One in Ten
Engaging the brightest minds working to solve one of the world's toughest challenges—child abuse. Join us for conversations with leading experts on science, law, medicine, morality, and messaging. One in Ten is brought to you by National Children's Alliance, the largest network of care centers in the U.S. serving child victims of abuse. Our host is Teresa Huizar, NCA's CEO and a national expert on child abuse intervention and trauma treatment. Visit us online at nationalchildrensalliance.org.
One in Ten
Teen Suicide in an Online World
In this episode of 'One in Ten,' hosted by Teresa Huizar, Dr. Sheryl Chatfield from Kent State University discusses the alarming rise in youth suicides and its correlation with technology use. Delving into data from the National Violent Death Reporting System, Dr. Chatfield highlights the significant impact of technology, including social media and gaming, on youth mental health. They explore the triggers leading to suicidal thoughts, focusing on restrictions on technology use as precipitating factors. Dr. Chatfield also discusses the demographic trends in youth suicide and suggests prevention strategies, emphasizing the importance of diverse leisure activities and open communication between parents and their children. The episode concludes with practical advice for both professionals and parents on how to support youth effectively.
Time Stamps:
00:00 Introduction and Episode Overview
01:22 Guest Introduction: Dr. Cheryl Chatfield
01:27 Research Origins: Technology and Youth Suicide
03:42 Trends in Youth Suicide
05:21 The Role of Technology in Suicidal Behavior
07:17 Understanding Suicidal Ideation in Youth
15:56 Age-Related Differences in Suicide Motivations
20:18 Impact of Mental Health Crisis on Youth
25:07 Conflicts and Restrictions Leading to Suicidal Behavior
26:48 Grieving the Loss of a Chatbot
27:35 Addiction and Withdrawal Symptoms
28:36 Social Media and Gaming Stress
29:48 Fear of Missing Out
31:05 Identity and Online Presence
32:13 Technology Use and Mental Health
36:44 Demographics of Youth Suicide
40:43 Prevention Strategies
46:52 Encouraging Diverse Activities
51:14 Concluding Thoughts
Resources:
Did you like this episode? Please leave us a review on Apple Podcasts.
Teresa Huizar: Hi, I'm Teresa Huizar, your host of One in Ten. In today's episode, Teen Suicide in an Online World, I speak with Dr. Sheryl Chatfield, associate professor at Kent State University. Now, when we think about youth suicide in the context of child sexual abuse, we often think about the crisis point of the disclosure itself, this moment in time when a child has suffered so much that they're thinking of suicide as a way of stopping the suffering, but also they're hoping against hope that an adult will listen and help.
We know as child abuse professionals, that we should be screening for suicidality in those critical moments, but have we given enough thought to the ways in which online environments can both amplify the circumstances in which suicidality arises and also serve as a vehicle for cries for help. How should parents and professionals intervene?
And most importantly, how do we support teens in ways that prevent suicidal thinking in the first place? I know you'll find this conversation as thought provoking as I did. Please take a listen.
Hi Sheryl. Welcome to One in Ten.
Sheryl Chatfield: Well, thank you Teresa. It's great to be here.
TH: How did you first become interested in the intersection between technology and youth suicide?
SC: Yeah, that's a great question. And not surprisingly, I've put some thought into that because I sort of expected some question about, you know, where did this even come from? And it wasn't a direct, it wasn't like I woke up some morning and said, oh, I wonder what's going on with technology and the internet and young people.
I had actually had an opportunity to do some research using the National Violent Death Reporting System data, which is the data that our most recent work is based on. I had a little funding opportunity from the American Public Health Association and I was doing research on older adults and I was doing research on death by suicide among older adults.
And this sort of indirectly led one of the students I was working with to ask about using similar data or data from the same data set to look at youth and adolescent suicide. So we requested the data. And she was most interested at the time in arguments and conflicts proceeding suicide. So we sort of split up the cases, the narratives and read them.
And independently each of us started to see this trend was technology. The first thing that we started to notice, and this was data from a few years ago, were instances where technology was restricted, a punishment from a parent. Parent took away a device and very shortly after, a death by suicide of a young person followed.
This was also consistent with my former student's interest in the conflicts and arguments because often there was a conflict and argument. So we started to see this trend. It was a prevalent enough trend that as we wrote this paper up on a small number of cases. We discussed this at length and that's what motivated us to take a look at a bigger sample or actually all the data that we could get to see, you know, how often was this happening and how, and what was going on in all the different ways, the something to do with technology, whether it was hardware or software, what was going on in the instances when we could identify something in a case narrative prior to a death by suicide of a young person.
TH: So, you know, you're talking to an audience of child abuse professionals mostly who deal with child sexual abuse, and we know from literature that about 12% of the kids who come into Children's Advocacy Centers and are interviewed about possible child sexual abuse have suicidal thoughts or feelings at that time from the assessments that are done there.
We know that, so this is a topic that while it might initially seem a little odd about, like why are you here to talk about this on the, actually, this is something that we give a lot of thought to in terms of our crisis response, and so it was a reason that we wanted to talk to you about that today.
However, some people are more conversant with the literature around suicide and teen suicide in general. Much more so than others. So I wanna just kind of do a little bit of level setting here and say, what do we know over, say the last 20 years about youth suicide in general? You know, how common is it?
Just generally, what do we know about it?
SC: It's historically not been, I mean, going way back, it wasn't very common at all, and it is still not the biggest segment of death by suicide that still is residing in the older adult population. Although in recent years, the rates for young adults are starting to creep upward, and in some age bands is starting to get closer to the older adult rate.
But the real profound change in youth death by suicide around 2007 and then maybe between 2010 and the later part of the tens and the rate went up substantially during those time periods. And you know, that's led some other researchers to really key in on the technology because of the increased ownership of smartphones and access to and use of the internet for all kinds of things.
But basically sometime in the early to mid-aughts, the rates for youth started to creep up and have continued to increase most years with the exception of 2020 and maybe a little 2021 because the rate for death by suicide overall went down during the peak of the pandemic. And I think that's because people were very busy with a lot of other things. There were a lot of other things going on for people. There was a lot of distractions, but it is, again, creeping up in youth and adolescents, unfortunately, in some of the data that you can find, some of the records that you can find from the Centers for Disease Control, you can find ages 10 to 14 and then you find like 15 to 21, and we've been keying in on the under 18.
You know, the people who are generally defined as not yet adults, and it's not always easy to break that out for the people that are 21, but although in some instances people are still reserving similar services as they were when they were youth, when they're up to age 21. So there is a good reason to capture that information, but then also it can lead to a circumstances change.
But yeah, in summary, something that didn't used to be very common at all, say in the middle to late 20th century has become increasingly, I wouldn't say common, but increasingly noticeable in an age of people where this was not typically the main concern. It's the second leading cause of death among youth and adolescents at this point, and has been for several years.
TH: I remember that from your paper. Yes, that's correct. And I certainly knew it wasn't uncommon, but I have to say the second leading cause of death for young people, I think that did surprise me honestly, as to its commonality. And then you also talked in the lit review a little bit about, you know, there's completed suicides, which still are blessedly, if not rare, certainly not highly common either even as the second leading cause of death. But there's also this, you know, and I would say our audience is probably more familiar with this. Kids having suicidal thoughts and ideation, kids coming up with a plan, an actual plan, and those numbers are higher. And I think that that also is just something where I think we can be misled by thinking that, you know, if there's not a suicide attempt, that there must not be any concern for suicide.
But in reading your lit review, it became clear to me that suicidal ideation is actually quite common in youth.
SC: And you know, there's challenge there in the sense that it's become a common for young people to make comments about suicide. And in some other research where we did some group interviews with young people, you know, they commented themselves on the difficulty of knowing when their peers were serious or when their peers were just being, you know, overly dramatic or just.
Saying I could kill myself. The same as they might say, oh, I could kill my parents. And not really thinking about the intent behind the words, and it's just something that people say, but in several instances because we read all the detailed narratives of these, you know, two, 3000 cases. And I've read in this and other research, I've read many, probably the majority of case narratives that are available for youth death by suicide.
So I spent a lot of time reviewing these because we read both the ones that have a role of technology and then we read the other ones as well. Because we're separating these out and it's not uncommon to see the parents or guardians say they had no idea that a young person was considering suicide and then their friends to say, Oh, you know, this person mentioned it on social media regularly and had a strategy and or had some kind of a contingency plan or something like that. So the fact that people are sort of thinking through it in a maybe fantasy sense, it's difficult to tell when that fantasy sense maybe shifts into an actual plan.
And I think it is far more common than people realize that these discussions take place. But there remains the challenge of knowing. When is the discussion serious, and when is the discussion more speculative or more sort of being ironic or humorous, or even just being thoughtless or if the discussion takes place over time?
Or if intent is expressed over time? At what point is it serious? If somebody says 20 times, I feel like I should just end it all, and then at the 21st time, you know, they take a dramatic action. It's very difficult for people around, loved ones, friends, peers, to recognize and to be able to tell the difference between a real legitimate aim and intent from, you know, maybe just expressions of frustration or even sort of posturing to impress your peers.
TH: I mean, I think what's not new and what you're saying is that. 'cause I'm just even thinking back about my own teenage years, I don't think it's uncommon at all that there are all kinds of things, including this, that parents don't know that is readily known among peers and that peers are talking about suicidal thinking, even with a frequency that the parents have no idea about.
I can think of friends of mine from high school where that was true. So I think that that's not the new part. It feels to me like part of the new part is that if you don't have yourself a good suicidal plan, and I'm using that kind of in quotes, you know, obviously I don't think any plan to commit suicide is good, but if you're struggling to think of a way to do it, guess what?
AI will be your helper really quick. To help you come up with one. And it's that fast forwards that I think in a different way from suicidal talk in the past where one might have heard some of that and struggled to know whether it was like something serious or not serious. I think that it's on a faster jet way to something serious.
Maybe now just because you're not gonna have to spend a whole long time thinking how you get ahold of something or do something, which I think probably was the case in the past. Unless you had ready access to a weapon or pills, you were gonna have to do some real thinking to figure out how to actually enact a plan.
To that point, I just wanted to mention for the listeners that, to your point, in terms of commonality, I think it was the CDC data that you were quoting, that it was one in five basically had suicidal thoughts. 16% had created a plan and nearly one in 10, it was like one in nine I think had actually had a suicide attempt.
So these are not small numbers. I think that was 2023 data maybe. Those are not small numbers. Like this is something that I think just completely aside from child abuse, we should be thinking as adults about and how we, you know, better support kids so that you don't have these kinds of appalling numbers.
'cause kids are feeling clearly fragile and unsupported if you are looking at essentially, you know, one in 10 kids having attempted it and 20% of all kids have thought about attempting it. That's just a lot.
SC: Yeah, and also bearing in mind that we were working in a pre-AI or a pre widespread use of AI context with most of the data that we had, but there was no shortage of resources on the internet.
That's to provide directions. There are how to make a noose videos. There are places where you can buy medications in bulk and in some instances that's, that's, you know, that's what was done there. There also were some ironic instances where a young person who died by suicide when their internet history was scanned, they showed both that they were looking for suicide help resources and for resources on how to die by suicide.
So clearly conflicted about, you know, about what to do. But you know, going back to sort of my own youth, which is further back than yours. I don't think that it was as common to consider that death by suicide was something a child did. It was never depicted in media or popular media. It was always some disgraced older person.
Or, or it was a relationship kind of a thing, a dramatic thing, but to think about a 8-year-old or a 10-year-old and some of the improvised methods that children use. Yeah, I don't think that, at least for myself, and I don't think for my peers, that things like that even went through our head because we didn't have the kind of 24/7 unregulated content access that young people have now. So they're getting ideas and then they're moving on with those ideas and they're sharing the ideas because there is a plethora of information out there. You know, AI, there's some suggestion that it may be making things worse. Depending on, you know, which version of which thing you're using and what kind of prompts that you're giving it.
But people were doing a pretty good job using the internet to find information even before the widespread availability of the AI models.
TH: It's so interesting that you say that, and I completely agree with that. When I was a CAC director, gosh, that'd be almost 20 years ago now, but we had a, I don't remember if she was nine or 10.
But she came in and she could very clearly talk about what her suicide plan was, and it was one that could have been executed and that she planned to execute. And I think when you think about these very young children, I think that's the part that people don't often think about is like they're used to it being older teens that they need to keep an eye on and think about.
But this is someone who had been sexually abused for a long period of time and just didn't see an escape from that aside from suicide, and I think it was at the time to us almost 20 years ago. So shocking and horrifying to think about some very young person having to think about that as the only escape from the situation that they were in.
And fortunately she disclosed her abuse and we were able to interrupt that. But it's just one of those things where I think we all need to take this as a subject more seriously. And speaking of younger versus older. I think another thing which I appreciated you laying out in the paper was that people's motivations differ and in part by age.
And so can you talk a little bit about kind of what is the difference between, and we realize every person is different, so we're just kind of saying overall at the population level, but between younger children and older, I guess you would say, teens, youth, what are the different reasons each might come to a point where they're considering suicide?
SC: Yeah. To me, simply the older children are the more it starts to look like adult suicide. And that means relationships, you know, and of course it's more common in males than females, basically at every age. So relationships is a very big, I wouldn't say predictor, but it's a constant. It's often there.
And you know, also the mode, and we didn't count the mode in this paper, but the firearm use goes up with with age because there tends to be more access and you find more improvised means like some sort of hanging in younger children because they don't always have the access. Younger children, sometimes there are issues that maybe we wouldn't even take that seriously. As I mentioned before, the child didn't do their homework. If, for instance, dad turns the Wi-Fi off because the child shouldn't be on the internet or takes the phone away, while it's not definitive that that's what caused the incident, that's what happened immediately proceeding the incident.
Child was not allowed to continue gaming, couldn't stay up all night and game, or you know, just the sort of behavioral kinds of things. But then you also have, I'd say, relational issues with younger children, but they're more peer-to-peer kind of things. We didn't see a large number of bullying issues, but we did see some conflict issues.
Another thing with older children, like high school aged children is some kind of a major disappointment. Didn't get into a college, got in trouble and was, you know, thrown off a sports team or something. The things that they feel like in some cases are building the framework for the rest of their life.
There's some sort of an interruption there. And I think that relationship issues in older children are the same thing. They sometimes think that this is the one, this is the person, and then there's a conflict or breakup. And more often, I think in older children than younger children, some role of substance use.
So someone is, you know, drinking heavily and then probably, maybe not in their right mind, although we did see substance use through all ages, including antidepressants and other prescription substances. But that just in general, I would go back to saying that older children look more like adult death by suicide, a major disappointment, a relationship issue, something that they think is really gonna impact the way they feel and the way they feel for the long term. And then younger children, it's often just a sort of a quick conflict, a quick disappointment. I can't get on the internet because I didn't do my homework and I'm frustrated at my parents, so this is what I'm gonna do. And you know, I'm not a psychologist psychiatrist, I'm public health behavioral researcher, but I don't think that young children are really capable of thinking through the whole span of life. This is just a very impulsive, instant kind of decision and in many cases if you can interrupt it, about to happen and then sort of sleep on it or think about it, that you can probably prevent or at least delay, but hopefully prevent something from happening.
TH: But it's a good point that there's this impulsivity piece with very young children, and I think the interesting thing about teens is that while it may not be as impulsive, it's still sort of rooted in this sort of catastrophizing, because of course, when you're that age, you don't have the benefit of years of life to reflect that. Okay. This Romeo and Juliet situation is not the end if you break up with this person or whatever, just because you're so young. So to you, it feels very genuinely catastrophic, even though you know, I think as you age you find out that that's not the case. I'm wondering too, what role you think it plays, the kind of just sort of general mental health crisis for youth that we're in. You know, the Surgeon General issued a report on this sort of coming out of COVID, the fact that so many young people really experienced that in a way that isolated them from peers.
And so while the suicide rates may not have gone up during that period, it also makes you wonder if there was a lag in that just based on the social isolation they had. They weren't in school, they couldn't see their friends as often, like all of that sort of thing. So do you have a sense it might not be in, you know, it's not in the data you have because that was pre-COVID, but I'm just curious about what you think about this sort of general atmosphere of not great mental health. Yeah, and not great mental health care for kids.
SC: Yeah, and you know, I mentioned interrupting and I think COVID served as an interruption for many people.
They were either with their parents or their family all the time, or they had enough other challenges as you're suggesting. I don't think that mental health substantially increased because of or following the pandemic. I think it just was a major interruption that sort of derailed a lot of people and they were occupied with other thoughts.
Now I teach undergraduates and upper graduate students in a university and mental health among young adults is, there's a lot of discussion about it and it's also in my students. My students are very interested. They're very aware. Their perception is that mental health is a real struggle. Their perception is that there aren't adequate resources in a university setting for everyone who needs the kind of help that they need at the time that they need it.
Their perception is that a lot of their peers are suffering, and I had a chance about a week ago to talk to some of my students in the context of doing an activity where people were doing some sharing. And you know, it's the same kinds of pressures that that people have long had about worrying about what other people think about them, about worrying, about fitting in, about worrying about the future, about worrying about will they be successful enough to satisfy their needs and other people's needs. I think because of the fact that I come from a pre-internet youth and then have, you know, seen the evolution of it, I think that the major thing that has changed as far as mental health and perceptions of mental health is when people are plugged into devices all the time.
There isn't much escape. They're not really getting the clearheaded thought and immersion in other activities that allow them to escape both their own personal stressors, so other people talking to them or talking about them, but also they're perceiving global stressors. They're perceiving big picture stressors that have to do with economies and governments and conflicts and all kinds of things like that.
But years ago, a young child probably could have made a choice whether or not to sit in front of a news program on a television. And more times than not, they probably would've chosen not to sit in front of a news program on a television, but now even in the social media, you know, they're hearing about local and global issues and the concerns that they have about their own self-worth, their own relationships.
And so I feel like the constant being plugged in has just exacerbated some of the stressors that were already there and has made them seem more permanent and continual than perhaps they were. And that's part of the reason why it's like to be a worsening mental health is it's just there aren’t any breaks from it for people.
TH: But, you know, one of the things I was thinking about as you were talking is it's not just that you don't get a break from external individuals or events or that sort of thing on social media or online in general. It's also that if you are prone to ruminate about things, you know, people often treat social media like Dear Diary, and you can sort of endlessly ruminate and people will like that and comment on that and reinforce that behavior.
You know what I mean? Just over and over. Because right, you're gonna get all this sympathy, you're gonna get all so. It's also that cycle isn't being interrupted. Where in person, you know, a parent or somebody else might notice that somebody's ruminating and be like, you need to go outside and play.
Or you know, you need to be with your friends, or let's go for a walk, or, I mean, whatever it's going to be, let's play a video game. There's not much opportunity for that interruption of that either. I think if you're spending a lot of your life online and on social media in one form or another.
SC: Right. I agree.
TH: I wanna talk a little bit about something you've brought up several times, which I thought was one of the most interesting aspects of the study, and that has to do with the sort of conflict that's sort of preceding many of these suicides and that a lot of it was about the restriction of access to either devices, social media, video games, whatever it was like, right?
Maybe there had been this unhealthy relationship with those things and the parent had been concerned for a while. They restrict that out of concern. So doing this sort of thing that a parent would ordinarily do, right? Like, I'm very concerned about what's happening here. We're gonna put that phone away for however long.
And again, we're not saying that it caused it or blaming anybody, we're just saying, then there's a suicide of that person. And what made me think about that, and I wanna hear more about this in relationship to the study, but I also wanna talk about something that was in the New York Times very recently, which was a story about a young man who had been communicating with an AI chatbot.
And he thought this person was both a friend and sort of a partner of his over time, and he eventually committed suicide. And I can't remember if it was the day before or if two days elapsed. It wasn't very long, but his mother removed and, well, his parents, not just his mother, they removed access to this chat bot.
Like they, I don't know if they took his phone, I don't remember. Or what they did. But they did something. Probably had to have taken his phone to cut off that contact. After the suicide, the mom in the article is quoted as. basically, not thankfully blaming herself, but she said a very interesting thing, which is what she realized is he was grieving it like a death.
The loss of this chatbot, like that relationship had become so important to him that losing it felt like a catastrophic loss to him. I think that's very, very terrifying, but also very interesting in terms of just her own insight based on what you're saying. I mean, what you were saying, what she is saying are essentially in alignment.
So what did you find in your study about this? Because I think unfortunately, we're probably gonna see more of this.
SC: Yeah. Right. And the incident of the physically taking away the device was probably the first kind of incident that made me think, Hey, there's something going on here that sort of looks like addiction.
It sort of looks like tolerance and withdrawal. It's sort of looks like a drug addiction or alcohol addiction, or you know, addiction to whatever, gambling addiction or whatever. Where a person, you know, you're combining a young age immaturity, impulsive behavior. A group of people that don't as often exhibit, you know, substance use addiction because of access and things like that.
It's much less common in eight- or nine-year-olds than with older adults and a general sort of lack of ability to maybe see the future, to maybe have patience because those things have sort of been trained outta people with a lot of the way that online. I guess just online, everything works.
It's very instant. And so you get an emotional response in that case, you know? And then there were a couple of things that we saw in our data, and one of my co-authors had mentioned that they felt like what was going on in some instances is young people losing access to a device. They know their friends are still engaging their peers.
Group is engaging on social media, but they're no longer able to contribute to the narrative. So people are talking about them, they can't defend themselves or they can't offer their perspective on things. So that can be very stressful for people because, you know, young people can be stressed if somebody doesn't like their post, if somebody doesn't acknowledge that they've done something.
That can be a stressful thing. Well, to think that your girlfriends or your boyfriends or your. You know, your many friends are talking about you and you aren't able to participate in that can be really frustrating for people. So we see that where it's a social media thing where that's what's the problem.
And then we also had seen it where it was a gaming thing where that was the thing that was being lost, although, in many cases, I think the chat that goes along with the game or other interaction may be almost as important as the game itself. So that may be more of a social, social relational kind of a thing.
But yeah, that fear of missing out seems to be a big trigger of getting emotionally upset when you lose the device. It's also like your leisure activity. It's got everything. And you know, that's what we've bought is phones or tablets that have everything, for some young people, they don't have a room full of other tech devices.
They don't have board games or anything like that. They may or may not, but maybe less common. So they've lost the thing that is both critically important to them, whether it's a chatbot friend or a game, or it's being part of the narrative. But they've also lost all the other distractions when the parents take away the phone or cut off the Wi-Fi.
And they don't always have some kind of a substitute that's attractive to them. I mean, you could say, now go outside and play. And some young people would just look at you and you know, play what they're like, what's that? So, because it's a lot of activities, you know, integrate like a technology aptitude.
It's not just, I'm going outside, but I'll go outside and then I'll take some pictures of the things I've seen and I'll post them to my Instagram and you know, so it's like at every turn. I think that when you take a device away, sometimes every alternative someone has is a coping mechanism, feels like it's gone.
TH: There's also a piece of it that I think ties to identity, like people's online identity is not necessarily the same as their offline identity for one thing. So they feel like they've lost this almost curated sense of themselves. It was out in the world getting accolades and reinforcement and all of these things.
And depending on how they are online, like if they have an avatar, other kinds of things, like they might in a video game that's just a whole other. That's a whole other loss. I mean, what it feels like to me is a kind of a common thread in some of these things is there's a lot of different ways one might experience a loss.
That leads up to a suicide in some way. But there's this underlying thread that there's a loss of something, a loss of recognition, a loss of identity, a loss of friendly contact, a loss of distractions, a loss of alternative things to whatever it is. But this thread of loss is, I think, something for us to think about when we're thinking about how to interrupt this, but in a way that doesn't create another hole, essentially.
SC: Right. That was one of the things that the research group had discussed, you know, as we were going through these is we're not trying to give people a message that you can't do anything about your child's technology use, or you should be afraid that's going to lead to self-harm, but you know, there isn't necessarily an easy quick fix to this.
I mean, there's it, it requires probably a lot of thought. And I've tried to follow the people like John Haight who have written about this and about wise use of technology from the time that children are very small. You know, unfortunately a lot of things just got thrown out at people. And the evolution was so fast, and I think we're seeing some of that with AI.
They didn't have time to stop and reflect about what are the wise uses and what are the possible perils and what are the potential pitfalls. And so now in a lot of cases, both in families and in schools, and even in some government instances, there's a lot of talk about how to cut things off, how to, you know, put up a wall.
And I don't think there's any wall that some kid can't figure out a way to jump over or crawl under. So the strategies have got to be much more sophisticated than just take a device away. But I also wouldn't suggest that, oh, don't take a device away because your child will die by suicide. Because you know, most children don't die by suicide.
So I think the key there is for the parents or whoever's considering this to have a better idea of what's going on and why there's problematic use and why it would be a problem to restrict the use and have a better understanding of, I guess, the dependency or the depicted relationship and figure out some kind of a compromise.
I mean, because it's never healthy to be 24/7 glued to your phone or glued to anything. You know, any kind of, of a single, like a mono leisure kind of approach is not gonna be a healthy thing. It gets into an obsessive thing. So it's about sort of, I guess, moderation is finding the moderation and finding the healthy relationship.
I'm personally skeptical of friendships with AI, but that's me. I mean, for me, the internet was a wonderful thing when it became widely available because of the access to resources that I didn't have as a graduate student, I didn't have to walk down to the library and try to hunt a bound journal and hope that someone hadn't razor bladed out the article that I wanted.
You know, I could just get online. So I'm not a Tech person. No, but I am a wise use of tech person and let's have a lot of like a good repertoire of leisure activities and coping mechanisms that aren't all just dependent on a box. Because you know, as we've seen in some of these weather-related catastrophes, sometimes there's no connectivity.
People forget that when it hasn't happened to them. I lived in Mississippi during Katrina and that was the early days of the internet. But it was bad enough that cell phone service was dramatically interrupted back in 2005. And people seem to think, and that this includes young people, it may not be your parents taking it away.
TH: It could be an actual disaster. It could be all kinds of things that would interrupt that, and so how do you cope? I think that the other thing is that when a situation seems out of hand, that's really the time I think to reach out to a professional about it. You know, if you're that worried as a parent about what you're seeing in terms of changes in behavior on the part of your kiddo or their overuse of technology or whatever, maybe that's the time to talk with a counselor or school counselor, someone about that, because it doesn't have to also be all or nothing.
I mean, I think part of what kids experience in part of what you know, parents may have an impulse to do is. Oh, they sort of like realize suddenly that there's a danger here and then completely cut off whatever access, right. Or whatever. And then this is what gets viewed as a huge catastrophe that's not survivable.
And it's like, well, okay, but isn't there a middle position that isn't, you're cut off to infinity. And also you cannot have unlimited access and talk to your chat bot 24 hours a day. Like it feels like there's some room for more conversation, but I wanted to ask you a little bit about the demographics because you know, in your study, again, and I have to say this, this surprised me that about 31% of cases of these youth suicide involved technology, which we've been talking about, I mean.
I would've guessed maybe a little less than that, but now the more we talk, I'm like, oh yeah, I give it 10 years and it's probably gonna be even a bigger percentage than that sadly. But talk a little bit about the other aspects of demographics in terms of age. You were talking about gender earlier, that it seems to be more males than females.
Just what do we know about who in general, among teens, you know, tragically is taking their life in this way?
SC: Right. Yeah. And especially, you know, more noticeable as you get into the older age, but it's white males who die by suicide at a great rate, and I believe that holds true through all ages, that it is white males who die by suicide when a race and ethnicity rate.
Since in a proportion rate, American Indian or Alaska native have a disturbingly high rate for the small proportion of the population in the US that rate is high again, through all age groups. So that's one segment of the population, you know, that there's maybe not comprehensive understanding of what's going on there, but it's easy to not really key in on something when the number is low, but the proportionate rate is very high.
So there's some complex issues that make that pretty alarming, and it goes up with age. There have been some years, I think when we've had suppressed data from the CDC with the very young ages. Eight was about the youngest age that I've ever seen in any data, although I believe in some newer data there might be some children younger than that, but it's very, very small number. But it climbs, you know, with age. And again, that sort of goes to that idea that it starts to look more like adult death by suicide because you have more sophisticated relationship kinds of issues going on with older children.
But yeah, it's one of the, I guess odd issues that we see in public health where white males seem to have the biggest problem or exhibit this on a more frequent level. And when you start to look at other instances of self-harm, attempts, and plans and things like that, then you start to see a more diverse group of people.
But when it comes to actual completed suicide, it's, you know, usually around half of the total is white males, and then everything else is divided from there.
TH: What's interesting to me about that, I mean, I'm not surprised it's males in that they tend to choose the more lethal methodology. Right?
Choosing a firearm means is more likely to be completed versus swallowing pills or something like that. So that's probably part of that. But it also makes me wonder in terms of the amount of time spent online, they also are more likely to be subjected to sextortion. So we had guests on here talking about, again, that triggering suicides or suicidal planning or whatever.
Thankfully some parents have been able to intervene and so I just wonder to what extent, this sort of a horrible cocktail of both being more likely to use a lethal means and also having exposure to more targeted online exploitation that's likely intended to humiliate them. You talked about disappointment as a reason, but I would say humiliation is one of the ones that sort of crop up around sextortion.
Right? And tragically that seems to be an area in which it's growing. So I just worry about what this means for, you know, for male teens. I guess this is kind of a good segue into prevention. I wanna talk for a minute. You know, you've had such a deep dive into this data and what it means and our better knowledge, and I always feel like better knowledge about how and why something is occurring helps us hopefully prevent it to a greater extent.
What do you take away from your own, not just this particular study, but your own knowledge of youth suicide as what first of all professionals should be thinking about in the way that we talk to both kids and families on these topics, but also, you know, how to really talk to parents about this in a way that doesn't terrify them, but makes them feel like they're better equipped to address this?
SC: I mean, there's sort of. Maybe it's oversimplification, but there's sort of three big categories I see here, and that's one is the very young children and they are different. The sudden rash, impulsive behavior with some kind of improvised mean. We did see a number of people who had a long history of mental health care, including inpatient psychiatric care, including medications, and those may be the most difficult instances because people are intervening.
They are intervening, and you don't know what the, there may have been attempts. You don't know what all the triggers are. There are issues with people going off medications because they don't, you know, they don't like the feeling of the medication. So there's a really complicated way, you know, sort of prevention strategy when somebody's already in treatment.
I don't know that I have good answers for that. And then the third group would be these older, mostly males. And you mentioned humiliation, and we did see, I think just one sextortion case, but that's not even always known when that's going on. But in these relationship issues, there's a component of humiliation.
Sometimes a boy is ashamed because the girl has broken up with him. He's ashamed because the girl has decided she prefers another boy. You know, so there's some issues going on there. And I had some opportunities to interview some college age young men a couple of years ago talking about counseling and counseling resources.
And you know, the thing that keeps sort of coming up is this image of, and people sometimes blame their parents or sometimes they blame a sort of a family, you know, heritage, but men don't have mental illness, men have to be strong. Men have to tough it out. Men shouldn't need this kind of help. Men should be able to deal with things.
And while that sounds very 20th century to me, or even middle 20th century to me that I heard that two years ago from young men. So that whole, take it like a man and you know, we don't get counseling in our family. We, you know, we're able to, that's for people who can't handle their problems. That, that kind of a stereotypical approach to that, you know.
And the suggestions I got from the young people I interviewed were, you know, create some messaging that encourages men to seek treatment that communicates that it's not a sign of weakness, that some people thought that everyone could benefit from mental health counseling. So if everyone can benefit from mental health counseling, then it isn't an issue of what kind of a person you are.
It's an issue of you're a person. To me, that kind of messaging could be helpful for the, especially the older teens as far as the younger children go, and prevention, you know, and this, again, I'm getting into that, you know, don't not feel like you can't take corrective measures with your children because you're afraid that something will happen.
And I think that ideally, and this may be no help for some people, but having the conversations about the technology use from the time you first introduced the technology to children, and I do tend to agree with some delay and giving them the totality of the internet until children have at least a little bit more maturity and have also had a chance to develop some other interests.
So that they have a more, I guess, diverse leisure repertoire that doesn't just depend on, you know, the thing in the box, but there are other things that they can do so that it's maybe not so much of a focus when it finally does become something that children use. And I do think that for parents and guardians and other people who are interacting with children, to have open, honest conversations.
And to be honest, it's about their own use. This is a sort of an issue that we, that we butted against now and then people don't always want to hear that, that we think technology is a problem because a lot of people have a technology problem, not just children, but I think that everyone has to be willing to sort of face, you know, where their level of dependency is and think about it.
And it's hard for a parent who's constantly using devices to tell their children that they should never use devices, because that's where children learn their behaviors is from their parents. So, but yeah, those are, those are just some thoughts I have about that. But I think that especially, you know, with the children who are in care, I see that as maybe the biggest, the most challenging group of people if they're already getting treatment and for some reason it's not being effective.
You know, that's just a real struggle to figure out, you know, how to keep them from taking a fatal step in some cases. And, you know, and you mentioned sexual abuse, and this is often going on with children who are in, in residential care or in long-term care is they're having there's a lot of family issues going on. And I mean, some of these cases is, it's difficult to read. Most of the people I work with are parents. I'm not a parent, but most the people I work with are parents and we all have to take breaks now and then because, 'cause you know, the tragedy of some of these instances is just crushing sometimes.
TH: What gave me hope about what you said though, and I had not thought about it as a prevention strategy, but I definitely think it is now that you said it has to do with really cultivating in children and frankly in adults too. More than one social outlet. More than one interest. More than one hobby, more than one way to make friends and spend their time.
I just think that, you know, as you were saying that, I was thinking about a friend I was talking to when she was talking about all those things that her kids were involved in, how exhausting it was, but also now talking to you, I'm thinking and how relieving. Because they're not just dependent on some online environment for their friendships, for their reinforcement, for whatever they have, all of these other things as well.
So let me just sort of ask you the final question I ask everyone, which is, is there anything else I should have asked you and didn't, or anything else that you wanted to make sure talked about today?
SC: Wow. That's a good question. It seems like we talked about just about everything, but I will return a little to the fact that you mentioned the multiple activity thing.
You know, I'm going back to maybe the nineties. I feel like that was a time period when a lot of people were happy to park their kid in front of a video game. What they used to call the latchkey kids. Kid comes home from school and there was a lot of fear about they aren't gonna be safe by themselves or they aren't gonna be safe with their kids, with their friends, you know?
So we want them in the house playing the game. And that was maybe when we started going down in some ways, the wrong road with that. 'cause I had seen some children that I thought were video game addicted even before the internet was as common as it is now. And I'm actually, my first graduate degree is in recreational therapy, so I'm actually a certified therapeutic recreation specialist.
So one of the things that I have training in is use of recreation and leisure activities for illness, injury, and disability. So I'm constantly sort of thinking about those things, but it doesn't have to be programmed stuff. It doesn't have to be, they're in this class and this class and this class, you know, but it may be for kids who have had a lot of technology, it needs to be more than just go outside.
There needs to be some activity and some kind of things. And it may be as simple as, Hey, let's go build a little obstacle course outside that you can practice on or you know, and the internet is surely AI. Surely full of some activities, some ideas for activities. Plus there are even books out there that people can consult and so I think that, you know, with some creativity getting away from the, not that programmed activity is all bad, but I see young people get distraught over sports and band. Or things like that. The pressure and the time and sometimes they just wanna have fun. So I think keeping a creative approach to diversionary activities. And there's no reason that parents can't. And other relatives, other friends can't also be involved in these things, you know, so you can have some fun playtime as a family.
I mean, and going back to my childhood, I remember massive neighborhood tag games, where the parents were all outside. Everybody was outside, so it was a safe environment, but running across multiple people's backyards. In the heat of the summer with the lightning bugs and nobody cared who was it and nobody cared who got tagged.
And I don't think we can quite turn the clock back, but we can think about recreating some of the kind of environment where there's a little more option for just free play and free expression, whether it's indoor things, whether it's, here's a piece of paper and some pencils versus a coloring book or it's outside here, let's build a course for the dogs to jump over or you know, whatever kind of thing.
Then I think people will find the time goes by and they may even, they don't care about the fact that they missed some social media or some other kind of a tech activity 'cause they had a good time.
TH: Well, I just love this and I think it's, we've been talking about such a dark, difficult subject and I'm glad that we're able to end it on such a practical note about what adults can do in a positive way to keep kids safe and protected and interested and creative and all the things that we want for them.
So, well, Sheryl, you come back and talk to us anytime as you publish future research. I think this is a critically important topic, and I just so appreciate you sharing your knowledge with us.
SC: Oh, well, I can't thank you enough for reaching out to ask me to talk about this because, I mean, I won't say it's not like enjoyable, but I, but I really do like to talk about this and share the information that I have been able to learn through the years through this work.
TH: Thank you again.
Thanks for listening to One in Ten. If you liked this episode, please share it with a friend or colleague. For more information about this episode or any of our others, please visit our podcast website at oneintenpodcast.org.
