Seeds of despair

Child suicide may be rare but when it does occur its impact is
felt throughout the adult world. Frances Rickford explores the
possible causes for such a desperate measure.

Nine-year-old Oteas Tedder was found dead by her mother, hanged
in her bedroom. Jevan Richardson, aged 10, was found by his father
hanging by a nylon stocking from a shower rail. Daniel Overfield,
aged 12, hanged himself from his bunk bed by his dressing gown cord
and was found by his mother. Thirteen-year-old Kayleigh Davies
hanged herself from a cupboard in her bedroom after being sent home
from school. Amy Burgess, aged 16, threw herself from the top of a
multi-storey car park on the day her mock GCSEs were due to

When children kill themselves, it’s a big story and deeply
disturbing to adults. How could we have created a world so painful
that a child cannot bear to continue living in it? We search
frantically for simple explanations – it was exam pressure,
bullying, getting into trouble at school, or a family row.

Suicide among children is, thankfully, rare. According to
official figures, in 1999 suicide or self-inflicted injury was
mentioned in the coroner’s report in a total of 25 deaths of
children under the age of 15,1 but it is widely
acknowledged that the true rate may be much higher.

Coroners are likely to want to spare the family from the extra
pain of a suicide verdict, so opt for open verdicts, misadventure
or even accidental death. Suicide verdicts recorded for children
are double checked for validity on a monthly basis by civil

Some may interpret this caution as squeamishness. But there may
also be genuine questions over the state of mind of children who
kill themselves – and whether they fully understood what they were

In a fact sheet for parents and teachers on suicide in young
people, the Royal College of Psychiatrists says child suicide is
rare because children under the age of 14 lack the ability to plan
or carry out complex tasks on their own, and don’t understand the
permanence of death.2 “When children kill themselves it
is usually by accident, sometimes because a game has gone
tragically wrong”.

But ChildLine recently reported that it is receiving a growing
number of calls from children and young people where the main
problem recorded by the counsellor is a suicide attempt or serious
intention.3 Between 1990 and 1991 and 1998 and 1999 the
number of suicidal calls more than doubled, from 346 to 701. Most
were from young people aged 15 or 16, but there were calls from
children as young as six who had already taken an overdose or
conveyed a serious intention to kill themselves.

Suicide among teenagers over 15 is much more common, and has a
dramatic gender bias. It was registered as the underlying cause of
death for 105 young people aged between 15 and 19 in 1999 – 78 per
cent of them young men. Among men aged between 15 and 25, the
suicide rate has more than doubled over the past 30 years from
seven per 100,000 in 1971 to 16.4 in 1997, while for young women in
the same age group it has barely increased – from 3.3 to four per

Interestingly, the ratio is reversed for children calling
ChildLine about suicide. Four times as many suicidal girls as boys
have called the charity, which could indicate that it is girls’
ability to ask for help and talk through their feelings which is
saving their lives. The Royal College of Psychiatrists notes that
boys are less likely than girls to show their distress before
making a suicide attempt, and in about one in five cases a young
person who tries to kill themselves will have shown no previous
sign of distress.

Much more commonly, in three out of five suicide attempts the
young person has been showing signs of emotional or behavioural
difficulties for months before, and has not been able to find help.
Another fifth will have had serious problems for a long time and
will already be in contact with professional services. It is this
group which is most at risk of trying to kill themselves again.

As with adults, research suggests that young people who have
made previous attempts to harm or kill themselves are most likely
to do it again. Behaviour sometimes written off as
attention-seeking should be taken seriously and, according to the
Royal College of Psychiatrists, should trigger a specialist mental
health assessment.

Steve Lewis is a community psychiatric nurse, working for the
multi-disciplinary child and adolescent mental health service in
Warrington, Cheshire. He and his colleague Jeanette Makin visit and
carry out risk assessments on all under-16s admitted to local
hospitals as a result of suicide attempts or self-harm. The team
used to have a social worker, but since the last postholder left,
the job has remained unfilled.

He reports that the team has found that looked-after children
who take a big overdose are particularly likely to have a history
of self-harm which has never been picked up. Lewis also reports
that those young people who come closest to succeeding with a
suicide attempt are most likely to have serious family-related

The average age of children referred to the team for suicide
attempts is 14 to 15. The pattern of referrals reflects times of
stress for children, with peaks at the start of the school term and
exam periods. He estimates that in slightly more than half of all
cases, children have taken overdoses of Paracetamol, often using
alcohol and other medicines as well. In one recent case a boy went
to stay with a friend who was epileptic and took a large overdose
of his friend’s anticonvulsant drugs, with cider.

“At the time the child takes the overdose there is a strong
motivation to end things, but they usually regret it and seek help.
Those who don’t tell anyone, perhaps leaving a note, are the most
worrying. Most we discharge from the ward on the day with a package
of services. The paediatric ward is not the right place for these
young people, and the staff are not equipped to cope. But
in-patient resources are scarce.

“We’re more likely to involve social services in the case where
we need to look for a hospital bed because the risk is high –
perhaps one or two children in every 10.”

Media coverage of child suicide has tended to focus on bullying
as the cause, and ChildLine too has found that children calling
about bullying are more likely than others to mention suicide.

Tim Field has co-authored a book about children whose death or
suicide has been associated with bullying.4 He believes
there is a clear pattern to bullying-related suicide in

“Bullying causes psychiatric injury over time, leading to
reactive depression which can cause a person’s objectivity to
waver. Typically, the child gets bullied for a long time and
finally says something, but instead of the situation being resolved
they may find themselves in greater danger. The school goes into
denial and the parents, if they take it up, get labelled as

But Peter Wilson, director of the children’s mental health
charity Young Minds, believes the causes of suicide among children
and young people are more complex. “Some kids do live a nightmare,
but lots of children who are bullied don’t kill themselves. About
one in 20 teenagers has a significant clinical depression and in
children under 12 it’s about 2 per cent. But not all children who
are depressed try to kill themselves.

“We’re not going to eradicate suicide. But children and young
people do need well-trained people to talk to. Also a lot depends
on how well modulated parents and carers can be, staying with and
bothering about their teenage children when they become secretive,
hostile and difficult. So there should be opportunities for them to
talk through things as well.

“Suicide among younger children is a disturbing problem which we
don’t really understand much about. What it does show is that
children have extreme states of mind, and we should be providing
services which respond to that fact.”

1 Office of National Statistics,
Mortality Statistics: Cause, England and Wales 1999,
(Table 3), Stationery Office 2000.

2 Royal College of Psychiatrists, Mental
Health and Growing Up: Suicide and Attempted Suicide
, Fact
sheet 29 for parents and teachers. RCP, 1999

3 Brigid McConville, Saving Young Lives:
Calls to ChildLine About Suicide
. ChildLine 2001

4 Neil Marr and Tim Field, Bullycide:
Death at Playtime
, Success Unlimited 2001. From Success
Unlimited, PO Box 67, Didcot, Oxfordshire OX11 9YS.

Suicide indicators

Calls to ChildLine have led the organisation to put forward the
following as likely indicators for high suicide risk among young

– Talking about methods of suicide

-n Dwelling on insoluble problems

– Giving away possessions

– Hints that “I won’t be around”, or “I won’t cause you any more

– Change in eating or sleeping habits

– Withdrawal from friends, family and usual interests

– Violent or rebellious behaviour, or running away

– Drinking to excess or misusing drugs

– Feelings of boredom, restlessness, self-hatred

– Failing to take care of personal appearance

– Complaints about headaches, stomach pains, tiredness, or other
physical symptoms

– Becoming over-cheerful after a time of depression

– Unresolved feelings of guilt following the loss of an
important person or pet (including pop or sports idols)

Source: ChildLine 2001

More from Community Care

Comments are closed.