S-1991-01-1991_OVE
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L’ASSOCIAnON MEDICALE MONDIALE, INC LA ASOCIACION MEDICA MUNDIAL. INC
THE WORLD MEDICAL ASSOCIATION. INC.
P.o. Box 63 – 28, Avenue des Alpes
01212 FERNEY·VOLTAIRE Cedel(, France
Telex: 385755F WMASFVF
Cable Address: WOMEDAS. Ferney-Voltaire
Telephone: SO 40 75 75
. Telefax: 5040 59 37
November 1991
WORLD MEDICAL ASSOCIATION STATEMBWr
OD
ADOLESCENT SUICIDE
10.23
Original: English
. ~.
Adopted by the 43rd World Medical Assembly,
Malta, November 1991
The past several decades have witnessed a dramatic change in causes
of adolescent mortality. Fifty years ago adolescents mostly died
of natural causes, whereas they now die from more preventable causes.
Part of this change has been a worldwide rise in adolescent suicide
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rates in both developed and developing countries. Suicides are probably
under reported due to cultural and religious stigma attached to self-
destruction and to an unwillingness to recognize certain tr.aumas,
such as some automobile accidents, as self-inflicted.
Adolescent suicide is a tragedy that effects not only the individual,
but also the family, peers, and larger community in which the
adolescent lived. Suicide is often experienced as a personal failure
by parents, friends, and physicians who blame themselves for not
“det ec t i ng warning signs. It is also viewed as a failure by the
community by serving as a ,vi vi d reminder that modern society often
does not provide a nurturing, supportive, and healty environment
in which children can grow and develop.
Factors contributing to adolescent suicide are varied and include:
depression, emotional isolation, loss of self-esteem, excessive
emotional stress, mental disorders, romantic fantasies, thrillseeking,
drug and alcohol abuse, and the availability of firearms and other
agents of self-destruction. Most often suicide is the result of several
factors acting together, rather that anyone isolated factor. The
lack of a consistent personal profile makes it difficult to identify
those adolescents at risks- for suicide.
The health care of adolescents is best achieved when physicians provide
comprehensive services, including both medical and psychosocial
evaluation and treatment. Continuous, comprehensive care provides
the physician the opportunity to obtain the information necessary
to detect adolescents at risk for suicide or other self-destructive
behavior. This service model also helps to build a socially supportive
patient-physician relationship that may moderate adverse influences
adolescents experience in their environment.
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– 2- – 10.23
The World Medical Association recognizes the complex nature of
adolescent biopsychosocial development, the changing social world
faced by adolescents, and the introduction of new, more lethal agents
of self-destruction. In response to these concerns, the World Medical
Association recommends that national medical associations adopt the
following guidelines for physicians.
1. All physicians should receive, during medical school and residency
training, education in adolescent biopsychosocial development.
2. Physicians should be trained to identify early signs and symptoms
of physical, emotional, and social distress of adolescent patients.
3. Physicians should be taught to assess suicidal risk of their
adolescent patients.
4.
5.
6.
Physicians should be taught the treatment and referral options
appropriate for all levels of self-destructive behaviors of their
adolescent patients.
When caring for adolescents with serious trauma, physicians Sh!ld
evaluate the possibility that the injuries might have been self-
inflicted.
Health care systems should facilitate the establishment of mental
health consultation services aimed at preventing suicide, and
cover the socio-medical care given to patients who have attempted
to commit suicide.
7. Epidemiological studies on suicide,
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of prevention, should be developed.
its risk factors and methods
~~s r~sx ractors and methods
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