Recent data revealing that youth suicides have risen to a 15-year high has put the spotlight on a topic that is not often discussed in the media.
Singapore's overall suicide rate has fallen but youth suicides have risen to an alarming level.
Last year, 27 young people aged 10 to 19 killed themselves. This was twice as many as in 2014 and the highest in 15 years.
It has led the Ministry of Education to look at reviewing ways to prevent teen suicides, as mentioned by Minister of State for Education Janil Puthucheary in Parliament last week.
At suicide-prevention agency Samaritans of Singapore (SOS), volunteers recently gave out black plasters - the second year it is doing so - to get people to talk about their feelings.
Although there is no foolproof way of preventing suicides, the first step is get suicidal teens to talk about their feelings, experts said.
COMBINATION OF FACTORS
Very often, suicide is due to the intersection or combination of events which happen at the same time or in quick succession, which wears down a person's coping abilities.
MS CHRISTINE WONG, executive director of SOS.
"The common problems we observe in teens today are conflicts with parents, and peer relationship issues including bullying, exam stress and boy-girlfriend issues," said Dr Ong Say How, senior consultant and chief, Department of Child & Adolescent Psychiatry, at the Institute of Mental Health.
Parents can play a big part in helping their teens face these problems.
They can talk with their children about how the latter feel about their problems and brainstorm solutions to mitigate their situation, said Dr Ong. "No feeling is too small to talk about and it should not be dismissed or brushed aside."
Parents and family members should continue to monitor the teen.
They should watch out for emerging warning signs, address his distress or suicidal thoughts, offer emotional support and encourage him to seek professional help, he said. Warning signs include emotional or behavioural changes such as changes in eating or sleeping habits and expressions of hopelessness.
There is no definite period of time for a teen to become suicidal after facing a stressor. Mr Ong said: "In some cases, the teen might act impulsively without planning, often because he was unable to see a way out of the situation or was unable to tolerate his negative emotions."
Parents can be alert to their teenaged children's behavioural changes by being involved in their lives and maintaining communication with them, said Dr Ong.
"Parents should not dismiss or minimise the teen's experiences or feelings or pass remarks to further aggravate his sense of loss or shame," he said. "Remarks like 'just snap out of this' or 'I told you so' are counter-productive."
A person's threshold in coping with a stressor, his coping pattern and emotional resilience differ from others', said Ms Christine Wong, executive director of SOS.
"Very often, suicide is due to the intersection or combination of events which happen at the same time or in quick succession, which wears down a person's coping abilities," she said.
"There may be a precipitating or 'last straw' event. Suicide is rarely due to a single event or factor. "
Various circumstances put people at a higher risk of suicide, said Ms Lee Yi Ping, a senior youth support worker with the Community Health Assessment Team at the Institute of Mental Health.
She said family and friends can pay closer attention and give support or seek help for the affected person if they spot any of the following signs:
•An episode of depression, psychosis or anxiety.
•A personal crisis or life stressor, especially one that increases a sense of isolation or impacts on self-esteem, such as failing or doing badly in a major exam.
•Loss of social support because of relocation or when a close friend relocates.
•An illness or medication that triggers a change in mood.
•Exposure to the suicidal behaviour of others, such as peers, family, friends or celebrities.
"Young people tend to be more prone to impulsive tendencies," said Ms Wong.
Getting them to calm down when they are in a heightened emotional state can help them think better through their thoughts, feelings and actions, she said.
"Suicide prevention is more than just about the relevant professionals averting crises in an emergency situation," said Ms Wong. "It is about paying attention to those around you and it starts with all of us doing something every day, in our own little ways."
This includes asking loved ones how they are, finding out how they feel and being there for them as they work through their problems.
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