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Teen suicide is an often preventable tragedy. It is an appropriate focus of research and inquiry. Two new studies focused on the issue raise both important clinical and policy questions.
In the September 2007 issue of the American Journal of Psychiatry, researchers looked at children and teen suicide rates in the United States and the Netherlands, two countries which have put major warnings on the medications to treat depression, with a resulting substantial drop in medication prescriptions for children and teens. They observed a large increase in suicide in children and teens following controversy about advisory warnings—one that correlates to the drop in prescriptions for antidepressants. Suicide has many dimensions, and medication treatment is an important one. This study is an opportunity to begin to put key pieces together relating regulatory demands, warnings and the tragedy that is suicide.
One possibility is that the FDA "black box warning" on the use of antidepressants with children and adolescents has reduced access to a useful (but risky on rare occasions) treatment—with bad outcomes as a result. It will take more study and time to fully assess how central this element of the rate increase is. NAMI will support and follow that research.
NAMI favors fully informed consent about the risks and benefits of all treatments and the often overlooked risk of no treatment of all—along with careful monitoring of individuals who have suicidal concerns and a comprehensive treatment plan that looks at all aspects of a child’s or teenager’s life in order to maximize their chances of a safe recovery from depression or other psychiatric illnesses.
Also this week, the Center for Disease Control released a report documenting that the rate of suicide in teenage girls is increasing. Again, this could have many causes but it will be important to follow in terms of whether it is a clear and persistent trend or an anomaly.
Programs like Columbia University's Teen Screen have been shown to be safe and are an important way to reach out to at-risk children and teens. With parental consent, NAMI endorses the program.
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