There are headlines that fall like a blow, and the death this Friday of two sisters just 12 years old in Oviedo is one of them. This tragedy has put suicide in minors back into focus. In 2021, this was the cause of death for 22 people between the ages of 10 and 14, the highest number since 1991, according to the National Statistics Institute. Experts have been sounding the alarm since 2020. The confinement triggered emotional discomfort and mental health problems in young people, and the figures have not recovered from that. The cases of suicidal thoughts or attempts in adolescents that the Anar Foundation has attended to in its help lines have experienced a sharp rise: in 2019 there were 958 and last year, 4,554. They have practically multiplied by five. Psychiatrists and psychologists call for an end to the fear of talking about suicide with young people who need it, and warn of the high imitative effect in these age groups.
“Starting in September 2020, when life at school began to normalize, but not yet in leisure and free time, we began to see an increase [de intentos de suicidio], especially in girls”, explains Joaquim Puntí, clinical psychologist of the program for the prevention of suicide attempts in adolescents at Hospital Parc Taulí, in Barcelona. In the attempts there are more young women, in the consummated suicides, men over 45 years of age. The president of the Spanish Foundation for Psychiatry and Mental Health, Víctor Pérez, confirms that “confinement was the trigger”. He gives the example of Catalonia. Adolescents treated there in the Suicide Risk Code, a program that allows minors with suicidal behavior —that is, with thoughts of suicide or suicide attempts— to be seen by a psychiatrist in 72 hours, went from 601 in 2020 to 1,492 in 2021 “In 2022, there is a small drop, but it is still a high number,” he continues.
The data is in line with that published by the Anar Foundation, which has a telephone and a chat room to help minors with problems. “Only last year we attended 4,554 cases of suicidal ideation or attempt, in 1,275 of them, the suicide attempt had already begun,” summarizes Benjamín Ballesteros, its technical director of Programs. He is a psychologist and emphasizes that suicide is multi-causal, it does not obey a single reason. And “it is always a symptom” of something that is happening to the child. “60.9% of the cases were related to violence, such as bullying, intrafamily physical and psychological abuse, sexual assaults and gender violence in the environment. 27.4% of the cases had associated health problems [a esa ideación o intento de suicidio], such as self-harm, which is the main predictor of suicidal behavior and has also increased a lot in recent years; others, behavior problems, also sadness, depression, eating disorders and anxiety”.
Ballesteros continues to break down data that draws an x-ray of the problem. “Last year we did a study on the profile of minors with suicidal behavior. 71.3% are women (they ask for more help than they do, and if they try they are more definitive), they are between 13 and 17 years old, they are from a migrant family, they have had previous suicide attempts, poor school performance and health problems mental, such as self-harm as a way to alleviate suffering”. He calls on parents to be very careful to control their children’s activity on the Internet, where there is “a lot of content related to suicide and self-harm”, and to be attentive to certain signs: “If there are sudden changes in the adolescent’s character, such as feelings of sadness, depression or even greater aggressiveness; if he isolates himself; if we see that he verbalizes things like that life has no meaning; if he harms himself… We are observing that if the minor has a problem that he does not know how to solve and he feels a burden for others, there is a high risk”.
For this reason, all those consulted agree, one should not be afraid of talking about suicide and asking directly about these thoughts, and one should not react by minimizing them or saying phrases such as “don’t talk nonsense”. Professional help should be sought and the health system used, says Cecilia Borràs, president of the After Suicide Association of Survivors. She says that families experience it “with a lot of bewilderment.” “Many end up finding out when it has already happened, and they did not know anything. It seems that the world of adolescents and adults does not coincide, and there they realize that they had just spoken or written about it in a newspaper”. The association, which cares for relatives who have lost someone to suicide, was launched in 2012. In nine years, they treated three cases of minors. “Last year there were two and this year we are going for one”. She believes that there are fewer and fewer taboos and parents are more aware. But still, she says, many teens call the helplines because they are afraid of causing more problems for their families. For this reason, she stresses that it is important to talk to the children. “The word suicide does not kill. What is going to kill is that the methods are reported ”, she assures.
The president of the Spanish Foundation for Psychiatry and Mental Health agrees that “the imitative effect on young people is devastating.” The two girls from Oviedo have died three months after two minors from Sallent (Barcelona), a brother and a sister, attempted suicide; he died and she was seriously injured. Joaquim Puntí, from Parc Taulí, supports this idea. “When there are media suicides, in the following three or six months, adolescents with similar characteristics can act the same.” Experts stress that it is important to convey the temporality of the problems.
Puntí points to mental illness as a risk factor, although he points out that many of his patients do not suffer from any and other variables must be taken into account, “such as temperament or personality, for example if he is someone very impulsive, and hopelessness”. And also to the educational, family and social contexts: “Feeling that they have support from a group of equals or an adult is a protector of suicidal behaviour”.
In the case of minors who have already had a suicide attempt, adds Puntí, it is essential to “work with a safety plan”, which he explains as follows: “We analyze with them what happened that day, what they felt before the attempt. If those thoughts come back, they have to distract themselves with activities they enjoy, for example, dancing or drawing. If this fails, external help must be sought, they must have reference people to call to go out and distract themselves, even without talking about the subject. If this step is not enough, they will have identified two or three people with whom they can talk about what is happening to them, who can be an adult or even a peer. And if this fails, you have to seek more specialized help, such as your psychologist or psychiatrist, the suicide prevention lines or, ultimately, go to the emergency room. Puntí says that the boys go out like this with the feeling that “they have shares in their pockets” to which they can resort. “Most of the boys who have had a suicide attempt, after 24, 48 or 72 hours see it differently. Something can always be done when the idea of suicide comes.
Something in which Víctor Serrano, who directs the suicide prevention program at the Hospital de Sant Pau, in Barcelona, agrees. He criticizes that the specialty of psychiatry is not being strengthened and regrets that Spain is “the second in the European country with the fewest psychiatrists.” Serrano, who works with adults, says that young people increasingly go to the emergency room earlier to ask for help and attributes this to the fact that there is more awareness on the subject and on mental health. He emphasizes that the most important thing is, “above all, not to judge.” “If your son has had an attempted suicide,” he says, it’s vital “to provide a space in which he can talk and offer help.”
People with suicidal behavior and their families can call 024, a hotline of the Ministry of Health. They can also go to the Telephone of Hope (717 003 717), dedicated to the prevention of this problem. In cases that affect minors, the Anar Foundation has the telephone number 900 20 20 10 and the chat on the page https://www.anar.org/ for Help for Children and Adolescents.
