How young is too young?
It’s a compelling question that arises time and again among adults seeking to safeguard youth from suicide: how young is too young to initiate dialogue with children that can protect them from suicidal thoughts, gestures and attempts?
The answer is clear. The earlier, the better—as long as the dialogue is age-appropriate and grounded in best-practice.
But is there an evidence basis for sound programs that address suicide in elementary-school students? Yes. “Generally, youngsters in elementary school can be taught coping skills, help-seeking behaviors, and health promoting activities, which should reduce the likelihood of later suicidal behavior,” says Madelyn S. Gould, PhD, MPH, a national expert in youth suicide prevention.
One program that Dr. Gould cites is the Good Behavior Game, first developed more than 40 years ago ((GBG; Barrish et al., 1969) to socialize first graders as students in the classroom, and reduce aggressive, disruptive behavior so as to improve academic achievement.
“The original developers did not have suicide prevention on their ‘radar,’ yet a follow-up into young adulthood showed a positive impact on suicide outcomes,” Dr. Gould notes.
Long-term impact of the Good Behavior Game in a randomized controlled trial includes:
• Reduced aggressive and disruptive behavior during first grade (Dolan, Kellam, et al., 1993)
• Reduced likelihood that initially aggressive students would receive a diagnosis of conduct disorder by sixth grade (Brown, Wang, Kellam, et al., 2008)
• Significantly reduced likelihood that persistently highly aggressive males would receive a diagnosis of antisocial personality disorder as a young adult (Petras, Kellam, et al., 2008)
• Prevention of suicidal ideation and suicide attempts (Wilcox, Kellam, et al., 2008)
• Significantly reduced risk of illicit drug abuse or dependence disorder at ages 19-21 (Kellam, Brown, et al., 2008)
“So, the bottom line: I think it’s a good idea to start in elementary school, but not to focus on traditional suicide prevention programs that are implemented in high school,” adds Dr. Gould.
These revealing self-portraits were created by third graders, and suggest a range of emotions and self images that young children can display. Research suggests that, while rare, suicidal gestures can be displayed by children age six or even younger. More frequently, young children can exhibit separation or general anxiety disorders. If left unrecognized or untreated, these may lead to clinical depression in later years, which can predispose teens and young adults to thoughts of suicide. Experts urge schools, parents and communities to engage with children as young as six with prevention messaging that is safe, age-appropriate and positive-focused to build protective factors.