SIOUX CITY | Sleeping all day, barely eating, withdrawing from friends and activities and self-harming behaviors like cutting are not just a phase, but signs that a teenager could be contemplating suicide.
But Daniel Gillette, physician leader for behavioral health at UnityPoint Health-St. Luke's, said the ways teens hint at their intentions are not always explicit or shared with adults.
"If you have a gut feeling that you should be worried about your friend, your gut's probably right," he said.
According to the federal Centers for Disease Control and Prevention, suicide is the third leading cause of death for young people between the ages of 10 and 24. Approximately 4,600 young lives are lost each year in the United States to suicide.
According to the National Institute of Mental Health, scientific evidence has shown that most people who take their own life have a diagnosable mental or substance-abuse disorder. Depression, a treatable condition, is associated with suicidal behavior.
Sean Akers, a pediatric psychologist at Children's Hospital & Medical Center in Omaha, will give a presentation on teen suicide Oct. 2 at the Upper Midwest Regional Pediatric Conference in Sioux City. He said the vast majority of teens who attempt suicide reveal their intentions beforehand.
"They may not go out and say, 'I'm thinking of killing myself,' but they're going to start mentioning certain things," he said. "We can't not take it seriously."
Akers said teens should receive therapy early on and not wait until their depression worsens.
"If you're starting to see some of these warning signs or you're starting to get worried about depressive symptoms such as the isolation, sadness or anger, you get them into therapy and you get them into talking," he said. "If you wait until it's a crisis, it gets worse."
Gillette, immediate past-president of the Iowa Psychiatric Society, said he's aware of a few suicides in the community involving teens this year.
Akers said clusters of suicides occur in communities from time to time. Over the past few years, he said the number of teens attempting suicide in Omaha has increased. He's not exactly sure why.
The Sioux City Community School District is taking a proactive approach, directing students to the mental health services they need through a Youth Mental Health First Aid program.
Shelly Lewis, the district's project director, said a federal Project Aware Now is the Time grant is funding an eight-hour course to help staff and community members identify and respond to signs of mental illness.
"We're sort of arming all of our staff that work with young people to recognize these things," she said. "As we do that we'll be recognizing more students that need assistance."
Lewis said therapists are assigned to schools that have a high percentage of students in need of mental health services. West High School, she said, has a support group for teens struggling with depression.
"School-based therapy is often a good option for students because they can get services in the schools and it's convenient for the parents," she said.
Teachers and staff, Lewis said, can make referrals to student assistance teams. Those teams then discuss what's going on with a student to determine if they could benefit from mental health counseling. School counselors and administrators, she said, also make requests for student therapy services as well as parents.
"We do have a fair amount of parents who come to the school and say, 'I know my child is struggling,'" she said. "It's ideally a collaborative process between the parent and the school to determine that services are needed."
She said the district plans to identify and meet additional mental health needs through the grant in the future.
"I think there's definitely a need for more services," she said. "It's really difficult for students in our community to get the help that they need in a timely manner. That's a challenge for a lot of families."