In 2010 more people died by suicide than were killed in war, by murder, or in natural disasters. In Norway, the location of a heart-rending new study of suicide notes left by children and young teens, suicide is the second leading cause of death for this age group. We need urgently to do more to understand why so many young people are taking their own lives.

The researchers Anne Freuchen and Berit Grøholt predicted that, given their immaturity, the young authors of suicide notes would show signs of confusion. Also, because diagnoses of mental illness are lower in children and young teens, the researchers predicted that the notes would show fewer signs of inner pain compared with notes left by older teens and adults.

In all, Freuchen and Grøholt had access to 23 suicide notes left by 18 youths (average age 14; 5 girls) who took their own lives between 1993 and 2004. They also interviewed the children’s parents and referred to police reports. For comparison, the researchers also interviewed the parents of 24 youths who died by suicide during the same period but did not leave a note.

Analysing the notes revealed ten themes, each of which was present in three or more of the notes: they were addressed to someone (most often parents); the author gave reasons for the suicide; they declared their love; expressed a settlement with themselves (e.g. “it’s better for me to be dead”); expressed a settlement with someone else (e.g. “I do this for you, dad”); asked for forgiveness; expressed good wishes (e.g. “good luck in the future”); expressed aggression (e.g. “you bastards”); over half included instructions (e.g. “give Peter Playstation 2”); and just under half expressed inner pain.

Contrary to their predictions, Freuchen and Grøholt said that “the notes are coherent and do not reveal confusion or overwhelming emotions. The children and young adolescents emphasise their consciousness of what they are about to do and they take full responsibility.”

According to the parental interviews, the children and teens who left the notes had not sought help with the issues that led to their suicide. At the same time, they had communicated their thoughts about suicide more often than those who didn’t leave notes. One has to wonder why this did not trigger more effective preventive action. Similarly, three of the notes took the form of school essays, and yet none of them were acted upon by school authorities.

The fact that many of the notes conveyed declarations of love and gave explanations suggests, the researchers said, that the authors were well aware of the implications of their actions. “These children and adolescents somehow retain their dignity,” the researchers said. “They act like decent people do, they bear their pain alone, and even manage to take care of others by leaving detailed instructions with respect to giving away their assets.”

The researchers do not extract many practical lessons from their findings, other than calling for more research into parent-child/teen relationships in the hope of developing preventative strategies. Moreover, they cautioned that it is not possible to generalise or draw conclusions from this small sample. Another methodological limitation is that the suicide notes are from an era that pre-dates the rise of social media (which can be a source of threat, a support, and an outlet), so it’s not clear how relevant insights from this study are for young people today.

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Anne Freuchen, and Berit Grøholt (2013). Characteristics of suicide notes of children and young adolescents: An examination of the notes from suicide victims 15 years and younger. Clinical Child Psychology and Psychiatry DOI: 10.1177/1359104513504312

–Further reading–

The mental health charity Young Minds has a helpline for parents.

Mindfull is a new website for 11 – 17 year-olds who are feeling down or depressed.

Occupational hazard – links between professions and suicide risk have changed over time.

What’s different about those who attempt suicide rather than just thinking about it?

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.