May 21, 2015


A recent article in the Spokesman Review states, “Five teen suicides this school year – including three in the past month – have jolted the community. It’s the highest number in the history of Spokane Public Schools, prompting parents, students and community members to ask what they can do to help.”

As a Pediatrician here at CHAS I have noticed since mid –March an increased number of teenagers coming into my office for significant suicidal concerns with several reporting that they don’t feel safe going home from the clinic. This is very alarming and hard to manage if our Mental Health Staff has a full schedule. Periodically, the only option we may have available is to ask the family to go to the Sacred Heart Children’s Hospital Emergency Room for safety and to get prompt access to a mental health professional or other services.

Another article from the Inlander just three years ago, covers this local topic as well. They report, “experts say the region needs to start talking about the problem. Spokane has a rate of suicide higher than the state average. It’s the city’s second-leading cause of death for people ages 10-24.” Suicide isn’t just an issue for Spokane, but the entire Inland Northwest. Coeur d’Alene has the highest suicide rate in Idaho, and Idaho consistently has one of the highest rates in the nation, according to a report by Suicide Prevention Action Network of Idaho.

Both articles go on to discuss the need to work on being open and frank with all adolescents. As a medical care team we need to remember to do annual mental health screenings for all teenagers and the PHQ (Patient Health Questionnaire) is a validated test and a reasonable way to open the conversation with any teenagers in your office. The biggest obstacle is getting over the awkwardness of discussing this topic which is hard for many individuals to do. Teenagers tend to be more open and honest when they feel you are open with them and showing them that you actually care about their personal story.

Scientifically we know the adolescent brain works differently than the adult brain as teenagers seem to be pre-programmed to take greater risks and have less inhibition of impulse behaviors. This makes them appear to live more in their current emotions and less in their analytical/reasoning brain where adults tend to spend more of their time. This can lead to behavior that seems uncharacteristic and reckless to others but does not seem strange or out of the ordinary to teens in my office when they bring up the topic.

To try and keep this commentary to a minimum, I have provided links to both of the recent articles which I feel are informative for our community. They do go on to provide resources which I have attached below.

What Causes Suicide?

According to the National Alliance on Mental Illness (NAMI), “90 percent of youth suicide victims have at least one major psychiatric disorder, although younger adolescent suicide victims have lower rates of psychopathology.” Overall, NAMI asserts that 90 percent of people who complete suicide could have been treated for a mental or substance-abuse disorder.

Suicide Prevention Meetings

Prevent Suicide Spokane is hosting a meeting about what can be done in the community to help. The event is 1 to 3 p.m. Friday at Spokane Regional Health District, 1101 W College Ave. For more information contact Sabrina Votava at (509)475-7334 or

Prevention Resources

First Call for Help Crisis Hotline: 509-838-4428

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

LGBTQ Crisis Hotline: 1-866-4-U-TREVOR

American Foundation for Suicide Prevention:

QPR Institute:

Youth Suicide Prevention Program:

Some Warning Signs

  • Talking or writing about death, dying or suicide when these actions are out of the ordinary for the person
  • Acting reckless or engaging in risky activities — seemingly without thinking
  • Increasing alcohol or drug use
  • Withdrawing from friends, family and society
  • Feeling anxious or agitated, being unable to sleep, or sleeping all the time
  • Experiencing dramatic mood changes
  • Changes in eating and sleeping habits
  • Unusual neglect of personal appearance
  • Marked personality changes
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • SOURCES: National Suicide Prevention Lifeline (; National Alliance on Mental Illness (

By Dan Moorman, Physician