Senate Bill 2038 passed during the North Dakota 65th Legislative session and requires school districts to provide behavioral health professional development to teachers and administrators with the hopes of reversing the current trend.
Alison Traynor, Suicide Prevention Program Director at the North Dakota Department of Health, believes the new legislation is a great start, but addressing social isolation in the home, at school and in the community is vital to confronting the growing concern.
“We know that youth suicide is the second leading cause of death for young people in North Dakota,” Traynor said. “We have legislators asking us, ‘Does social media play a role? What is to blame for the rise?’ We don’t have any clear research that can definitively say this or that, but what we do know for sure is that social isolation, real or perceived, is a leading risk factor for suicide in youth.”
An annual study by the Centers for Disease Control and Prevention released June 15 outlined North Dakota youth’s growing mental health concerns, noting that the state ranks higher than the national average in youth depression and thoughts of suicide.
According to the study of youth behavior in 2017, 74 percent of all deaths among persons aged 10—18 years resulted from one of four causes: motor vehicle crashes, unintentional injuries, suicide and homicide – with suicides gaining the most momentum in the last decade.
Suicide is now the second leading cause of death in the nation for people between the ages of 15 and 19, according to the CDC. Estimates by the American Association of Suicidology show that for every completed suicide there are as many as 25 people who attempt suicide, but aren’t successful. In 2017, 2,023 North Dakota residents called the National Suicide Prevention Lifeline, requesting support for suicidal thoughts or actions.
“Rural states tend to have higher suicide rates than our non-rural neighbors. North Dakota is one of those rural states that sadly rank high,” Traynor said. “Recent studies show North Dakota has the steepest increase in suicides, a 58 percent rise since the year 2000, whereas in the 90s our rate was comparable to the national average.”
The CDC began routinely monitoring youth health behaviors and experiences in the first half of the decade in an attempt to identify contributing factors leading to the steady increase per year of deaths among students from risky behaviors. The CDC’s initiative and collaboration efforts with state education departments led to national annual surveys of youth, with an annual report detailing the areas of concern.
The annual report for 2017 found significant improvements with regard to risky sexual behavior, substance abuse and violence when compared with previous years. However, one area showed an alarming rise – both nationally and locally.
The report found that 31.5 percent of students in North Dakota experienced persistent feelings of sadness or hopelessness within the previous year, with the most significant rise found in female students.
The CDC survey found that nearly 20 percent of high school students had seriously considered attempting suicide within the previous year, with a significantly higher percentage of female students following through on attempts. The numbers reflected a 120 percent increase since 1970; spiking by 58 percent since 2000 and showing no signs of slowing.
“We need to have more suicide prevention resources made available for schools so they have the capacity to focus on this issue at the ground level,” Traynor said. “Supportive and healthy communities and families are really key.”
A tenth of high school students in North Dakota admitted to planning to commit suicide in the previous year, just shy of the national trend of 13.6 percent. Of those who contemplated and planned a suicide, seven percent followed through.
“Access to lethal means like firearms are a factor but so too is the access to information on how to complete suicide. That information has become more prevalent than ever before with the internet being so accessible,” Traynor said. “Take the time to connect with kids in their life, every day. Don’t be afraid to monitor and take a look at the materials kids are accessing online.”
Sexual minority students, those identifying as lesbian, gay or bisexual, were at greater risk of experiencing mental health issues, including attempting suicide, according to the study.
Nearly 50 percent of sexual minority students admitted to seriously considering suicide, while a quarter of those students made attempts.
“Some of the models that I saw out of Minnesota spoke to that isolation faced by sexual minority students and the component of parental relationships in suicides,” Traynor said. “A major contributing factor is whether or not a parent is supportive or hostile toward the subject.”
Sampling used by the CDC study consisted of all regular public, Catholic and other non-public schools with students in grades 9—12 across the nation. Alternative schools, special education schools, schools operated by the Department of Defense, Bureau of Indian Education schools, and vocational schools were excluded, raising concerns with many advocates who believe those segments of the population are most at risk for suicide.
Traynor was less cynical but did agree that the inclusion of those segments of the population were important for a better picture of the scope of the issue.
“From my perspective as a practitioner, I always want to embed best practices into everything I do. I’d absolutely like to see the inclusion of special education, Department of Defense, Bureau of Indian Education and vocational schools in the CDC sampling,” she said.
Under SB 2038, school districts will now provide additional resources for students who face mental health struggles, while many non-profit community service organizations are also available for parents concerned with the mental health of their children.
FirstLink provides local behavioral health services to individuals in need of assistance through a helpline at 701-235-7335. They also provide suicide support at 1-800-273-8255. The resources provided by FirstLink are free, local and available 24 hours a day, 7 days a week.
The Jason Flatt Foundation Inc. is an educational organization dedicated to the awareness and prevention of youth suicide. They provide tools and resources for students, parents and teachers/youth workers to help identify and assist at-risk youth. As an example, they provide online training modules that provide information on the awareness and prevention of youth suicide, including modules focused on identifying signs of concern, risk factors and how to approach an at-risk youth.
If you are thinking about suicide, or know someone who is, call the National Suicide Prevention Lifeline at 1-800-273-8255.