Emma* has a semicolon tattoo on her left wrist. The punctuation mark isn’t a trendy tattoo design like a mustache or an arrow; rather, it has come to symbolize a juncture where life — like a sentence — could have ended but didn’t.
Semicolon tattoos are worn by people around the world who have struggled with, but survived, suicidal thoughts and attempts. “It’s an award on its own to say you’ve made it,” Emma said over the phone. (She requested a pseudonym for privacy.)
Emma, now 20, experienced suicidal thoughts from the time she was 12. She was living with a psychologically abusive family member, which made her socially withdraw at school. For most of her adolescence, she had no friends and was bullied.
“I thought the very, very worst of myself,” she recalled. “Things that I shouldn’t have been remotely considering — someone who is 50 shouldn’t be considering — I was considering at 12. I was full of self-loathing. I hated myself and I thought that I deserved everything I got.”
The idea that someone so young could be contemplating suicide is distressing. But I heard Emma’s story shortly after reading of two separate incidents of girls (one aged 12, the other 14) live-streaming their suicides. Now, Netflix’s popular (albeit controversial) series, 13 Reasons Why has likewise sparked conversations about the realities of youth suicide.
These stories illustrate that even pre-teens can experience profound anguish, to the point of considering — or even committing — suicide. And in some parts of the world, the risks seem to be mounting.
Overall, very few children between the ages of 10 and 14 take their own lives. Global data show that between 2000–2009, the annual rate of suicide was 1.52 per 100,000 boys and 0.94 per 100,000 girls.
That said, according to the Center for Disease Prevention, suicide is now the most common cause of death for children in this age group in the United States — even more common than road accidents. Between 1999 and 2014, suicide rates among girls in this age group in the U.S. rose by 200 percent. Rates for boys also increased, by 37 percent. A similar trend, though not as stark, is also seen in countries like Canada and Australia.
Suicidal thoughts among young people are linked to various forms of abuse, such as bullying, sexual assault, and mistreatment at home. WHO also reports that people who face discrimination — such as indigenous people, people from minority ethnic groups, people from rural areas, and LGBT people — also face increased risk. And if one young person in a community takes his or her life, Victoria Wagner, Executive Director of the Youth Suicide Prevention Program in Washington State, warns of a potential “contagion effect” in that area.
Unfortunately, according to research published in the British Journal of Psychiatry suicide among this age group is likely underreported. Many people don’t realize that people so young could harbor such dark intentions, and in some cases, the stigma of youth suicide may mean coroners don’t mention it as the cause of death.
“Not many people are open to speaking about it,” said Emma. “It can be really hard for parents to accept that someone is a bit different…. I needed that reassurance and I didn’t get it.” Her parents and teachers never commented on her growing isolation. She felt unsupported and alone.
Emma’s story shows that the actual suicide rate captures only a proportion of kids who are struggling. According to the World Health Organization, about half of all mental illnesses begin by age 14. In Australia, of the consultations the Kids Helpline undertakes with young suicidal people, one in five were under 13.
Brian Bresee’s son Samuel took his own life at age 14 after facing bullying at church and school. “A part of me died with my son,” he said. “I laid in bed for almost a year afterward, getting out just to crawl to work… the pain is beyond imagination. The only escape from the pain for the longest time was sleep, I woke up to a horrible nightmare every morning.”
Bresee has been involved with the campaign to reform bullying laws at home in Nevada — including an anti-bullying hotline, anti-bullying education programs, and legally mandates for schools to swiftly investigate all reports of bullying.
There are other examples of mounting pressures on governments to provide greater mental health resources. Earlier this year in Canada, the CBC reported, Isadore Day, the Ontario regional chief with the Assembly of First Nations, suggested that a class action suit against the federal government could be an appropriate way to address the epidemic of suicide among indigenous youth. (Suicide in Canada disproportionately affects First Nations people, especially those in the 10–14 age bracket.)
Globally, the WHO and others recommend anti-bullying advocacy as a method of suicide prevention, alongside restricting access to means to suicide (such as firearms and lethal pesticides), and ensuring young people access to support services.
Where resources fall short, it’s also possible for interpersonal interactions — between parents and their children, teachers and students, and among friends — to make a difference. A willingness to talk openly with young people can go a long way. “When someone close notices a significant change out of the norm… there is nothing wrong with asking a young person if they are thinking of suicide,” Wagner says.
Emma agrees. “You’re showing that you care, and that can be really important to someone regardless of what they’re going through,” she said. “You’re making them feel valued.”
When I asked Emma how she managed to get through her childhood years without adequate mental health counseling, she said, “Music.”
“I used to spend most lunchtimes in the music room…I loved it. To this day I still see music as a great tool. I couldn’t overstress the importance of it. It made me realize that I’m more resilient than I originally thought I was.” As she played instruments and wrote songs, she had space from her thoughts and problems. She wasn’t judged, she was learning things she was passionate about, she could express herself.
Emma is now studying to become a counsellor in Newcastle, an Australian city just north of Sydney. She wants young people going through abuse to know that “who you are is not shaped by how other people treat you.”
“I still have a long way to go,” she said, “but if I could go back in time and reach out to myself, year-by-year…I’d go back and give myself a hug and tell myself that everything’s going to be okay.”
If you’re in the U.S. and having suicidal thoughts, please call National Suicide Prevention Lifeline on 1–800–273–8255. It is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.
