"Suicide." Few words strike as much fear into the hearts of parents. While the incidence is rare, thank God, the numbers are definitely increasing, even in the Jewish community. Parents, therefore, need to familiarize themselves with the risk factors, as well as learn what they can do to prevent such a tragedy from occurring in their home.

RISK FACTORS

The major risk factors for suicide can be summarized by the acronym "sad persons."

Sex. Gender plays a significant role. Teenaged boys are much more likely to commit suicide. Teenaged girls are more likely to make unsuccessful attempts to take their lives.

Age. The vast majority of completed suicides are committed by adults over age 60 or by teenagers. People 20-60 are less likely to commit suicide.

Depression. Anyone suffering from clinical depression is at risk for suicide. Symptoms of clinical depression include loss of appetite, feelings of hopelessness, sleeping disturbances (too much or too little) and loss of interest in activities which used to be pleasurable for that person. Depression may be caused by one or more of the following: biochemical factors, major recent losses or untreated childhood trauma or abuse. Typically, the risk of suicide is highest during the first three months of recovery from major depression.

Prior history. Anyone with a history of impulsive or violent behavior or of making suicidal gestures or attempts is much more likely to commit suicide than someone who has never done so. A suicidal "gesture" is an act which is not sufficiently self destructive to cause death, such as slitting one's wrists. A suicidal attempt is an act which could result in death if the victim is not found in time, such as an overdose of sleeping pills.

Extended illness. Severe, chronic physical illness can lead to major depression (see: "D" above). In addition, long standing psychiatric illness, such as schizophrenia or bipolar disorder, can cause intolerable suffering and torment which could push someone over the edge.

Rational thinking loss. Part of rational thinking is to consider the consequences of our behavior. Once someone has become irrational, negative consequences are no longer a deterrent.

Support system lacking. When people feel well connected to friends or relatives, they are less likely to feel so desperate, alone and helpless that they will take their own lives. Conversely, when one feels isolated from friends and alienated from family s/he is at greater risk of suicide. One of the highest risk factors for teenagers, for example, is when one of their friends commits or even attempts to commit suicide.

Organized plan. If someone has a clear idea of just how to go about it, s/he is much more likely to commit suicide than someone who is only contemplating it in general terms. The plan may include not only the method but also how to dispose of personal property or prized possessions. One student, for example, gave his teacher all of his personal notebooks the night before he jumped off the roof of the school building to his death.

No spouse. Statistically, singles are at greater risk. That may be one reason for teenagers being over-represented among suicide victims.

Substance abuse. Any history of alcoholism or drug abuse increases the risk of suicide because it indicates that this is an adolescent who deals with problems by trying to escape.

WHAT PARENTS CAN DO

First and foremost, take all threats of suicide seriously. It is a myth that people who talk about it do not do it. Statistics show that 8 out of 10 people who committed suicide gave some warning before taking their lives.

Try not to be judgmental ("Don't talk like that") or moralistic ("The Torah forbids it"). False reassurances ("Everything will be fine") are equally unhelpful. Instead, show concern ("You seem to be going through a difficult time right now"). Try to empathize ("It sounds like you are feeling overwhelmed and hopeless"). And encourage verbalization of feelings ("Tell me what is bothering you").

If your son or daughter has expressed suicidal thoughts, do not leave him or her alone for long periods of time. Offer to be and, if necessary, stay with him or her, or arrange for someone else to do so, until the immediate crisis passes.

Finally, insist on an immediate psychiatric consultation. Make an appointment as soon as possible for your child to be evaluated by an experienced mental health professional who can properly assess the degree of suicidal risk. Volunteer to go with your child to the appointment and be sure to follow any recommendations you receive.