Suicide is at an epidemic rate in the United States. According to the CDC it is the third leading cause of death for children between the ages of 10 to 18 years old. Using a gun in the third most common method of suicide in the United States. For boys it is the most common way to attempt suicide (CDC). For many people this may not be surprising. However, it is time that we seriously try to prevent children from attempting suicide and eliminate this epidemic.
The problem with eliminating this epidemic is the access to mental health care and the stigma society places on mental health care. As a psychotherapist who treats suicidal teenagers, I have run into numerous difficulties with insurance companies when I have a suicidal teenager or child. Many insurance companies will only allow the child to be seen once a week. If the child is acutely suicidal, they usually need to be seen twice a week. Many parents can barely afford their copayments and cannot pay for an additional session on their own. This places a great deal of stress on the parents and places the child in danger.
Some people will say the teen should then be hospitalized. This is not an easy answer either. There are not many pediatric or adolescent inpatient psychiatric units in our area. I have had numerous situations where a child or teen may spend over 48 hours in an emergency room because there are no inpatient beds at any of the psychiatric units. In fact, one Thanksgiving I had a mother page me and I had never seen her son before. He was suicidal, but the hospital said they had no beds and gave her my number to call and told her she had to leave the hospital.
If a teenager is hospitalized, often they are only allowed to stay 72 hours and then discharged home. They have to be discharged because the insurance will not authorize more time. It doesn’t matter what the psychiatrist on the inpatient unit recommends. The insurance makes their own decision based on the treatment guidelines. Again this places the child in danger and creates a great deal of stress on the family. Often parents give up and accept the insurance companies decisions. It is too much dealing with a child who wants to die and getting the run around by your health insurance that you have been paying high premiums to for years. Additionally, many times the child or teen is discharged back into my care but I am never notified by the insurance company or hospital and the insurance company does not want my opinion, but they discharge the teen to me for psychotherapy treatment and to monitor.
In addition to the access to mental health care there is the negative stigma associated with it. Many parents wait a few weeks before bringing their teenager to be assessed for suicidal thoughts. They do not wait because they are bad parents, they wait due to the shame. If there child is diagnosed as depressed they are afraid about how people will react to their child and them. In fact, if a child is out of school due to being hospitalized for being suicidal, we instruct the school administrators to tell the staff the teen was out due to appendicitis or a death in the family. They are afraid if teachers or students find out the teen was suicidal that people will think the teen is crazy and not want to associate with the teenager. This may sound bizarre, but it’s true. Most patients schedule their psychotherapy appointments at times when no one will notice they are gone and try to come into the office without anyone seeing them. Our society has a very strong negative stigma about mental health. Many people with mental health issues have difficulty making friends, finding jobs or just being treated as a normal person, if others know they have mental health issues. This stigma is causing many people not to seek help. As a result, many teens due commit suicide because they kept their feelings a secret. They did not want to be labeled a “freak.” However, this stigma is ruining the lives of many children and teenagers and destroying numerous families.
Mental health care is no different from physical health care. No one is ashamed of being diabetic so why should a teen have to be ashamed of having depression? We must demand that insurance companies treat physical and mental health care the same. Additionally, our society needs to treat them the same and not be afraid of someone who is depressed or embarrassed if you are diagnosed with depression.
Finally, the last issue I want to address is the method many teenagers use. Many teenage boys use guns because they believe no one can stop them and it is guaranteed to work. However, this is a myth. Guns have a strong kick to them when fired and often move slightly. Many teenage boys try to commit suicide with a gun and instead of committing suicide, they shot their face off. Instead of dying they end up in ICU in worse condition having to undergo numerous surgeries and being scared for life. This is one reason why we need sane gun laws. We have laws about how old you have to be to drive or smoke. We also have laws mandating that we must where seat belts. We have these laws because research has shown they make us safer. These laws have not restricted our freedom so sane gun laws will not restrain our freedom.
The ABC News show 20/20 did a story about a young man who was depressed and finally attempted suicide with a gun. It goes into all the difficulties he faced when the gun moved. He was fortunate because he was eligible for one of the first face transplants. However, this story shows the destruction that occurs when they use a gun as their method of suicide and it fails. Please watch and see what this young man and his family must undergo. While watching the after effects of this failed suicide attempt, think about how senseless it is the millions of teens and families undergo this situation when it could have been prevented if they were not ashamed and had easy access to mental health care. Please watch this show, 26-year-old’s incredible face transplant journey: ‘I see me’ – ABC News – https://abcn.ws/2OLXuL5 via @ABC.
Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. He is an expert at treating suicidal children and teenagers. For more information about his work or private practice or if there is an issue you would like him to address visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.