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Spike in child suicides

Psychiatrists say more children wanting to die

BY KIMONE THOMPSON Features Editor — Sunday thompsonk@jamaicaobserver.com

Sunday, April 03, 2011    

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FIFTEEN-year-old Tia Murray of Barracks Road, Savanna-la-Mar in Westmoreland, was found hanging from a mango tree in the community last week, the victim of her own hand.

She is one of two cases of suspected child suicides so far this year.

Her family has said they saw no signs that something was wrong with the girl, but mental health experts point out that suicides are usually triggered by a particular stress event in which a person feels there is no way out, rather than by a long-term feeling of depression.

President of the Jamaica Psychiatric Association Dr Yvonnie Bailey-Davidson told the Sunday Observer that since the start of the year, the number of suicidal thoughts and attempts she has seen in children, both in her private practice and on consultancy visits to public hospitals, has increased astronomically and that the ages of those involved seem to be getting younger.

The spike, which she said she noticed for the first time in her 16 years of practice, represents a 50 per cent jump in the numbers she usually sees.

Suicide is a manifestation of a range of psychiatric disorders and those who attempt it, she said, are usually depressed, are "acting out", or are psychotic.

"I've been seeing more suicidal ideation, more self-mutilation, and some of them are actually trying to kill themselves with overdose and hanging," Bailey-Davidson said.

"I haven't had so many before... I don't know what is triggering this," she confessed.

Clinical psychologist Dr Tammy Haynes has witnessed a similar increase in her practice.

"Over the last two years I have seen about a 50 -70 per cent increase in the number of children who are referred, but I've also seen an increase in the number of children under 12 during the last year," she told the Sunday Observer.

"(Those under 12) haven't got as far as thinking of killing themselves; sometimes they wish they just didn't wake up in the morning. It usually has to do with problems they are experiencing at school. Some children may be victims of bullying, or they are having social skills problems or they are not doing well in school," said Haynes, who specialises in neuropsychology.

But, as she reasons it, the figures may not represent a true increase in the number of children presenting with depressive disorders.

"(It is worrying) in a way because it's unusual to see more and more children like this. However, in another sense, it is good that their parents are recognising that something is wrong and are taking them to see a psychologist or psychiatrist. Before, parents wouldn't know exactly what was going on. If the child was suffering from depression or some sort of anxiety disorder they wouldn't know what it is and the child would get into more trouble, be punished or just be ignored.

"But when you see more children coming in, it doesn't necessarily mean there is an increase in the number of children having depressive or mood disorders, but more of an awareness among parents and teachers that something is wrong and knowing who to refer the child to, which is what I think is happening, moreso than just an increase in the numbers," Haynes said.

In the 10-and-a-half years up to June last year, 33 Jamaican children and adolescents took their own lives, an average of three per year.

That's the equivalent of three football teams or an entire classroom.

Of the 33, 26 were as a result of hanging, four were from ingesting poisons, and one each was caused by shooting, drowning and jumping.

The figures, which were provided by the statistics department of the Jamaica Constabulary Force, also show that 2001 had the highest number of reported child suicides for the period — 10.

The second highest number was five, the total for 2008. The years 2002, 2003, 2006 and 2007 each accounted for three, while 2005 had two, and there was one each for 2000, 2004, 2009 and the first six months of 2010.

Data for the period July 2010 to March 2011 were not readily available last week, but according to reports carried in the media, in addition to Tia Murray's suspected suicide, there has been at least one other case involving a child and one of attempted suicide by an adult in just the first three months of 2011.

In March, 35-year-old Constable Neil Buchanan was found on the floor of the Bluefields Police Station in Westmoreland with a gunshot wound to his head. His service pistol was found next to him.

In January, a man tried to kill the mother of his child and himself, but failed at both attempts. He reportedly shot at the woman, but missed, then shot himself. His wound wasn't fatal and he was later hospitalised under police guard.

For the same 10-and-a-half year period, from 2000 to June 2010, the total suicide figure, including both children and adults, was 555. But it's the trend among persons under age 18 that is more worrying, according to Bailey-Davidson, who ventured plausible reasons for the increase.

"Adolescents are more stressed; they are more exposed to sex matters, drug abuse, experimentation; they are bored. When you investigate, these are just minimal complaints, so you wonder (about) their coping strategies and the issue of self-control with their aggression.

"And the sad thing is we don't have an adolescent unit to admit these adolescents and do therapy with them when we have these situations. We are badly in need of an adolescent in-patient unit," the psychiatrist said.

The Ministry of Health operates 20 child guidance clinics across the island that treat children and adolescents. Where the cases are outside the scope of practice of the clinics, the young patients are referred to public hospitals or to private specialists. Children under 12 can be admitted to paediatric wards in general hospitals or to Bustamante Hospital for Children while adolescents get referred to the psychiatric ward (Ward 21) at the University Hospital of the West Indies.

"Ward 21 admits adolescents because there is nowhere else for them, but we need a place for adolescents alone, both in-patient and residential facilities," stressed Bailey-Davidson.

"Many more people are not admitted because there are no beds for them. Ward 21 is a 20-bed unit and they don't admit them (adolescents) to Bellevue. That's why we need an adolescent unit; it's knocking on our doors," she said.

Bailey-Davidson, who specialises in paediatric as well as adult psychiatry, said she has also found that the tendency towards suicide is fuelled by a struggle to answer questions about the purpose of one's existence.

"Research is showing that religious belief, having a faith where they worship and get along with other people and where there is support, both practical as well as emotional, and spiritual guidance, do well for adolescents to reduce the inkling of suicidal ideation and suicidal attempts. People need connection, they need guidance and a sense of well-being with respect to their existence on this earth," she said.

On the subject of pre-teens and suicidal thoughts, Bailey-Davidson said children under 12 didn't grasp the concepts of death and dying and suggested that in expressing thoughts to kill themselves, they are merely repeating what they have heard older folk say.

In 2008 there were three pre-teens who committed suicide.

In one case, a 12-year-old girl reportedly hanged herself in her bedroom after a fight with a sibling. In another incident, which occurred Sunday, February 10, the body of 11-year-old Natalia Morgan was found hanging by a piece of cloth from a breadfruit tree at her home in McQuarrie district, Hanover. Then, in July that same year, 12-year-old Romario Royes hanged himself when two of his pigeons escaped and he was unable to recapture them. In a cruel twist of fate, the birbs returned two days after the boy's death.

In a previous interview with the Sunday Observer, the health ministry said it was seeking to increase access to the child guidance facilities and was undertaking an "ongoing programme of training teachers and guidance counsellors to equip them with the necessary skills to identify children and adolescents with, or who are at risk for developing, mental health problems".

It said it had employed a consultant child and adolescent psychiatrist at the child guidance clinic which serves Kingston and St Andrew.

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