We must act to head off teen suicide

Joseph S. Camardo, Philip T. Ninan, and George M. Wohlreich, medical doctors and fellows of the College of Physicians of Philadelphia, wrote this for "The Public's Health" blog, www.philly.com/publichealth.

If you were walking on a college campus today, could you identify the minds that are plagued by despair and suicidal urges? In fact, 18 percent of undergraduates in the U.S. have suicidal thoughts; about one in 10 make plans to end their lives. Nearly every day on campus, three die by suicide. Isn't this an epidemic?

College students struggle with the blossoming of individuality, defining themselves in a novel context, the competition and challenges in mastering knowledge, and peer pressures. It can be exhilarating - and terrifying.

How can the student - much less friends, parents, student health services, and professors - distinguish between transient thoughts of suicide and thoughts that lead to action? This is the great dilemma. What makes thoughts of suicide cross the line into action; and what differentiates the one in many attempts that results in death by suicide?

For most people, suicidal leanings are a transient emotional state one that can be modified if you are aware and prepared to confront it. Nearly all do. For others, it becomes an overwhelming urge - the only answer.

A student's suicide is always poignant - the loss of such promise, of a life unlived. But this is also a pressing public health issue. We must focus on what happens on each day between the stories of these tragedies. The ability to identify a young adult at risk of suicide is much improved with screening tools and counseling, but they are not perfect. There is no blood test, no scan, no physical sign. The number of college-age adults who die by suicide should be zero. A campaign to achieve that goal should be maximum, relentless, and now.

We need more education. We've made giant strides talking about pregnancy, smoking, drugs, sexually transmitted diseases, and other public health issues. We need to talk about suicide. We need to explain that our own brain can modify itself to control urges and choose a path for life. We need to explore with students the boundaries that mark the beginning of illness, and talk about available treatments - not just once in a while, but all the time.

We may need more screening. In college, a closed community with a fabric of communication, it may be that a broad screening program has the collateral benefit of maintaining awareness; not just of the risk of suicide but also of the significance of ideation. What would it be like if students found out that their suicidal thoughts were not so uncommon? A screening program that explains the risk might just make way for a more intelligent and less onerous discussion. For too many, the very nature of the problem shames them from reaching out, or deludes them into denial and the illusion that greater effort will suffice. And what are we doing to identify students at risk through the communication tools that they use most commonly? Students today do not go to the student health service; they go to their social network. That's where we need an immediate and sustained connection to a suicide counselor, and an immediate intervention.

Not a single change in attitude toward health takes place without a nonstop, high-volume campaign of awareness, education, understanding, and access to professional help.

We must demystify the hobgoblin of suicide!