend needs help too get help she advises these teenagers to be with their suicidal friends get them to some help and say youll stay with them this spring she spoke to a class at unionville high school in addition to talks aimed at preventing suicide she also goes into the school once theres been a suicide we give information on how to convey it to the class and also tell them how to identify other kids who are at risk says ms licht she also advises staff its im portant for a teacher or parent to say theyve noticed when an adolescent appears depressed not in a punitive way but in a caring understanding way its important for them to know someones noticed they arent feeling good she says sadness is normal and both parents and teacher should teach kids its okay to feel sad and depressed at times dont teach that its wrong or bad adults often tell adolescents i dont care what you do with your life as long as youre happy these kids have to know that its normal for them to feel unhap py at times she says she says she finds her work with the outreach program worth while if teachers parents and adolescents become more aware of some of the signs of suicidal behaviour they can be more help ful in responding you cant prevent every suicide she says but you do what you can who to cau telecare hotline 7311212 your family doctor ministers or religious leaders in your community family life centre 2942371 york central hospital emergency department 8831212