Detecting and Preventing Suicide among Teenagers

Melissa Ridenour

According to both the American Academy of Child and Adolescent Psychiatry and the Center for Disease Control, suicide is the third leading cause of death for youth ages 15 to 24. Teen suicide affects everyone. Family and friends feel a guilty sense that if they had only done something different, the suicide could have been prevented. Therefore, it’s important to understand its causes, how to detect potential suicidal vulnerability, and how to help prevent it.

Causes of Teen Suicide
As teens grow up, they often feel stress, self-doubt, confusion, social and interaction problems with friends, peer pressure, concerns about succeeding, and pressure to meet parental expectations. Some teens suffer from clinical depression as well. Most teenagers experience such feelings to a certain degree at some point in their growing years. Those who are overwhelmed with such feelings and are unable to deal with them are more at risk for suicide.

There are several causes for teenagers to potentially want to take their own lives. Anxiety or depression left untreated can be a contributing factor. Feelings of hopelessness, helplessness, and worthlessness can cause teenagers to contemplate ending their lives. Other contributing factors are lack of success in school, bullying at school, violence at home, divorce, death of a loved one, rejection by peers, and the suicide of a friend.

According to the Center for Disease Control, such pressures of life make it too difficult for some teens to cope. As a result, sometimes overwhelmed teens welcome suicide as an escape from the pressure and pain.

Detecting Teen Depression and Potentially Suicidal Teens
According the American Academy of Child and Adolescent Psychiatry, parents should be on the lookout for specific signs in their children that could be indicators for a potential suicide risk. Such indicators include withdrawal from family and friends, as well as a lack of interest in activities the teens formerly enjoyed. Parents should look for any change in eating and sleeping habits or in hygiene and personal appearance.

In addition, parents should watch for personality changes and rebellious or violent behavior. Difficulty concentrating, decline in the quality of school work, and persistent boredom and malaise are possible signs as well. Persistent complaints of stomach aches, headaches and fatigue could be symptoms of emotional problems that can be signs of potential suicidal tendencies.

Equally important signs to watch for include statements from teens that they are bad and that they feel terrible inside. Other verbal hints include such statements as, “I won’t be a problem for you much longer. It’s no use. Nothing matters anyway.” Such statements from teens are clear indicators that they may be at least contemplating suicide.

If teenagers start giving away cherished possessions or throwing away favorite belongings, a way of getting their affairs in order, parents should consider such behavior an indicator of the risk for suicide. In addition, parents should watch for any signs of hallucinations or bizarre or strange thoughts.

Teen Suicide Prevention
According to the American Academy of Child and Adolescent Psychiatry, if teens threaten to commit suicide, parents should take the threat seriously and immediately seek professional help from a qualified mental health professional. Parents should not hesitate to ask their teens if they have suicidal thoughts. Such a question will not put the idea into children’s heads, but will, instead, assure teens that someone cares and open up an opportunity for discussion about it.

Parents should determine if their teens are suffering from depression and, if so, get medical treatment for the depression. Counseling is a good preventive strategy for depressed or potentially suicidal teens as well. Counseling can provide teens with coping strategies for dealing with their life problems. Frequently, once teens learn how to cope with problems, their suicidal desires dissipate.

It is essential for parents to treat their teens with understanding, compassion and respect. Parents should demonstrate unconditional love, offer emotional support, and make their teens feel important, loved and wanted. Parents should demonstrate to their teens that overcoming their problems and life challenges is possible and that they will help them with such challenges.

Resources
Related information can be found in the articles, “Coping with a Bully: How to Stop Bullying” and “Strategies for Dealing with a Bully Dilemma”. The article, “Dealing with Grief” provides related information about dealing with the death of a loved one.

Death's Angels

Meet the Women Who Clean Up Dead People
by Allie Holly-Gottlieb

A COUPLE OF weeks ago, a man possibly impersonating a Mormon stabbed a woman repeatedly when she opened her front door. She didn't die right away, and she tried to escape. But the man dragged her back up the steps and shot her. She bled all over the ground and inside the house and died. The end.
Actually, that wasn't the end. Someone had to clean up the murderer's mess. Meet Theresa Borst, 39, and Stacy Haney, 33. They clean up gore for a living. And they're really happy about it. "We keep people from being traumatized twice," they say in unison, as if they repeat that explanation daily.

Borst used to be a house cleaner. She's married with three kids. Haney was laid off from her 11-year job as a Boeing engineer. She's also married and has two kids. They both have big, red hair, live in rural Snohomish County, and seem nothing like mobster handyman Harvey Keitel in Pulp Fiction--the man who orchestrated a cleanup after John Travolta shot some guy in a car.

carlotta10: Women Seeking Men These women are cheerful and fun to be around. They're best friends who keep track of each other's menstrual cycles. They keep secrets from their husbands. (Like the time they were at a Belltown restaurant after a job, and asked the waiter for a good place to go dancing in Seattle. He sent them to Capitol Hill's Neighbours without telling them it was a gay bar.) Borst makes hair appointments for Haney, and locks up their shotguns and pistols so Haney's young kids can't get at them.

The women met each other in 1994 when they were volunteers with Snohomish County Search and Rescue, where they helped find people who were lost in the mountains. During a search-and-rescue class about crime scenes, they asked the teacher, "Who cleans up after a crime?" He told them the families did, since there were no professional trauma-scene cleanup services around there at the time. So, with about $25,000 from an inheritance, Borst and Haney opened Bio Clean LLC, a bio-recovery company based in Marysville, 25 miles north of Seattle. Mostly at the behest of home, apartment, and business owners, the company cleans up after violent crimes, suicides, drug lab busts, and bad cases of diarrhea.

To do this, Borst and Haney became trained to handle biological waste, and were certified with the state health department to clean up methamphetamine labs. They bought all sorts of crazy ozone machines, powerful deodorants, and sheet-rock- destroying tools. They bought a company van, put their Bio Clean name on it, and filled it with bio-tubs for transporting blood and body parts to the medical waste facility. They hired four employees to help them work so they could be on call 24 hours a day all over Washington. After work, they smell like pickled, rotten chicken. (One time the smell was so bad on their street clothes after a job that they changed outside in the garage and ran into the house naked at 3:00 a.m.)

Bio Clean's first job was a suicide in Edmonds. Borst and Haney walked in with respirators, dust masks, latex gloves, chemicals, cleaning machines, and their Tyveks (a one-piece suit with a hood and booties, which protects against toxic chemicals and hazardous biological materials). They were nervous. "We took a deep breath and walked in and just went for it, cutting apart a [bloody] couch."

That mess turned out to be relatively small. It only took a couple of hours to clean. However, Bio Clean's assignments can take days or weeks to complete. For instance, try cleaning up a 45-day-old decomposed body that dripped through the floor, or getting rid of a maggot infestation. During the busy summer months, Borst and Haney frequently work 18-hour shifts, clocking in three jobs per day.

There are roughly 200 companies like Bio Clean across the country, according to Ron Gospodarski, president of the Washington, D.C.-based nonprofit advocacy group American Bio-Recovery Association (ABRA). But most of them come and go quickly, because the need for them hasn't been well defined. To legitimize the industry, ABRA is pushing for national legislation which would mandate that only properly trained and licensed companies can clean up crime scenes and other hazardous waste sites. California passed such a law in 1998.

Washington state doesn't require certified companies to clean up death sites. Health department certification is only required for drug lab cleanups. Employees need blood-borne pathogen training before cleaning up a death at work, but they don't necessarily get it. Individuals can legally clean up after dead family members or friends. There are fewer than 10 bio-recovery companies in Washington, according to Borst.

Bio Clean is well known by police officers throughout the state. However, those detectives refuse to talk with The Stranger about Bio Clean. "We just don't think it's appropriate for us to be talking about the crime scenes in any way that discusses the nature of the crime, especially violent crime," says Seattle Police Department spokesperson Sean O'Donnell. "We're talking about body pieces, and blood, and the whole bit. It's really a personal issue."

In fact, after receiving a phone call from The Stranger, King County police officers lectured Haney and Borst for talking to the media about crime-scene cleanups, Haney says. They shouldn't "exploit the families," the cops told them.

Unlike the cops, Borst and Haney seem eager to discuss the taboo topic of death, as well as their own disgusting memories. Two weeks ago, while calmly sipping glasses of white wine in a log-cabin-style bar off I-5 in Marysville, they talked about handling blood and guts and traumatized families. They've found eyeballs and teeth and mustaches. Borst recalls picking up someone's entire face once. She thought it was a mask. It wasn't. Some guy had shot his face off. When she noticed the blood dripping down her arm, she screamed.

The hardest things to clean out, they say, are the maggots. "When they totally invade a home, that's the hardest to get rid of," says Haney. "When you're standing outside the front door, you can actually hear them from outside. They're crunching. That's when you know it's going to be really bad."

Maggots are gross, but vomit is the one thing that makes Borst and Haney sick. "We do a lot of police cars, where people vomited, and it's alcohol and vomit and whatever they ate, and it's sat overnight, sometimes two or three days," Haney explains. "You've got to clean it up, and it's just really, really difficult. Just the texture, through your gloves."

The one thing Borst and Haney are reluctant to reveal is what the job pays. Borst gives a broad fee range of $500 to $20,000. The average "contained" suicide, staged on a bed for example, costs about $1,100 or $1,200. They also don't like to share specifics, like which chemicals--various kinds of phenols and other disinfectants--work best on blood or urine.

Borst and Haney have become confident, even boastful about their work. Property managers sometimes call them in when another bio-recovery company botches a job, Haney says. Bio Clean backs up Haney's bragging with an impressive portfolio, featuring gory "before" shots and sparkling "after" shots.

They even seem eerily jazzed about cleaning up blood and guts. From their perspective, it's just a job. They happily share some of the incidental facts they've learned: maggots help medical examiners determine how long someone's been dead; it takes about two weeks for a corpse to liquefy and drip through the floor; the chemical that cops use to track footprints is carcinogenic.

"It's such a feel-good job," says Borst, who has had the occasional nightmare about a man trapped in a bio-tub in the company van. "I mean, people need us; we help them." Families of dead people think of the pair as heroes, according to Borst, and sometimes send Christmas cards for a year or two after using Bio Clean.

An insight into crime scenes clean up services

Crime scene cleanup companies also clean unattended deaths, damaged environments due to tear gas, and other crime and distress scenes. The larger crime scenes that involve mass murder scenes, terrorist attacks and anthrax and other biochemical damage is also taken care by these companies. Crime Scene Cleanup services may also include bird and rodent infested areas. The cleaners in this case require special experience and equipment than a typical cleaning company’s experience and equipment.

Typically, crime scene cleanups start taking place only after the coroner’s office and other government bodies releases the “scene” back to the owner or some other responsible person concerned with it. The cleaning task can not begin till the police investigation is completely finished on the contaminated scene.

In most cases crime scene cleanup is a small business activity. Mostly, small cleaning services like carpet cleaning or water damage companies add services for Crime Scene Cleanup for diversifying their activities. The prominent and recognized organizations in this field of cleaning consist of the Institute of Inspection, Cleaning, and Restoration Certification (IICRC) and the American Bio-recovery Association (ABRA).

Earlier crime scene cleanup was a loathsome job but today it has become a lucrative business. Crime scene cleanup companies can charge anywhere between $100 to $600 per hour depending on the “level of trauma” and the quantity of hazardous material that the cleaners have to deal with and dispose of.

While a crime clean up service is ultimately a business like any other, advertising and marketing your services can be tricky. In a job that involves tragic death; most companies avoid mainstream methods of advertisement. Some choose the standard phone-book route while many others advertise on the side of their vans. Most of these companies largely depend on discreet options like passing out their business cards at service-industry gatherings, police stations and funeral homes.

An important requirement for success in this industry involves being considerate towards the sensitive nature of the work. There are certain crime scene clean-up companies that provide a grief counselor to the families at no cost while others offer discount to needy people. There are many countries where this type of service is funded by government or by religious organizations.

While some people call this emerging field a social trend of commercializing death, others call it plain capitalism. But for many others it still remains an essential service, a godsend. The fact is that whether you like it or loathe it but if you ever end up with blood and brains splashed all over your bedroom walls, you will definitely be relieved that there is someone you can call to clean it up.

American Bio Recovery Association, bio-recovery corporation, blood cleanup, crime scene cleanup, death scene cleanup, suicide, trauma scene cleanup

By Nancy Shute

Suicide is the third leading cause of death among teenagers, and it's a tragedy that can be prevented. Given that almost 15 percent of high school students say they've seriously considered suicide in the past year, parents and friends need to know how to recognize when a teenager is in trouble and how to help.

Parents can be clueless when it comes to recognizing suicide risk factors, or at least more clueless than teens. In a new survey of teenagers and parents in Chicago and in the Kansas City, Kan., area, which appears online in Pediatrics, both parents and teenagers said that teen suicide was a problem, but not in their community. Alas, teen suicide is a universal problem; no area is immune.

The teenagers correctly said that drug and alcohol use was a big risk factor for suicide, with some even noting that drinking and drug use could be a form of self-medication or self-harm. By contrast, many of the parents shrugged off substance abuse as acceptable adolescent behavior. As one parent told the researchers: "Some parents smoke pot with their kids or allow their kids to drink."

Both teenagers and parents said that guns should be kept away from a suicidal teen. But since parents said they didn't think they could determine when a teenager was suicidal, parents should routinely lock up firearms, the researchers suggest. That makes sense. Firearms are used in 43.1 percent of teen suicides, according to 2006 data, while suffocation or hanging accounts for 44.9 percent.

The good news: Both parents and teenagers in this small survey (66 teenagers and 30 parents) said they'd like more help learning how to know when someone is at risk of committing suicide and what to do. Schools and pediatricians should be able to help, but we can all become better educated through reliable resources on the Web. These authoritative sites list typical signs of suicide risk, and they also provide questions a parent or a friend can ask a teenager to find out if he is considering killing himself. Here are good places to start:

The American Academy of Child and Adolescent Psychiatry lists signs and symptoms of suicidal thinking, such as saying things like "I won't be a problem for you much longer."

The American Academy of Pediatrics urges parents to ask the child directly about suicide. "Getting the word out in the open may help your teenager think someone has heard his cries for help."

The National Suicide Prevention Lifeline provides free advice to someone considering suicide, as well as to friends and relatives, at 800-273-TALK.

The National Alliance on Mental Illness's teenage suicide page makes the point that talking with someone about suicide will not "give them the idea." "Bringing up the question of suicide and discussing it without showing shock or disapproval is one of the most helpful things you can do," the NAMI site says. "This openness shows that you are taking the individual seriously and responding to the severity of his or her distress."

Teen depression and suicide risk linked to late bedtimes and chronic sleep deprivation

A report from the Jan. 1, 2010 issue of the journal Sleep found a surprising link between the typically late bedtimes of teenagers and teen depression and suicide.

Parent-set bedtimes affect teen's mental state

Adolescents with parent-set bedtimes after midnight had a 24% increased incidence of depression and a 20% increase in suicidal thoughts compared to teens with a bedtime before 10 pm.

Most of the teens in the study reported adhering to the bedtimes their parents set for them, showing that it's up to parents to give appropriate guidelines for avoiding sleep deprivation.

Length of Sleep Matters for Adolescents

The length of sleep matters, too, according to the researchers. Teenagers who reported getting less than five hours of sleep a night had a 71% higher risk of depression and a 48% higher risk of suicidal thoughts than adolescents who got 8 hours or more of sleep.

The AASM (The American Academy of Sleep Medicine) recommends nine or more hours of sleep a night for adolescents.

The study was conducted by James E. Gangwisch, PhD, assistant professor at Columbia University Medical Center in New York, N.Y and colleagues and looked at over 15,000 teenagers' sleep habits and mental states. The teens in the study ranged from 12-17 years old.

Other studies indicate more benefits from increased teen sleep.

In previous studies, shorter sleep durations in children and teens have been linked to higher rates of obesity, school performance and general social well-being. And adolescents who don't get enough sleep due to insomnia are far more likely to develop mental health problems, including substance abuse.

Crime Scene Leftovers Pose Problem For Sanitation

Call it the Case of the Bloody Mattress.

City sanitation workers in southwestern Kentucky were recently left with the problem of how to dispose of a bloody mattress put out with the trash.

The mattress came from a home where police say a 37-year-old man appears to have died from self-inflicted stab wounds. The problem came when trash collectors realized they couldn't pick up a potential biohazard, but didn't want to leave it by the side of the road in a residential neighborhood in Hopkinsville.

"This was an area of concern for us because blood is considered a biohazard and not only can our trash trucks not pick it up, but it could be dangerous for people in the community," said George Hampton, a route supervisor for Hopkinsville Solid Waste Authority.

The Kentucky New Era reports that the mattress disappeared by midweek, but sanitation officials didn't take it and were still trying to make sure it was properly disposed of. The location of the mattress remained a mystery at week's end.

Hopkinsville sanitation workers received an anonymous call reporting a mattress, possibly covered in blood, that had been set on a curb outside of a home. That was the concern of the anonymous caller, Hampton said, who said children in the neighborhood could start to play on the mattress and come into contact with the dried blood that might have diseases.

Because there was blood on the mattress, sanitation workers couldn't haul it off with the rest of the trash.

"It raises a question for us about where we take it from here," Hampton said. "Someone has to clean up messes like these and we can't do it."

Solid Waste Superintendent Bill Bailey said sanitation workers aren't allowed to pick up possible biohazards, including blood, from the side of the road. Instead, Bailey said, the department needs to call other landfills to see who will pick up and take the items.

"Sometimes we can process and wrap it in plastic and dispose of it that way. But other times we have to contact a company that deals with disposing of medical waste."

Charlotte Write, a spokeswoman for Stericycle, a national company that specializes in medical waste disposal, said medical waste is generally burned to kill pathogens that can live in dried blood.

"It is important to dispose of all medical waste, especially waste that comes from the body, so as not to spread diseases," Write said.

Hopkinsville Police Chief Guy Howie said the families must clean up the scene of a murder or suicide or pay to have it done.

"It doesn't sound very friendly, I know, but that's just how it has to be handled," Howie said. "Someone has to clean it up and someone has to dispose of all of this, it's just a matter of figuring out who. It's amazing that just one mattress on a curb can raise so many questions."

Someone solved sanitation's problem by taking the mattress from in front of the home. Bailey said sanitation workers didn't remove it, but finding out what became of the mattress is important. It had to be properly sterilized and disposed of.

"We can't just stick it in our landfill and be done with it," Bailey said. "Whether it's on that curb or not, it's still hazardous material."

This Won't Help Pack the Pews

A man thought to be on PCP broke though a window at Rainier Beach's Unity Church of God in Christ Saturday. Because this was not a movie, the glass cut him in various places, and he left a trail of blood as he went on an "unholy rampage" KOMO's Joel Moreno says. Church volunteers were starting to clean up the blood when they were told the man was HIV-positive and had hepatitis C, which made the scene a biohazard. A parishioner speculated the incident was related to the man's brother's suicide in 1980--he hanged himself from a plum tree on the church's grounds.

NOTE: This is the best reason why, untrained people should never cleaner a scene where blood or bodily fluids are present. Contact a trained company