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The Other Adolescent Suicide

Susan Notes: This account of the tragic aftermath of zero tolerance policies, achievement tests, and excessive expectations that have led to stress-induced suicide is both informative and tragically personal. The author wants to share her daughter's story in hopes it will both alert and help others. For me, the point here is that schools are imposing very harsh policies on children. Children.


Dedicated to Becky and the students of the Neshaminy School

Mental health professionals have become adept at assessing clinical depression; our acumen for recognizing the depressed and suicidal teen has been so refined that identifying and referring them for assistance is almost perfunctory. Unfortunately, teen suicide continues to increase and, in fact, it is often not these dysphoric youth who are filling the ranks. Instead schools report self-inflicted deaths among their top-ranked, extra-curricularly involved, and socially well integrated students who hail from healthy families. Responding to and preventing suicide in students, who reach despondency despite having the protective factors delineated by the National Standards for Suicide Prevention, is critical. Unfortunately most of the research and prevention on teen suicide has been limited to those related to diagnosable mental illness. This denies prevention to the 40% of adolescent suicides that may not have an attached mental illness (Am Acad Child Adoles Psychiatry, 2003). William Kirk (1998, p2) dispels the myth that the majority of adolescents are mentally ill at the time of their death, suggesting psychological autopsies show most young people were relatively coherent and rational at the time of their demise. In fact, according to Alexandra Robbins (2006, p15,) the 114% increase in suicide among teens 15-19 years old between 1980 and 2002 has been attributed to pressure. A 2004 Mediamark survey of American teens found that more than half reported being stressed some or all of the time while 2/3 identified school work as their primary stressor (Robbins, p 66).

Maine received national coverage when Sports Illustrated connected a series of teen suicides to a common football team. Eastside, Oregon struggled with 3 teen suicides in rapid succession; all described as athletes and children of privilege. A school district in Pennsylvania lost 7 children to suicide in 3
years, six of whom were active in the school and community with two having parents in the mental health field. While these schools have gained the media's attention, most schools can readily identify similar well-presenting students who complete suicide after a relationship break-up, rejection from a college, a one-time law violation, or a perceived catastrophe often tied to the unyielding zero tolerance policies in place today. The key in these deaths seems to be a culmination of stress. William Kirk (1993, p.20) suggests todayâs youth are exposed to many stressors despite little evidence that they are equipped to deal with it. Today's child attends 12 years of school, just as they did 150 years ago, while they must learn and integrate 5 times the material. Enormous pressure is now placed upon students with national testing and senior dissertations as requirements for graduation. Students are admonished that only ample community service and extraordinary extra-curricular involvement will yield acceptance by a top college. Moreover, the rising cost of college focuses teens on earning that elusive scholarship. SAT's have changed, making tutoring for the exam a near rite of passage. Robbins (2006, p. 358) refers to a 2005 article in Adolescence where it is acknowledged that successful teens may even experience more pressure than non-successful peers due to the need to maintain their high performance. In fact, suicide attempts among successful teens tend to be more lethal, thereby raising the percentage of completed acts as compared to peers with more mental illness based attempts. Thomas Armstrong (2006, p28) further asserts that as students are subject to increased pressure through testing, course requirements, and more homework, those who are particularly vulnerable to stress develop anxiety related symptoms including somatic complaints, sleep disturbances, irritability, and aggressiveness.
Hard-line zero tolerance policies, enforced by harsh untrained staff, have contributed to toxic school environments and more pressure. There is also recent recognition of the stress on youth athletes who may over-participate in a sport as they are encouraged to specialize by practicing year round via tournaments, travel teams, lessons, and special conditioning. In fact, it has been reported that doctors believe there is an epidemic of over-use injuries among American youth, which they blame on the aggressive culture of youth sports. But are these additions to the already angst filled teen years the antecedent to suicide? Research suggests the answer is yes; sometimes multiple pressures build, and with them so do thoughts of death and the act of suicide, until finally the act is attempted by a youth who simply has no coping mechanisms left (Kirk, 1993, p19). Kay Redenfield (1999, p.197) notes this is particularly true for, âthose who may unknowingly have a low flash point or biological vulnerabilityâ . Carol Staudacher (Beliefnet n.d.) explains that each person has their own moral code, set of beliefs and expectations so that feelings of chaos and despair may result when life, according to those expectations, becomes impossible.

Modern research of the brain helped scientists demarcate the functions of each area as well as identify changes over the growth span. The largest part of the human brain is the frontal lobe and within it the prefrontal cortex which is responsible for advanced executive functions. MRIâs confirmed that the adolescent frontal lobe experiences significant growth of gray matter until the early 20's when its pruning is completed (Time, May 10, 2004). Simultaneously, a process called myelination begins whereby white matter develops and serves as an insulation for the brains circuitry and facilitates a more precise and efficient system (Time, May 10, 2004). Dr. Deborah Yurgelun-Todd (Time, May 10, 2004), of Harvard Medical School, noted that teens respond and make decisions from emotional centers of the brain and are often unable to evaluate the consequences of their behavior because it is in the underdeveloped frontal lobe where organization, planning, and strategizing occur. This scientific brain-mapping provides insight into the aforementioned high achieving teens, which present as well grounded, but when subject to a humiliation, perceived failure, or major stressors react with an impulsive fatal action. In fact, Redenfield (1999, p.189) reports 50% of all suicides are conceived and acted upon in the last five minutes of a person's life. For teens, which lack the brain development to foresee that a tragedy will pass or an error can be rectified, suicide may seem like a reasonable option. In his affidavit describing the need to treat juvenile offenders differently than adult offenders, Dr. Ruben Gur, Neuropsychologist and Director of the Brain Behavior Lab at the University of Pennsylvania said, "Evidence is now strong that the brain does not mature until the early 20's and that is relevant because these parts govern impulsivity, judgment, planning for the future and foresight of consequencesâ (see American Bar Association). It is clear that although an adolescent may physically resemble an adult, evolution has not yet compensated for the pressures placed on them by the modern academic world.

A simplistic explanation of this Other Adolescent Suicide is to liken the teen brain to a middle aged heart. Both are strong and expected to have years of life remaining in them. But just as chronic stressors can aggravate and facilitate a heart attack in a 35 year old they can exacerbate and trigger a brain attack in a 16 year old.

While strain will always be present; todayâs youth are required to undergo complex stressors biologically beyond them. Moreover, each adolescent is different in their response to stress and their individual breaking point is often unknown until it has been reached, sometimes fatally. There are two options. The first is to continue the current practice of blaming teens and their parents, for not having adequate coping skills, and require schools and youth programs to teach an ever increasing set of coping mechanisms. Similarly, emphasizing only mental illness as the cause of suicidal feelings likely thwarts a high achieving studentâs disclosure, viewing this as another sign of failure.

The second option is more basic but also more radical; it requires eliminating the unnecessary stressors. This calls for parents, sporting organizations, educators, colleges, mental health professionals and public officials to reassess their priorities and begin minimizing the pressure. Because teens stressors are systemic, it is this authorâs opinion that only this second option is viable both logistically and, biologically. There is much debate about the efficacy of suicide predictive tests when it would be more prudent to stop identifying who is at risk and stop making anyone at risk.

Once professionals, parents, and policy makers understand the significance of stress and strain on children it is important to take action both in schools and the greater society. In terms of schools, it is important to tone down the toxic atmosphere by allowing for mistakes, insisting upon mutual respect between students and all staff, and tolerating the need for student problems to be handled on an individual basis. One size fits all policies must be revamped. It must be made clear that zero tolerance means we will react but does not specify the reaction be punitive. Another step is for school districts to identify graduation requirements that are more appropriate for college students, and remove them from as a high school expectation. Advanced placement classes should be rare and strictly monitored so that they serve to stimulate students in special circumstances and not be promoted as the pathway to college. Although elimination of GPAâs as a source of competition between teens may be difficult, there are a number of districts who have, in fact, dissolved the lauded and dreaded class rank. Curriculums need to be established, or re-established, where adolescents can also complete developmentally appropriate tasks that occur through personal and creative teacher-student interactions. Several school districts hold classroom meetings to start the day in elementary school. This practice is recommended for all ages and grades, as it allows a period of respite form the rigors of the day where students can share concerns and issues and reduces the sense of isolation for everyone. The aforementioned Neshaminy School District identified the need to create a more supportive school climate while recognizing taxpayer limits as well as guidance counselor caseloads of up to 300 students. Based on Sandra Bloom model of Creating Sanctuary the district hired a professional therapist and built a room where stressed or distressed students could drop-in for support and evaluation. Bloom (1997, p.119)identified that stressful events are more seriously traumatic when there is an accompanying hopelessness and loss of control. Establishing a Sanctuary Room allow students control because they know there is a place to take their concerns with no appointment necessary and there will be a reasonable adult there to help them gain hope and solutions. Bloom advocates for the creation of healing environments and recognizes that humans need to make sense of what is happening to them in order for life to be bearable.

Parents and all adults who interact with children also need support, as they have become victims of societal pressure to produce successful children as measured by competitive standards. We need to begin educating adults on the dangers of overachievement and the stress associated with being a child and teen in the modern world. Psychologists have identified several factors contributing to the pressure put on children, including: successful adults expecting their children and those they work with to mirror their accomplishments, dual working families and childcare environments that attempt to fill children's days with activities, the high cost of raising and educating a child which encourages parents and society to expect a return on the investment, and societal messages that a nation's success is measured by the economic success of its children (Robbins, p 218). There is a dual benefit in teaching those who work with children and parents about reducing the pressure. First, it allows them to stop monitoring children's progress and simply mentor and parent them. Second, when adult's expectations are less intense and obvious children are more apt to feel safe in sharing their feelings of stress and pressure. A final suggestion involves simple nomenclature. It is important that we remember adolescents are merely larger older children. Their very brain development is proof that we should stop referring to them as young adults and remind ourselves they are still children.

In closing, it is hoped readers have gained an awareness of teen-suicide victims who do not meet the traditional criteria for depression or suicide risk. Explanations of the myriad factors, often insidious, that impinge on today's adolescents must be kept in mind by all who interact with youth. Until these pressures are significantly reduced or the adolescent brain significantly evolves to meet demands, our children remain at risk.

Their very brain development is proof that we should stop referring to them as young adults and remind ourselves they are still children.

History and how this level of strain has developed

Anyone negotiating life in the 21st century will likely agree we live in a high-paced technologically driven society. While the benefits of these advancements are obvious the toll they take on humans, especially children is more insidious. It is important to understand that while childrenâs primary obligation is to attend school, these institutions of education have been turned into bastions of stress. While this is in part due to the vast amounts of material youth must learn it is also the result of the American adults need to know we are the best.

In the 1950âs schools became the scapegoat for this nations wounded pride when the Russians beat us into space with the sputnik satellite. Schools were blamed for not adequately providing children with the skills to have won the first-in-space-war. Congress responded in 1958 with the National Education Defense Act which provided funding for studies of math, sciences, and foreign languages as well as money for new school construction. Later, in the mid 70âs, the American workplace showed a decline in productivity, rising unemployment, and losses in the market share to Japan and Germany (Anderson p176).Within a few years the 1983 report, presented to President Reagan, called âA Nation At Riskâ criticized and blamed high school graduates, who were allegedly unable to read and scoring poorly on tests, for the nations downfall. Although the claims against students were not verified, politicos needed to tie the poor economy to something so schools were identified for blame. Following this publication, state after state increased graduation requirements, lengthened school years and added more standardized tests while applauding teachers and schools whose students did well and shaming those who did not.
In sum, a fear of foreign competition and a fiercely held belief that the educational system could be linked to strengthening the economy and global position of the nation, prompted business and political leaders to force changes in the education system without regard to the emotional cost to its youth or limitations of their brain development.

Given the comparison of American students to their foreign counterparts it is appropriate to consider how students in other countries, considered our competitors, cope with academic pressure. Research from Hong Kong, in 2001, found an astounding 1 out of 3 teens were experiencing suicidal thoughts. In Korea, where flights are cancelled and roads are blocked to ensure quick passage to school on exam days, more than 8 out of 100,000 teens completed suicide in 2003 (Robbins, p35). Finally, a psychiatrist in India described a student who staged their own kidnapping and many with hysterical psychosis as a result of a 50% increase in pressure on students (Robbins, p36).

Beckyâs story
Becky Marseglia , the author's daughter
Born: May 1, 1988
Passed: February 7, 2005
Age: 16
*Method: passive hanging

Becky was born and raised in Levittown, Pa. She is the daughter of Diane and Mark who amicably separated when she was 10 years old and her sister, Katey, was 8 years old. At the time of her death Becky was a popular outgoing girl at Neshaminy High School where she was described as vivacious, impetuous and a friend to everyone. She loved to champion those who struggled.

From a young age Becky loved to act and, up until her death, was often the lead in class plays. She served on student council and in 9th grade was elected President of the Middle School (6-9th grade). She played varsity tennis since the 9th grade as well as rugby (her father coached) and track. Becky was Vice Chair of the Middletown Township Teen Task Force and served as the only youth on the Middletown Township Park and Recreation Planning Committee.
Becky was an active member of the US Civil Air Patrol (auxiliary of the US Air Force) since she was 13. She thrived in this challenging environment and chose to pursue the specialty of survival training and search and rescue. She once marched over 20 miles with broken feet and in full gear and was required to kill and eat a wild rabbit and snake! In this program Becky met and developed close bonds with teens all over Pennsylvania. Amazingly, over one hundred drove from all corners of the state to her funeral; one young man was flown home from the Air Force Academy for the services and another took leave from the Citadel Military School to be at the viewing and funeral. Such was the bond with her fellow cadets.

Between the Civil Air Patrol experience and being chosen as Honor Cadet for the Pennsylvania State Police Camp, Becky decided to pursue the military as a career and hoped to attend West Point. She was passionate and focused about this goal.

In November 2004, Beckyâs junior-year first semester grades turned out lower than expected and her SATâs were lower than necessary for West Point. Being an actress and still firmly entrenched in her military persona, Becky never outwardly expressed the apparent regret she felt at possibly having to give up her goal for West Point. Following her death, it became evident that she had struggled and met that conflict by secretly smoking marijuana with her peers This appears to have been on only a handful of occasions but may have been enough to foster feelings of guilt and angst over how this behavior was in opposition to her goals.

On February 2, 2005 Becky left for a Disney World vacation with the aforementioned, all male Civil Air Patrol Squadron.

On the day they were to return (Feb 7) one of the adult chaperones found an empty box of rolling papers near her suitcase. The chaperone gave it to the female commander, with whom Becky had a difficult past relationship. Becky was confronted by this female commander and a male commander whom she viewed as a father figure. In hysterics Becky admitted the empty box had been hers (from the past) and although she was 1200 miles from home, had no parental support, and was to fly home in 3 hours, she was told she was expelled from the program.

Becky must have been crushed by the knowledge that so many friendships and her bond with so many cadets was ending so abruptly. Too, she had to be dreadfully fearful when told her mother would be told of the rolling paper box (she begged them to tell only her father). In desperation, and under the further belief that this expulsion would completely eliminate a military college or career, a frenzied Becky ran from the confrontation scene at the hotel and into the woods where, within minutes, she used her T-shirt to take her life. In the pressure filled world of her adolescence Becky had been pushed over the edge and succumbed to a brain attack.

Her body was not found for 3 days.

An autopsy revealed there were NO drugs or marijuana in her system.


*Graphic:
Becky lost 2 friends to passive hanging in the past 3 years. This is a method of suicide that has the victim sitting or kneeling and leaning forward. They can EASILY stand up or move and stop the process because they are not âhangingâ. However, pressure from the âobjectâ on the carotid artery and against the throat produces dizziness and low blood pressure so that they âpass-outâ between 10 and 50 seconds and soon die. The method of death was learned by teens who heard of the âChoking Gameâ and discovered this method could be taken to another level.

Anecdotes:
+Becky was the 2nd of 4 classmates in the Neshaminy class of 2005 to suicide

+The Neshaminy School District allowed me to serve on a Suicide Task Force after the 3rd death. We studied the toxic and caustic environment of the school where there was too much competition, too many zero-tolerance rules, and a hard-line approach to teaching. The recommendations for change have been adopted by the school board

+Recently Harvard and Princeton eliminated their early admission programs and listed, as a secondary reason for the action, that it puts too much pressure on teens.

+Dr Rubin Gur, of the Univ of Pennsylvania, continues to be one of many renowned experts who are finding increasing evidence that the adolescent brain is not fully developed until the age of 22-23, particularly in the areas of the frontal cortex where the ability to delay impulses and view the future in a long term perspective is housed. His testimony was used as evidence to the Supreme Court in arguments that juveniles should not be charged as adults due to limitations in thought and brain development.

Statistics you may not be familiar with:
According to the Center for Disease Control:
10.9 teens are successful at suicide everyday.
One teen dies by suicide every 2 hours and 44 minutes or 4000 per year.

According to the American Association of Suicidology:

Suicide is the 3rd leading cause of death for teens (accidents and homicide rank higher).

Suicide is the 2nd leading cause of death to college age youth.

According to the Jason Foundation:

Suicide is a silent epidemic as 2700 teens attempt suicide every day in the U.S.

In the past 40 years teen suicide rates have tripled.

More teens and young adults die from suicide than cancer, heart disease, AIDS, birth defects, pneumonia and influenza and chronic lung disease combined!


References

Anderson, James; Cuban, Leslie; Kaestle,Carl; Havitch, Diane. (2001). School: The Story of American Public Education. Boston: Beacon Press.

Armstrong, Thomas. (2006). The Best Schools. Virginia: Association for Supervision and Curriculum Development.

Bloom, Sandra. 1997. Creating Sanctuary. New York: Routledge.
Centers for Disease Control. (1991) Morbidity and Mortality Weekly Report: Final Data. Atlanta: U.S. Department of Health and Human Services, Public Health.

Gage, F.,Jacobs,B., Van Praag, H.(July-August 2000). Depression & the Birth &Death of Brain Cells. American Scientist,88(4).Retrieved May 2006 http://www.americanscientist

Jamison, K.(1999), Night Falls Fast. N.Y.: Vintage.

JasonFoundation.org

Kirk, William Adolescent Suicide: A School Based Approach to Assessment and Intervention. 1993. Research Press.

Murray, B. American Psychological Association. (August 1998). 29(8). Retrieved April 2006. http://www.apa.org/monitor/aug98/homepage.html

Robbins, Alexandra. The Overachievers. New York: Hyperion. 2006.

Staudacher, Carol, Beliefnet.com Retrieved: September 2006 http://www.beliefnet.com/story/27/story_2750_1.html

âThe emergence of Youth Suicide: An Epidemiological analysis and Public Health Perspective,â M. Rosenberg, J. Smith, L.Davidson, and J. Conn, Annual Review of Public Health,8, p20)â"noted in Kirk p 6

Time Magazine. WALLIS CLAUDIA,KRISTINA DELL. (May 10, 2004.) Vol. 163 No. 19 Retrieved June 2006. http://www.time.com/time/covers/1101040510/#















— Diane M.E. Marseglia, MSW, LCSW
Paper presented to the Nat. Assoc.of School Psychologists,
2007-03-26


INDEX OF RESEARCH THAT COUNTS


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