SAN FRANCISCO — Megyn, age 12, was a happy, well-adjusted parochial-school student until seventh grade, when she became withdrawn and depressed.
Her anxious parents learned that several classmates were bullying their daughter on social media, pushing her into a downward spiral that led to thoughts of suicide.
Now 14, Megyn (her name has been changed to protect her privacy) entered a therapeutic residential program, and she is now on the road to recovery. But the most shocking part of her story may be the fact that her struggle is not unique, and the outcome for some of her peers is far more lethal.
According to a new report released by the Centers for Disease Control, suicide rates for girls age 10 to 14 tripled between 1999 and 2014. While the actual numbers — an increase from 50 to 150 annual deaths from suicide for this demographic — are low, they reflect a disturbing trend that marks sharp increases in the nation’s suicide rate across almost every age group.
“The report from the Centers for Disease Control is very concerning,” acknowledged Dr. Aaron Kheriaty, a psychiatrist and an expert on suicide at the University of California-Irvine School of Medicine.
“A couple of years ago, the World Health Organization started noticing an increase in suicide rates in Western countries, but it was hard to tell if this represented a significant trend,” Kheriaty said. “The CDC report shows that what we are seeing is a trend, and that almost every age category had seen an increase in suicide rates, for both males and females, but with the rate of increase greater for females.”
The CDC’s data analysis charted a 24% uptick in the nation’s suicide rate over the 15-year period, with an increase of 63% for middle-aged women, ages 45 to 64. Suicide fell among Americans over age 75.
Kheriaty emphasized that researchers still do not understand all of the reasons for the recent rise in suicides, with 42,773 people ending their lives in 2014, compared with 29,199 in 1999.
He noted that typical risk factors — like a biological predisposition to major depression or underlying personality disorders, like a tendency to impulsivity — remain relatively stable within the general population.
However, suicide can also be influenced by environmental risk factors, such as early exposure to abuse and neglect and attachment problems.
Kheriaty speculated that the rise of suicide rates could also be linked to the impact of digital communications.
“Our interconnected world sends a variety of powerful messages that can shape attitudes about suicide,” he said.
Researchers have found that some “behaviors spread through social networks,” added Kheriaty. “Suicide is one of those behaviors. If I take my own life, over the next year, people who are one degree of separation away from me have a higher chance of [choosing] suicide.”
Like other specialists in suicide, Kheriaty is also concerned about the impact of social alienation.
“One really important research question is: Are there factors in our country that are leading more people to feel socially isolated, without family and friends and without other social connection or social supports?” asked Kheriaty.
Dave Ross, the division director for behavioral-health services at Catholic Charities in the Archdiocese of San Francisco, told the Register that he was saddened but not surprised by the CDC’s findings.
With almost 40 years of experience as a clinical psychologist, Ross has worked with suicidal children and adults with serious mental-health problems.
He has also witnessed the searing impact of family breakups, job loss and loneliness.
“Suicide happens when people realistically believe or perceive there is no hope and they have run out of options,” said Ross. “They have no family, their spouses died, they lose their jobs or get jailed. Then you take that same concept and [apply it] to 10-year-olds who feel despair.”
The CDC report noted a sharper rise in suicide rates for white middle-aged Americans, and as Ross sees it, this demographic has been unsettled by financial stress, but also by shifting values that challenge their deeply held beliefs.
In previous generations, parents served as role models for their children, but Millennials are much less inclined to follow this path. Ross said patients tell him, “‘I thought my kids would identify with me.’ But older people are not sought after.”
Ross is based in Silicon Valley, where the tech scene is youth-oriented, and middle-aged employees often fear they have outlived their usefulness.
Yet, in this high-expectation, high-stress region, young people also face headwinds. A spate of suicides by local high-school students has pushed the rate in Palo Alto, Calif., in Stanford University’s backyard, to five times the national average, drawing scrutiny from the CDC.
Ross has worked with local experts to establish Heard: Health Care Alliance for Response to Adolescent Depression, an initiative designed to promote collaboration between primary care, mental health and educational professionals.
Sometimes the pressure to meet parental expectations for grades and college plans becomes overwhelming or underlying mental-health problems didn’t receive attention.
In other cases, say specialists, young people can become deeply despondent during family crises.
Lovannia Dofat-Avent, senior director for children’s services at Catholic Charities for the Archdiocese of Washington, has witnessed the emotional toll of family breakups as she oversees a mobile psychiatric-services program for children and teens funded by the District of Columbia.
“On average, we get 32 calls a month related to suicide,” Dofat-Avent told the Register, with most of the calls coming from D.C. public schools.
In one case, a child “was drawing pictures about death and dying. The teacher called the social worker or behavioral-health specialist, and they called us.”
Her team met with the child and learned that his parents had separated. The father had beaten the mother, but the child still missed the father.
In such cases, she said, an intervention is designed to help the child calm down and gain perspective. Parents are contacted and may also be evaluated and provided with services.
“If the child continues to express suicidal [thoughts], we will do an evaluation, and we may have them hospitalized,” she said.
Only once has she directed an intervention after a suicide.
“A father hung himself in the tree in the front yard, and the police asked us to work with the children, who were traumatized,” said Dofat-Avent.
Tragically, this kind of family crisis has become more common, and Charles Murray, an influential sociologist and author, believes the rising suicide rate is a symptom of a broader collapse of social cohesion, especially in once-stable white working-class communities.
In his bestselling book, Coming Apart: The State of White America, 1960-2010 (2013; Crown Forum), Murray charted the decline of marriage, steady work and church attendance in white working-class neighborhoods.
Social isolation, resulting in a reduction in “social capital,” has thus made it harder for troubled individuals to get help, Murray told the Register.
“More and more people are reaching late adulthood and they just don’t see any point in life. They look at themselves and have no reason for self-esteem,” said Murray, who noted a parallel increase in drug overdoses and alcohol problems.
As social bonds fray, therapists say it has become even more important to take time to listen when a colleague or acquaintance appears despondent.
“If somebody is depressed, someone needs to listen,” said Ross. “We can all identify with feelings of depression, but you need to listen without commenting on your own stuff or offering solutions too quickly.”
The tendency to immediately introduce a solution, he said, “reflects the fact that the person who is listening is deeply afraid: ‘Oh my God — Bob is suicidal.”
“You can say, ‘I am sorry you are feeling this way. What can I do for you?’ Then offer to check back in. ‘I am off on Friday; let’s take time for lunch,’” Ross said.
Pastors should also be prepared to listen and offer effective guidance when a parishioner is struggling with depression or dealing with the suicide of a loved one.
The Role of Pastors
Suicide prevention and support groups linked to Catholic Charities affiliates describe the pastor as the de facto “gatekeeper” for mental-health services and say it is imperative that priests, deacons and other parish staff receive adequate training.
Father Charles Rubey, the founder and director of Loss (Loving Outreach to Survivors of Suicide), a network of nondenominational support groups that began in the Archdiocese of Chicago, told the Register that pastors should begin by offering solace, not harsh moral judgments, when anguished family members seek consolation after a loved one commits suicide.
The Catechism of the Catholic Church states that suicide is “contrary to love for the living God.” But it also states that “[g]rave psychological disturbances ... can diminish the responsibility of the one committing suicide” and says the faithful “should not despair of the eternal salvation of persons who have taken their own lives” (2282).
It is the pastor who can offer a grieving family the healing message of God’s love and mercy. And while some specialists emphasize the practical assistance church membership can provide, Dr. Kheriaty also believes that religious teachings offer hope and spiritual wisdom in times of desolation.
“When we deal with suicide,” he said, “we are also dealing with a spiritual and existential crisis.”
Joan Frawley Desmond is the Register’s senior editor.