Impulsive Suicide: A Cautionary Tale

Impulsive suicides are seldom accompanied by the classic warning signs. The act is sudden, unrehearsed, and common among young people who are naturally impulsive to begin with.
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The June 7, 2010, cover story of New York Magazine ("The Leap") told the story of my nephew Teddy Graubard's suicide at the Dalton School in NYC last February, 2009 ("A Suicide at Dalton"). It is a complex story that covers many different aspects of this tragedy -- a tragedy that is reportedly repeated 10 times a day among high school students. For me and my family, one of the best outcomes of the New York Magazine story would be if it could serve as a call to action. A call for parents, teenagers, schools and other institutions responsible for the health, safety, education and well-being of vulnerable and often impulsive adolescents to review and formalize their policies and practices now, both with respect to prevention and also regarding proper crisis management, in the event a tragedy does occur.

A blog post published yesterday, June 6 on NYC Private Schools titled "Death in NYC Private School Revisited" discusses the New York Magazine article and provides a call to action, suggesting some useful guidelines, in the form of check lists, to help high schools and other institutions do just that. I want to share an excerpt from this article. The suggestions are well thought out and important, and I feel strongly that they are worthy of wider dissemination.

In discussing impulsivity, the author points out New York Magazine writer Jesse Green's discussion of impulsive suicide, citing Scott Anderson's "The Urge to End it All" from the New York Times.

As Anderson pointed out, impulsive suicides are seldom accompanied by the classic warning signs, such as prior attempts, diagnosed mental illness, or drug or alcohol abuse. The act is sudden, unrehearsed, and is thus especially common among young people who are naturally impulsive to begin with. Among 153 young survivors of nearly fatal suicide attempts interviewed in a 2001 University of Houston study, "70 percent set the interval between deciding to kill themselves and acting at less than an hour," Anderson reported, "including an astonishing 24 percent who pegged the interval at less than five minutes."

"Given the alarming statistics on suicide in general, and these risks involving impulsivity, we recommend that schools and districts continue to craft and develop their prevention and crisis policies. We also recommend that parents learn how to talk about and deal with this topic with their children, particularly if their children have been exposed to any media coverage on this topic.

From a prevention perspective:

* How do schools communicate difficult and challenging information?
* Who and how will this information be communicated to students and parents?
* Is there a uniform or flexible policy?
* If a child has done "something wrong," who communicates the information and how is the information communicated?
* Is a developmental, child-centered perspective used?
* Does it take into account the sensitivity of the child?
* Does the school environment matter (e.g., high performing students in competitive schools, whose grades will be affected)?
* Does the student's family environment matter? (e.g., will there be "severe" consequences for the child at home?)
* Does the school take into account the child's level of impulsivity?
* What is the staff training on mental health? Are social/emotional topics incorporated in curricula?

From a crisis perspective after a suicide:

* "Who is/are the best person(s) to to deliver the news? How many people?
* At what point, and how, are parents included?
* How are medical treatments, law enforcement, supervision of students handled?
* Depending on the size of the school, does a mental health team have to be hired?
* If and how is it talked about in assemblies, school programs, classrooms, etc.?
* Should students be banned from congregating? Why is that important or not important to policy?
* What happens if there are siblings in the school?
* What needs to be documented from a legal and law enforcement perspective?
* Who will and won't speak with the media? Does the school have a general policy on how families and student's interact with the media?
* How are social media policies handled (e.g., memorial page on Facebook)? Does the school have a general social media policy?
* How are these overall policies different or similar to peer schools?
* How does the school view the grieving process?
* How will anniversaries and memorials be handled?

The last paragraph of the NYC Private Schools article is especially noteworthy: "For schools that have not crafted and developed a prevention and crisis policy, we hope that you will start. If the national statistics are correct (for additional data, see: The TeenScreen National Center at Columbia University), the time is now to begin the discussion."

Taking actions as suggested here will not help Teddy, but I hope with all my heart it will benefit many other precious teens and young adults. If these check lists make sense to you, can you please share them with your school boards and administrators?

There is a famous Talmudic saying about saving one life being the equivalent of saving the whole world. Let's get started today.

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