Teen Suicide: Experts tell what to look for, how to prevent it

There are still several unknowns surrounding the Feb. 25 suicides of Gina Gentile and Vanessa Dorwart, but the teens’ decision to step in front of a speeding Amtrak train sent one very clear message to some experts,

“This was not a drama driven, woe-is-me call for help,” said Philip Rutter, psychologist and assistant professor at Widener University. “This was an exit strategy. … These were young women with a plan who wanted to make sure they died.”

Police say the Interboro High School sophomores planned their deaths and embraced one another before they were struck near the Norwood train station at 10:33 a.m. on a snowy Thursday morning.

That another classmate pleaded for Gentile, 16, and Dorwart, 15, to get off the tracks after deciding not to join them only fueled a story that quickly went national.

Those details, compelling as they might be, cannot recede quickly enough for parents and people who dedicate their lives to the study and prevention of suicide.

“My preference is that it not be covered at all but in a situation like this, where it probably can’t be avoided, you hope there will be some restraint,” said Tony Salvatore of Springfield, a suicide prevention specialist for Montgomery County Emergency Service, Inc. “If you are not channeling some of your energy and concern to prevention and education at a time like this, a terribly-sad event could turn into a long-term tragedy.

“People will just go on with their lives and not talk about it until something like this happens again.”

Suicide is the third-leading cause of death for 15- to 24-year-olds, behind automobile accidents and homicides, and the sixth-leading cause of death for 5- to 14-year-olds, according to the American Academy of Child Adolescent Psychiatry.

It accounts for the deaths of approximately 4,000 teenagers per year.

Attempts and thoughts of suicide are far more common.

In 2007, the Centers for Disease Control and Prevention reported that 14.5 percent of high school students seriously considered suicide in the previous 12 months and 6.9 percent made at least one suicide attempt.

Studies have found attempts among lesbian, gay, bisexual and transgender teens are two to three times more prevalent than among heterosexuals.

“There are four risk factors we typically associate with teen suicide — hostility, negative self-concept, isolation and hopelessness,” Rutter said. “We should be concerned whenever a young person is exhibiting one of these stressors but when they’ve got two or three, we should be very worried about some type of self-injurious behavior.”

Warning signs could range from the giving away of prized possessions, loss of appetite and change in sleeping habits or personality to self-mutilation like cutting or branding to talk of suicide or death.

A founding member of the Delaware County Suicide Prevention and Awareness Task Force, Salvatore said everyone has different pressure points and triggers.

“We’re all different in terms of resilience and have different responses to our experiences, whether it’s an economic problem, losing someone or a relationship that’s gone bad,” he said.

Classmates have pointed to the recent death of another Interboro student as a possible trigger for Gentile and Dorwart’s actions but experts warn against trying to cite a specific incident or reason for suicide, saying the act is more often the result of a number of underlying problems and factors.

Without a strong support system, good coping skills or a sense of self-worth, teenagers can become susceptible to severe psychological pain that leads to suicidal feelings.

“Those feelings can grow into thoughts of hurting yourself, which can lead to a plan that eventually gives way to the how,” said Salvatore, who serves on the board of Survivors of Suicide, Inc.

“As a person goes from one stage to the next, it’s like the Richter Scale, with the second step being 10 times more serious than the first and third step 100 times more serious than the second.”

Rutter said many teenagers are unable to wait out a temporary crisis.

“The thing that is so tough about teen development is that it’s all about the immediacy of the moment,” he said. “If something catastrophic happens on a Tuesday, they believe the rest of their lives will be similarly catastrophic.

“It is outside their developmental experience to think, ‘With time, this pain will pass.’”

On his Web site, Kevin Caruso, executive director of Suicide.org, urges people with suicidal impulses not to take a permanent step to treat a temporary problem.

“If you are in intense emotional and/or physical pain, remember that your judgment is being clouded by that pain,” he writes. “If you are considering suicide, you are trying to end that pain. Please do not confuse ending your pain with ending your life. The two are very different.”

Salvatore said temporary psychological pain can lead to a dangerous case of tunnel vision.

“It’s not that they stop loving the people around them or stop caring for them or want to hurt them,” he said. “But after a while, the pain becomes the center of their existence and all they care about is finding a way to stop it.

“Suicide is not a decision, it’s the outcome of a process.”

There are approximately 33,000 suicides in the U.S. each year, most by adult white males and more than half involving firearms. Delaware County averages about 60 suicides per year, typically no more than a handful by teenagers.

While suicide pacts are extremely rare, clusters, in which one suicide is followed by others, are more prevalent. Last year, the city of Palo Alto, Calif. lost four teenagers to separate suicide-by-train incidents in a six-month period.

In February 2000, three students in the Rose Tree Media School district hanged themselves in a two-week period, one a 12-year-old Springton Middle School student.

The deaths of Gentile and Dorwart were an anomaly in many respects, the first being teenage girls, while more likely than boys to attempt suicide, are about four times less likely to kill themselves and, when they do, the method is rarely as violent as death-by-train.

Rutter believes parents should have unfettered access to their children’s social media sites and friends should take any mention of suicide or death seriously.

“Often it’s friends who are privy to this kind of behavior before anyone else,” he said. “They need to know how to support their peers and recognize the danger when they read a friend’s Facebook post that expresses dismay or talks about offing themselves.

“Teenagers don’t use the same type of soft, conceptual language as adults. They say, ‘It’s going to happen Tuesday at 2.’ A kid who reads something like that has got to be able to go to a parent and say, ‘I’m worried about my friend, Joey.’”

Salvatore said the number of suicides would fall dramatically if the warnings were always so obvious.

“Unfortunately, this stuff doesn’t show up on and X-ray and people can’t see a lot of it,” he said. “There’s no light that pops up on the forehead that says, ‘I’m at risk.’”

Salvatore, who co-authored a pamphlet entitled “What Teens Need to Know About Suicide,” said a small investment in prevention and education could save a lot of lives.

“We’re not talking about a huge amount of money,” he said. “Just a little more education in schools, a little more sensitivity, maybe a little more screening by physicians or something as simple as a sign when you’re sitting in that cubicle which says ‘Do you or any of your family have any of the following symptoms?”

He said suicide prevention programs can be effective, citing one instituted by the Air Force in the 1990s that lowered the rate from 15 per 100,000 people to 5 per 100,000 people within a few years.

Rutter has gone as far as to set up a mock viewing in therapy sessions where the person with suicidal thoughts is asked to lay down and listen while their family members speak of them as if they were dead.

“I think parents should use this (tragedy) to have a horribly difficult conversation that covers what suicide is, whether their kids have ever thought about it, and what can be done to take it off the table,” he said. “Rather than dissecting the hell out of these girls’ experiences, we should be focusing on what goes on in young men and women that makes them think dying would be better than working through their problems.”

Salvatore said the Gentile and Dorwart families may be able to rebuild their lives over time but they will never get over the loss of their daughters.

“Think back to the hours and days after 9/11 — that vulnerability and helplessness we all felt,” he said. “Now here we are, nine years later, and everyone has gotten past it except for families of the people who died or jumped out of those buildings.

“That’s what it’s going to be like for those parents in Norwood.”

By Saturday, a Facebook memorial page for the girls had attracted 10,000 members.

Rutter said the girl who decided not to join Gentile and Dorwart on the tracks showed a lot of strength.

“She probably feels awful but what courage it took for her to choose not to die,” he said. “She’s to be commended.”

The funeral Mass for Vanessa Dorwart was held Saturday at St. Gabriel Church in Norwood. The Mass for Gentile will be held 11 a.m. Monday at Saint Gabriel with viewing hours from 5-9 p.m. tonight and 9-10:15 a.m. Monday at Kevin M. Lyons Funeral Service in Glenolden.