Violence in childhood increases the risk of youth suicidal behavior

There are conversations that save lives. I know this because, in addition to being a suicidal behavior researcher, I collaborate as a psychologist and counselor at the Catalonia Suicide Prevention Hotline.

On one of the most harrowing and difficult calls I remember from last year, there was a young man on the other end with a trembling voice. He had gone up to the roof of his apartment and told me that he didn’t want to live anymore, that he felt very tired, that he really didn’t know how he had gotten there. I don’t know how much time passed, probably more than an hour. There were long silences on that call. But the important thing is that, at the end of the conversation, her voice had changed, she was more serene. And he was very grateful to have been heard.

From the moment we take a call on the suicide prevention hotline, we have a clear priority: to hold the call as long as possible. It is important to carry out an evaluation of the situation in which the person is experiencing and try to guide them towards a change of perspective, ensuring that the person does not hang up until we are sure that they are not going to take their own life.

In this sense, the renowned psychiatrist Carmen Tejedor demonstrated that the time that elapses between when a person thinks of killing himself and the moment in which he acts, an average of 90 minutes pass. If the person exceeds this time, enough ambivalence and doubts are generated for them to rule out the suicidal act (for now). Therefore, those 90 minutes are vital. Hence, there is no time limit on the telephone before a call of these characteristics.

A suicide every 40 seconds

Each year, approximately one million people die by suicide in the world, which is approximately one death every 40 seconds.

However, the relevance of suicide as a global health problem is more clearly appreciated if the epidemiological data of the different age groups are analyzed separately. In this way, suicide worldwide is among the three leading causes of death in the age group between 15 and 44 years, becoming the second cause of death between 10 and 24 years of age.

Moreover, if suicide attempts were also taken into account, the incidence figures would be even higher (between 10 and 20 times for each suicide).

Given these figures, it is understood that youth suicide has been recognized worldwide as a serious social and health problem, both due to the high number of cases and the impact it causes on those affected, their families and society in general.

Looking for the causes

Only the “tip of the iceberg” of suicidal behavior reaches the health system. The rest remain hidden, which suggests that we are facing a clear underestimation of this phenomenon.

Given its severity, many researchers have attempted to explore factors related to suicidal behavior. In a landmark meta-analysis that included 37 studies, they found that those who had experienced four or more adverse childhood events (including child maltreatment and sexual abuse) had up to a seven times greater risk of developing social, mental and physical problems (including suicide), compared to those who had not experienced any adverse events in their childhood.

Shutterstock / Yupa Watchanakit

Interpersonal violence and suicidal behavior

Interpersonal violence is a serious public and social health problem that causes significant discomfort in children and young people, also generating high economic and social costs. This is recognized by the World Health Organization.

In this regard, a prominent study showed that people who have been victims of any type of interpersonal violence during childhood or adolescence have up to twice the risk of making suicide attempts when they are young or young adults. And this risk almost quadruples when the abuse has been sexual.

Other research suggests that some specific characteristics of sexual abuse increase the risk of suicidal behavior. Specifically, cases of sexual abuse involving contact and penetration. But also cases of intrafamily sexual abuse, in which the boy or girl is assaulted by someone they trust, their caregiver or an attachment figure. It is believed that this can shake the basic sense of trust that children have in themselves and in the world, discouraging them from seeking help and favoring the development of emotional or psychological problems that can lead to suicidal behavior

Existing literature has also highlighted the role of bullying in youth suicidal behavior. Peer victimization has recently become an issue of public concern due to alarming media reports of youth death by suicide. In this regard, various studies indicate that victims of this form of violence tend to report greater loneliness, greater school absenteeism, greater suicidal ideation, low self-esteem and higher levels of depression than their non-victim peers.

However, and although experiences of victimization are considered factors that precipitate the development of suicidal behavior, not all young people who have been victims manifest this behavior. This difference can be attributed to other personal or contextual factors, such as social support or a positive relationship with the family, which can play a protective role and help overcome adverse situations, a concept commonly known as resilience.

In view of these data, children and young people who have suffered interpersonal violence should be especially considered in suicide prevention programs, where specialized professionals can play a fundamental role in the identification and accompaniment of victims.

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