James Donaldson on Mental Health - How to Help Kids Deal With Embarrassment

Don't minimize their feelings, but do praise them for being resilient

Writer: Rae Jacobson, MS

Clinical Expert: Rachel Busman, PsyD, ABPP

What You'll Learn

- How can we help kids who feel embarrassed?
- What can parents do to model good coping skills?
- When should you be concerned about a child who feels embarrassed?
- Quick Read
- Full Article
- Model behavior
- Take your child’s embarrassment seriously
- But don’t overreact
- Praise positive skills
- Create perspective
- When to step in
- Embarrassment and social anxiety
- Life lessons

Back to Top

Downloadable Resources
- Helping Kids With Learning Disabilities Handle Embarrassment
- Supporting Self-Confidence in Kids With Learning Disabilities

Quick Read

For grown-ups, minor embarrassments are no big deal. But for kids, being embarrassed can be very upsetting. Helping kids build resilience and confidence will make sure they have tools to deal with embarrassment in a healthy way. 

Kids look to parents to see how to behave. When you feel embarrassed, set an example by responding calmly and keeping your cool. This doesn’t mean you should hide embarrassments. Instead, let kids see you handling embarrassing experiences in a reasonable way: “Whew! That was embarrassing! But it was kind of funny, too.” 

Embarrassment can be a powerful emotion for kids. Something that sounds small to you — like giving the wrong answer in class— may feel huge to your child. When kids are embarrassed it’s important not to dismiss their feelings, even if the situation that caused them sounds like no big deal.  

Instead, let them know you take their feelings seriously. Then, focus on moving on and modeling healthy coping skills. Offer perspective: “It might feel like everyone will remember this forever, but…” And praise resilience: “Sure, you made a mistake, but I loved how you just kept playing! That was amazing!” 

Embarrassing situations happen to everyone from time to time. But if a child regularly comes home from school upset, or has a major change in behavior or mood, there may be something more serious going on. Bullying could be a problem. Or if your child is so worried about being embarrassed that they avoid activities most kids enjoy, they could be struggling with social anxiety disorder, and may need help. 

For most adults minor embarrassments are just a part of life — annoying, but inevitable and hardly a big deal. But for many kids, embarrassing experiences can be very upsetting and, in some cases, may lead to serious issues like anxiety and avoidance.

We can’t protect our children from embarrassment, but we can help them build the resilience and confidence they need to deal with it in a healthy way.

Model behavior

Kids look to parents for cues on how to manage difficult emotions like embarrassment. “As parents we set the behavioral tone for our kids,“ says Rachel Busman, PsyD, a clinical psychologist, “So when we’re helping children learn healthy emotional habits, the first step is to consider how we handle similar situations in our own lives.”

Taking a look at how you deal with embarrassing experiences at home will help you set an example of healthy behavior for your child.

- Don’t obsess: If you tend to dwell on mistakes you’ve made (“I can’t believe I did that!” “I could have died of embarrassment!”), it’s more likely your child will do the same.
- Stay calm: If you lose your cool when an embarrassing situation happens to you, or react by becoming angry or upset, you’re sending a message to your child that it’s a big deal.
- No teasing: Kids accidentally do and say some very funny things, but it’s important not to mock mistakes or poke fun at embarrassing incidents. If small embarrassments are treated with ridicule, kids may start associating even minor missteps with feelings of shame and humiliation. Teasing — even if it seems gentle — can be very upsetting to kids, especially if they’re already feeling sensitive.

Take your child’s embarrassment seriously

There’s no yardstick for embarrassment. Something that sounds small to you — giving the wrong answer in class for example — may feel huge to your child.

If your child is embarrassed it’s important not to dismiss their feelings, even if the situation that caused them sounds like no big deal.

“We naturally want to downplay embarrassing experiences by saying things like ‘it’s not as bad as you think,’” says Dr. Busman. “But when kids are experiencing these big, really upsetting emotions that can feel like a brush-off.”

But don’t overreact

If your child comes home upset, what they don’t need is for you to get upset, too, or angry on their behalf. (“That sounds awful!” “Those kids should be ashamed of themselves for laughing!”) And don’t assume that they want or need you to do something about it. When a self-concious child worries that a parent will overreact or make an embarrassing situation worse, they’re likely to be reluctant to share their feelings.

“When a child is hurting, as parents we want to do all we can,” says Dr. Busman, “but if your kid is feeling embarrassed, heaping more attention on the situation can make it worse, not better.”

Praise positive skills

If your child shares an embarrassing situation with you, take care to validate their feelings, but don’t dwell on them or over comfort. Instead, praise positive coping skills. If they made a mistake during a piano recital, praise them for staying focused and finishing the piece. Reframing negative experiences will help your child identify healthy reactions and practice them, building what we call metacognitive skills. You could say: “I’m so sorry that happened today. I know it was upsetting but I am so proud of how you handled it. It takes a really brave person to keep playing when things are hard.”

Create perspective

If your child fell in gym class and other kids laughed, it may seem to them as though everyone saw, everyone laughed and no one will ever forget it — ever.

Of course you know that’s not true but kids, especially younger ones, often struggle to see beyond their own feelings, which can make embarrassing situations feel like front-page news. “Kids can be egocentric,” explains Dr. Busman, “so when something embarrassing happens to your child it can feel like everyone is thinking about it as much as they are, when in reality most kids will have moved on by the next day.”

Learning to put their feelings and experiences in context will help your child gain perspective and build resilience.

- Unpack: Help your child take a metacognitive approach to their feelings by asking open-ended questions. For example: Your child isn’t the only one who’s ever fallen down in gym class, so you could begin by asking how they felt when other kids did the same thing. Learning to put their own experiences in context can help your child start to see embarrassing situations from a better angle.
- Share: Sharing examples from your own life will help normalize embarrassment. “I dropped my handbag at the grocery store the other day. It practically exploded all over the floor. Everyone laughed, but then several people helped pick things up.”
- But don’t compare: Offering perspective is good but be careful to avoid comparing your experiences with your child’s. (“You think that’s bad, when your brother was your age…”) Your child may end up feeling like their experiences are unimportant — or not serious enough to warrant how upset they’re feeling — which can make them feel worse for not being tougher.
- Let your child take the lead: Sometimes questions are helpful, but there may be times when your child just doesn’t want to talk about it. “Letting kids take the lead is important,” says Dr. Busman. “If your child says, ‘I don’t want to talk about it’ or seems too upset, don’t push.” Embarrassment is a big feeling and sometimes kids just need space to cool down.

Helping your child gain perspective without minimizing their feelings will make it easier for them to move past negative experiences — and give them an important tool for building self-awareness in the future.

When to step in

Embarrassing situations happen to everyone from time to time, but if your child regularly comes home from school upset, or has a major change in behavior or mood, there may be something more serious going on.

- Bullying: Unfortunately, kids aren’t always kind. Most children will be made fun of at some point during their lives. Sporadic episodes of embarrassment are unpleasant — but not unusual. However, if your child regularly reports being teased or humiliated by their peers — especially kids who are bigger, older or more “popular” — there’s a chance they’re being bullied, and it’s time to step in.
- Behavioral changes: Feeling a little down or anxious after an embarrassing incident is normal, but lingering behavioral changes — not sleeping, low appetite, excessive worrying — are not.
- Overreacting or obsessing: If your child’s reaction to something embarrassing seems out of proportion to the situation or they seem unable to move past it, they may need support.
- Avoidance: Most kids who’ve had an embarrassing experience feel reluctant about returning to the class or social group where the problem occurred for a little while, but persistent avoidance is cause for concern. Some signs to watch for include frequently being too sick to go to school or asking to go to the nurse during a particular class, making excuses to avoid seeing friends, cutting class, skipping extracurricular activities or refusing to attend school entirely.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Embarrassment and social anxiety

For some kids, fear of being embarrassed itself can become a serious issue. If a child seems to live in perpetual fear of embarrassment — even when there’s no obvious reason to worry — they may be experiencing social anxiety.

Social anxiety usually occurs in children who’ve reached adolescence, but it can develop earlier. A child with social anxiety panics at the thought of participating in day-to-day activities because they worry chronically about what other people will think of them, obsess on how they appears to others, or fear making a mistake.

These fears can be very debilitating. For kids who see potential for humiliation at every turn, even basic interactions can feel like a minefield, and social, school and personal interactions often suffer. Withdrawal is common, but kids with social anxiety are also prone to lashing out when the threat of embarrassment overwhelms them.

The good news is that kids who develop social anxiety respond well to cognitive behavioral therapy, and with help can return to their normal activities.

Life lessons

It’s natural to want to protect your child from experiences that are hurtful or upsetting, but in the end, the best way for your child to build coping skills is through experience — with a side of support.

“Being embarrassed is part of life,” says Dr. Busman. “It’s tempting to try to shield our kids from difficult things, but in reality learning how to deal with those experiences in a healthy way is a skill that will serve your child well as they grow up.”

https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-to-help-kids-deal-with-embarrassment-5/

Don't minimize their feelings, but do praise them for being resilient

Writer: Rae Jacobson, MS

Clinical Expert: Rachel Busman, PsyD, ABPP

What You'll Learn

- How can we help kids who feel embarrassed?

- What can parents do to model good coping skills?

- When should you be concerned about a child who feels embarrassed?

- Quick Read

- Full Article

- Model behavior

- Take your child’s embarrassment seriously

- But don’t overreact

- Praise positive skills

- Create perspective

- When to step in

- Embarrassment and social anxiety

- Life lessons

Back to Top

Downloadable Resources

- Helping Kids With Learning Disabilities Handle Embarrassment

- Supporting Self-Confidence in Kids With Learning Disabilities

Quick Read

For grown-ups, minor embarrassments are no big deal. But for kids, being embarrassed can be very upsetting. Helping kids build resilience and confidence will make sure they have tools to deal with embarrassment in a healthy way. 

Kids look to parents to see how to behave. When you feel embarrassed, set an example by responding calmly and keeping your cool. This doesn’t mean you should hide embarrassments. Instead, let kids see you handling embarrassing experiences in a reasonable way: “Whew! That was embarrassing! But it was kind of funny, too.” 

Embarrassment can be a powerful emotion for kids. Something that sounds small to you — like giving the wrong answer in class— may feel huge to your child. When kids are embarrassed it’s important not to dismiss their feelings, even if the situation that caused them sounds like no big deal.  

Instead, let them know you take their feelings seriously. Then, focus on moving on and modeling healthy coping skills. Offer perspective: “It might feel like everyone will remember this forever, but…” And praise resilience: “Sure, you made a mistake, but I loved how you just kept playing! That was amazing!” 

Embarrassing situations happen to everyone from time to time. But if a child regularly comes home from school upset, or has a major change in behavior or mood, there may be something more serious going on. Bullying could be a problem. Or if your child is so worried about being embarrassed that they avoid activities most kids enjoy, they could be struggling with social anxiety disorder, and may need help. 

For most adults minor embarrassments are just a part of life — annoying, but inevitable and hardly a big deal. But for many kids, embarrassing experiences can be very upsetting and, in some cases, may lead to serious issues like anxiety and avoidance.

We can’t protect our children from embarrassment, but we can help them build the resilience and confidence they need to deal with it in a healthy way.

Model behavior

Kids look to parents for cues on how to manage difficult emotions like embarrassment. “As parents we set the behavioral tone for our kids,“ says Rachel Busman, PsyD, a clinical psychologist, “So when we’re helping children learn healthy emotional habits, the first step is to consider how we handle similar situations in our own lives.”

Taking a look at how you deal with embarrassing experiences at home will help you set an example of healthy behavior for your child.

- Don’t obsess: If you tend to dwell on mistakes you’ve made (“I can’t believe I did that!” “I could have died of embarrassment!”), it’s more likely your child will do the same.

- Stay calm: If you lose your cool when an embarrassing situation happens to you, or react by becoming angry or upset, you’re sending a message to your child that it’s a big deal.

- No teasing: Kids accidentally do and say some very funny things, but it’s important not to mock mistakes or poke fun at embarrassing incidents. If small embarrassments are treated with ridicule, kids may start associating even minor missteps with feelings of shame and humiliation. Teasing — even if it seems gentle — can be very upsetting to kids, especially if they’re already feeling sensitive.

Take your child’s embarrassment seriously

There’s no yardstick for embarrassment. Something that sounds small to you — giving the wrong answer in class for example — may feel huge to your child.

If your child is embarrassed it’s important not to dismiss their feelings, even if the situation that caused them sounds like no big deal.

“We naturally want to downplay embarrassing experiences by saying things like ‘it’s not as bad as you think,’” says Dr. Busman. “But when kids are experiencing these big, really upsetting emotions that can feel like a brush-off.”

But don’t overreact

If your child comes home upset, what they don’t need is for you to get upset, too, or angry on their behalf. (“That sounds awful!” “Those kids should be ashamed of themselves for laughing!”) And don’t assume that they want or need you to do something about it. When a self-concious child worries that a parent will overreact or make an embarrassing situation worse, they’re likely to be reluctant to share their feelings.

“When a child is hurting, as parents we want to do all we can,” says Dr. Busman, “but if your kid is feeling embarrassed, heaping more attention on the situation can make it worse, not better.”

Praise positive skills

If your child shares an embarrassing situation with you, take care to validate their feelings, but don’t dwell on them or over comfort. Instead, praise positive coping skills. If they made a mistake during a piano recital, praise them for staying focused and finishing the piece. Reframing negative experiences will help your child identify healthy reactions and practice them, building what we call metacognitive skills. You could say: “I’m so sorry that happened today. I know it was upsetting but I am so proud of how you handled it. It takes a really brave person to keep playing when things are hard.”

Create perspective

If your child fell in gym class and other kids laughed, it may seem to them as though everyone saw, everyone laughed and no one will ever forget it — ever.

Of course you know that’s not true but kids, especially younger ones, often struggle to see beyond their own feelings, which can make embarrassing situations feel like front-page news. “Kids can be egocentric,” explains Dr. Busman, “so when something embarrassing happens to your child it can feel like everyone is thinking about it as much as they are, when in reality most kids will have moved on by the next day.”

Learning to put their feelings and experiences in context will help your child gain perspective and build resilience.

- Unpack: Help your child take a metacognitive approach to their feelings by asking open-ended questions. For example: Your child isn’t the only one who’s ever fallen down in gym class, so you could begin by asking how they felt when other kids did the same thing. Learning to put their own experiences in context can help your child start to see embarrassing situations from a better angle.

- Share: Sharing examples from your own life will help normalize embarrassment. “I dropped my handbag at the grocery store the other day. It practically exploded all over the floor. Everyone laughed, but then several people helped pick things up.”

- But don’t compare: Offering perspective is good but be careful to avoid comparing your experiences with your child’s. (“You think that’s bad, when your brother was your age…”) Your child may end up feeling like their experiences are unimportant — or not serious enough to warrant how upset they’re feeling — which can make them feel worse for not being tougher.

- Let your child take the lead: Sometimes questions are helpful, but there may be times when your child just doesn’t want to talk about it. “Letting kids take the lead is important,” says Dr. Busman. “If your child says, ‘I don’t want to talk about it’ or seems too upset, don’t push.” Embarrassment is a big feeling and sometimes kids just need space to cool down.

Helping your child gain perspective without minimizing their feelings will make it easier for them to move past negative experiences — and give them an important tool for building self-awareness in the future.

When to step in

Embarrassing situations happen to everyone from time to time, but if your child regularly comes home from school upset, or has a major change in behavior or mood, there may be something more serious going on.

- Bullying: Unfortunately, kids aren’t always kind. Most children will be made fun of at some point during their lives. Sporadic episodes of embarrassment are unpleasant — but not unusual. However, if your child regularly reports being teased or humiliated by their peers — especially kids who are bigger, older or more “popular” — there’s a chance they’re being bullied, and it’s time to step in.

- Behavioral changes: Feeling a little down or anxious after an embarrassing incident is normal, but lingering behavioral changes — not sleeping, low appetite, excessive worrying — are not.

- Overreacting or obsessing: If your child’s reaction to something embarrassing seems out of proportion to the situation or they seem unable to move past it, they may need support.

- Avoidance: Most kids who’ve had an embarrassing experience feel reluctant about returning to the class or social group where the problem occurred for a little while, but persistent avoidance is cause for concern. Some signs to watch for include frequently being too sick to go to school or asking to go to the nurse during a particular class, making excuses to avoid seeing friends, cutting class, skipping extracurricular activities or refusing to attend school entirely.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Embarrassment and social anxiety

For some kids, fear of being embarrassed itself can become a serious issue. If a child seems to live in perpetual fear of embarrassment — even when there’s no obvious reason to worry — they may be experiencing social anxiety.

Social anxiety usually occurs in children who’ve reached adolescence, but it can develop earlier. A child with social anxiety panics at the thought of participating in day-to-day activities because they worry chronically about what other people will think of them, obsess on how they appears to others, or fear making a mistake.

These fears can be very debilitating. For kids who see potential for humiliation at every turn, even basic interactions can feel like a minefield, and social, school and personal interactions often suffer. Withdrawal is common, but kids with social anxiety are also prone to lashing out when the threat of embarrassment overwhelms them.

The good news is that kids who develop social anxiety respond well to cognitive behavioral therapy, and with help can return to their normal activities.

Life lessons

It’s natural to want to protect your child from experiences that are hurtful or upsetting, but in the end, the best way for your child to build coping skills is through experience — with a side of support.

“Being embarrassed is part of life,” says Dr. Busman. “It’s tempting to try to shield our kids from difficult things, but in reality learning how to deal with those experiences in a healthy way is a skill that will serve your child well as they grow up.” https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-to-help-kids-deal-with-embarrassment-5/

James Donaldson on Mental Health - Having any 4 of these 10 warning signs may signal higher suicide risk, IMH study finds

These acute warning signs include substance abuse, purposelessness, anxiety and withdrawal, among others, and typically appear a week before a suicide attempt, the study found

Warning: This story contains references to suicide

SINGAPORE: Anger, purposelessness, recklessness and anxiety – if a person exhibits four or more “acute warning signs” such as these, they could be at risk of suicide, a new study by the Institute of Mental Health released on Wednesday (Sep 17) found.

These signs appear a week before the person attempts suicide, said the Ministry of Health-funded study touted to be the first of its kind in Singapore.

In comparison, individuals who are not at suicide risk would display only one of the 10 warning signs.

The 10 warning signs are based on a framework developed by the American Association of Suicidology to assess suicide risk.

Put together, the first letters of each warning sign form the mnemonic “Is Path Warm”: Ideation, substance abuse, purposelessness, anxiety, (feeling) trapped, hopelessness, withdrawal, anger, recklessness and mood changes.

The study is the first in Singapore to use the “psychological autopsy” method, in which researchers carry out a detailed retrospective examination of the life and state of mind of someone who had died from suicide.

This involves gathering information from people who knew them, such as family and friends, as well as from coroner’s reports.

In total, the study involved 73 cases of deaths from suicides as well as 73 control cases which do not involve suicide – with ages ranging from 11 to 76 years for the suicide cases and 10 to 76 for the control group.

Face-to-face interviews were carried out between May 2021 and February 2024.

“The aim is to get a clear and accurate picture of the individual’s circumstances, personality and health to better understand what could have led to their death and provide locally relevant insights,” IMH said.

Based on provisional data provided by the Samaritans of Singapore, there were 314 deaths by suicide in Singapore in 2024, a decline from 434 in 2023 and 476 in 2022.

The study is significant as much existing research on suicide comes from Western contexts.

IMH said while core risk factors that led to death by suicide may be similar to those in Western countries, the way people experience distress and seek help can differ across cultures and social contexts.

Apart from the warning signs, the study also looked into the factors in a person’s life that are associated with suicide.

For example, the study found that those who died from suicide faced challenges such as unemployment, were smoking and drinking, and had relationship problems.

Associate Professor Mythily Subramaniam, the assistant chairman of the medical board (research) at IMH who led the study, said: “Suicide is never the result of just one factor, but it is a perfect storm when the struggles converge and become too much.

“It is important to understand that these overwhelming moments can happen in anyone’s life,” he added.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

FACTORS ASSOCIATED WITH SUICIDE

By comparing between the suicide cases and those from the control group, the study’s researchers found statistically significant differences in lifestyle, personal relationships, socioeconomic and academic background, and mental and physical health factors.

For instance, more than half of those who died by suicide - 52.1 per cent - did not have an education qualification beyond a diploma from the Institute of Technical Education (ITE), compared to only 13.7 per cent of those not at risk.

They were also more likely to be unemployed in the year before they died, at 30.6 per cent of cases versus 5.5 per cent.

In addition, 38.5 per cent of those who died by suicide were known to have a change in the level of participation in religious activities over the year before death, compared to 18 per cent of the control group. This change includes both an increase or a decrease in level of participation.

In terms of lifestyle and relationships, the two groups also had significant differences, the study found.

Those who died by suicide were more likely to smoke, at 22.8 per cent compared to 11 per cent of the control group.

Almost 24 per cent of suicide cases were more likely to drink alcohol on a weekly basis compared to just 2.7 per cent of the control group.

IMH also highlighted that 70 per cent of suicide cases had hobbies, interests or participated in other activities, compared to 91.8 per cent of the control group.

Victims of suicide were also more likely to have experienced relationship difficulties, such as break-ups, threatened separations or instability in their significant relationships.

In addition, almost 12 per cent of those who died by suicide were reported to have uploaded posts on social media that seemed different than usual, compared to just 1.4 per cent in the control group. 

MENTAL HEALTH

The IMH study also affirmed past research that most, but not all, suicide cases are likely to have been diagnosed with mental health conditions.

Around 71 per cent of suicide cases were more likely to have been diagnosed with mental health conditions, compared to 13.9 per cent in the control group.

Major depressive disorder was the most common condition reported (40 per cent of cases), followed by schizophrenia and other psychotic disorders (17.1 per cent), and bipolar disorder (8.6 per cent).

Moderate to severe symptoms of depression were also more likely to be reported in those who died by suicide in the month preceding their demise - 54 per cent - compared to 8.2 per cent in the control group.

“These factors may reflect the severity of their mental health concerns,” IMH said.

Individuals who ended their lives were more likely to have reported poorer health compared to the previous year and experienced greater limitations in their daily functioning. They were also significantly more likely to have suffered from insomnia in the weeks leading up to their death.

Loved ones of those who died by suicide shared in the study that they often could not tell the difference between ordinary stress and serious mental health conditions like depression or psychosis.

As a result, treatment was often delayed, as families focused on easing the stress rather than recognising the need for the distressed individual to seek care or continue treatment.

Among those to have lost an older adult who had been treated for pain or other conditions, mental health problems of the older adult were often overlooked.

Professor Chong Siow Ann, IMH senior consultant of the research division and department of psychosis, said the warning signs such as withdrawal, hopelessness or mood changes can sometimes be subtle or mistaken for normal stress.

“It is not always straightforward but this means that there were opportunities to notice changes if people around them were aware of what to look for,” she said.

https://standingabovethecrowd.com/?p=15741

James Donaldson on Mental Health - Hoarding in Children

Kids who hoard get very emotionally attached to the things they save, often things others discard

https://www.youtube.com/watch?v=VNZZduHuKlM&t=1s

Writer: Caroline Miller

Clinical Expert: Jerry Bubrick, PhD

What You'll Learn

- What is hoarding?
- Why do some children hoard?
- How does therapy work for children who hoard?
- Quick Read
- Full Article
- Emotional attachment to objects
- ‘Here for now’ thinking
- Things have feelings, too
- Hoarding vs. collecting
- When does hoarding develop?
- Treatment for children who hoard
- No shaming or judgments

It’s normal for children to collect things or to have a messy room. But most kids don’t get upset if someone cleans up their stuff or makes them throw away things like old pizza boxes. If your child is extremely attached to objects that seem worthless and is very upset by even the idea of throwing them away, it may be a sign of hoarding.

Kids who hoard can develop extreme anxiety about losing their possessions. They may even throw tantrums or become violent if their parents try to clean up or get rid of things. One common reason that kids hoard is that they believe objects have feelings and will become lonely or sad if they get cleaned up or thrown away. Kids might also get attached to things that are connected to good memories, like a candy wrapper from a sleepover with friends. They feel that throwing away the object would mean throwing away the memory too.

Children who hoard often don’t understand why they’re doing it. Unlike kids who are proud to show off collections, kids who hoard are often ashamed of their possessions. Some children who develop hoarding, especially younger ones, also have OCD. It’s common for kids who hoard to have parents who also hoard.

Treatment for hoarding is usually a kind of therapy called exposure with response prevention. A therapist helps the child practice being away from their stuff little by little. Kids also learn to manage the anxiety that comes up during this process. Over time, kids learn to hang on to fewer things and throw things away without getting upset.

When we think of hoarders, we visualize an adult who has filled a home with so much stuff — a lot of it worthless — that it’s difficult, if not impossible, to walk, sit down, or, say, cook or eat dinner. But children can be hoarders, too. Sometimes as young as 6 or 7 years old. And while children who hoard don’t have the run of the house in which to stash their compulsively acquired things, as adults do, they fill up their rooms, until functioning is seriously impaired.

When a child is referred over concerns about hoarding, says Jerry Bubrick, PhD, a clinical psychologist who treated many kids with anxiety and OCD at the Child Mind Institute, he asks a series of questions.

- Can you see the floor in your room?
- Can you get clean clothes out of your closet, or is it so packed with stuff that you can’t get in there?
- Can you sleep in your bed, or is your bed temporary storage for everything?
- Can you do your homework at your desk, or is your desk covered with all kinds of stuff?

Emotional attachment to objects

But it isn’t just the volume of things stashed in a child’s room that differentiates one who’s hoarding from one who’s just disorganized or messy. It’s the way the child feels about the things they save, and their reaction when someone makes them throw things away. “Parents bring their kids in because the kids are crying when the garbage is collected,” Dr. Bubrick says.

Most kids who have a lot of stuff that’s not well organized don’t get upset if someone occasionally cleans up and puts things away. But children who hoard do. “A hoarder is going to believe, on some level, that either they were violated — how dare someone touch their stuff? — or they feel like they lost a sibling,” Dr. Bubrick explains. “A possession is like a loved one.”

Dr. Bubrick gives an example of a child who saves cardboard tubes from rolls of paper towels. “I’ve seen kids hoard 50 or 100 of those things under the couch. They might think they’re fun to play with or they might think they would use one later. Parents might say, ‘Well, listen. You can keep two, but we’re going to throw away 98.’ Most kids would be okay with that. The kids who are hoarders are going to be devastated.”

Kids who develop hoarding disorder may not only become severely anxious and distressed if things are taken away, they may have tantrums, crying and yelling, or they may even lash out in a panic, kicking or hitting parents or breaking things.

‘Here for now’ thinking

Kids who are hoarders tend to pick up and pocket things on the street — coins and sticks and acorns, etc. — that end up in piles at home. Dr. Bubrick describes the pattern of making piles as “here for now.”

The child, he explains, thinks, “I’m not sure what I’m going to do with it. I don’t know where it goes, so I’ll put it here for now.” Eventually, there may be hundreds of things in those piles.

Things have feelings, too

Part of the reason for keeping things “here for now” is that kids who are hoarders worry that if they put things in a drawer, they’ll forget about them. And that might upset the things, which have feelings, too. “If something is locked up in a drawer,” Dr. Bubrick adds, “it might get lonely and it might miss me or it might miss the other possessions.”

Some objects are cherished because they are reminders of a happy experience. “This rock reminds me of the time I went on the walk in the park with my dad,” Dr. Bubrick notes. Or “This pizza box reminds me of the sleepover I had with my friends. If I throw away the pizza box, it’s like throwing away the memory.”

Hoarding vs. collecting

Experts note that children begin collecting things at a young age — typically things like stuffed animals, stickers, toy cars, dolls, action figures, or cards — and collecting can play a positive role in development. It helps children learn to categorize, develop expertise in a subject, practice organizational skills, develop a sense of control and mastery, and build identity. Children who collect show pride in their collections. They like to share them with others, and talk about them.

Children who hoard, on the other hand, do not organize their possessions, and they often feel embarrassed or uncomfortable letting others see or touch their things. Since their ability to purchase things is limited by parental spending limits, they acquire large quantities of things that have no perceived value to other people or are considered waste. And kids who are hoarders often don’t understand why they’re doing it.

Hoarding is related to OCD but, unlike OCD, kids aren’t compelled to hoard in order to alleviate anxiety. “The feeling they have when they pick something up is a sense of desire. That thing looks cool. I really want it. Or I need it. This could help me in some way,” Dr. Bubrick explains. “The anxiety comes when they’re forced to get rid of it. Or when someone moves it around, or touches it without their permission.”

When does hoarding develop?

When hoarding, which is an anxiety disorder, appears in children as young as 6 or 7, it’s usually alongside OCD or some other anxiety disorder. Children who develop hoarding disorder alone are usually tweens or older.

It’s not unusual for kids who hoard to be children of hoarders. About 50 percent of individuals who hoard, according to the DSM-5, have a relative who also hoards. When treating children for hoarding, clinicians often find that even if parents may not be diagnosed, they meet the criteria for hoarding. “Sometimes,” says Dr. Bubrick, “we have to treat parents to help the kids.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Treatment for children who hoard

The first-choice treatment for hoarding, as with OCD, is a form of therapy called exposure with response prevention, orERP. Children bring in things they have been saving (or have collected in their pockets on the way to therapy) and rate them, on a scale from zero to 10, by how much they feel they need them. Then, beginning with the least cherished, they work on letting them go.

In the beginning, Dr. Bubrick suggests that he hold onto the chosen items in his office, and the child tries living without them for a week to see how they will feel. “Most kids, in the beginning, will say, ‘That’s going to be too hard! I can’t do it! No way!’ Then, they do it and it’s hard for a day or two, and then they realize they can do it.”

These exposures help weaken the child’s belief that they can’t live without these things. A reward system gives kids points towards something valuable to them — including an activity they particularly enjoy — if they’re able to discard a certain number of things a day.

The goal is to slow down the acquisition and help kids to understand that an object could be attractive or possibly valuable, but still not something they have to own. “That’s the difference between need and want,” Dr. Bubrick notes. “With hoarders, we have to add on ‘Do I have room for it?’ Sometimes we’ll make deals with kids that if you really believe that you want this thing and/or that you need it, then you have to make room for it by getting rid of something else.”

No shaming or judgments

One important aspect of treatment is that, despite what you see on misleading hoarding shows on television, therapists don’t judge the value (or lack of same) of what patients collect. There is already a lot of shame in hoarding.

“We would never say, ‘What are you holding onto this for? This is ridiculous. Just throw this away,’ ” Dr. Bubrick notes, “because the patients already know that what they believe about their possessions is not what other people believe.” Shaming them further is not going to help.

The end goal of therapy is for the need to hoard to diminish, and for the kids to develop flexibility, to be able to throw things away, limit how much new stuff they acquire, and keep their rooms livable.

But it helps if parents are flexible too, Dr. Bubrick adds, “to give kids some latitude, short of being cluttered and dangerous. After all, we’re not looking to have kids be living in museums.”

Frequently Asked Questions

What does hoarding look like in children?

Hoarding in children can look like extreme anxiety about losing their possessions. They may even throw tantrums or become violent if their parents try to clean up or get rid of things. It’s common for kids who hoard to have parents who also hoard.

Why do children hoard?

What is the therapy for hoarding in children?

https://standingabovethecrowd.com/james-donaldson-on-mental-health-hoarding-in-children/

Kids who hoard get very emotionally attached to the things they save, often things others discard

https://www.youtube.com/watch?v=VNZZduHuKlM&t=1s

Writer: Caroline Miller

Clinical Expert: Jerry Bubrick, PhD

What You'll Learn

- What is hoarding?

- Why do some children hoard?

- How does therapy work for children who hoard?

- Quick Read

- Full Article

- Emotional attachment to objects

- ‘Here for now’ thinking

- Things have feelings, too

- Hoarding vs. collecting

- When does hoarding develop?

- Treatment for children who hoard

- No shaming or judgments

It’s normal for children to collect things or to have a messy room. But most kids don’t get upset if someone cleans up their stuff or makes them throw away things like old pizza boxes. If your child is extremely attached to objects that seem worthless and is very upset by even the idea of throwing them away, it may be a sign of hoarding.

Kids who hoard can develop extreme anxiety about losing their possessions. They may even throw tantrums or become violent if their parents try to clean up or get rid of things. One common reason that kids hoard is that they believe objects have feelings and will become lonely or sad if they get cleaned up or thrown away. Kids might also get attached to things that are connected to good memories, like a candy wrapper from a sleepover with friends. They feel that throwing away the object would mean throwing away the memory too.

Children who hoard often don’t understand why they’re doing it. Unlike kids who are proud to show off collections, kids who hoard are often ashamed of their possessions. Some children who develop hoarding, especially younger ones, also have OCD. It’s common for kids who hoard to have parents who also hoard.

Treatment for hoarding is usually a kind of therapy called exposure with response prevention. A therapist helps the child practice being away from their stuff little by little. Kids also learn to manage the anxiety that comes up during this process. Over time, kids learn to hang on to fewer things and throw things away without getting upset.

When we think of hoarders, we visualize an adult who has filled a home with so much stuff — a lot of it worthless — that it’s difficult, if not impossible, to walk, sit down, or, say, cook or eat dinner. But children can be hoarders, too. Sometimes as young as 6 or 7 years old. And while children who hoard don’t have the run of the house in which to stash their compulsively acquired things, as adults do, they fill up their rooms, until functioning is seriously impaired.

When a child is referred over concerns about hoarding, says Jerry Bubrick, PhD, a clinical psychologist who treated many kids with anxiety and OCD at the Child Mind Institute, he asks a series of questions.

- Can you see the floor in your room?

- Can you get clean clothes out of your closet, or is it so packed with stuff that you can’t get in there?

- Can you sleep in your bed, or is your bed temporary storage for everything?

- Can you do your homework at your desk, or is your desk covered with all kinds of stuff?

Emotional attachment to objects

But it isn’t just the volume of things stashed in a child’s room that differentiates one who’s hoarding from one who’s just disorganized or messy. It’s the way the child feels about the things they save, and their reaction when someone makes them throw things away. “Parents bring their kids in because the kids are crying when the garbage is collected,” Dr. Bubrick says.

Most kids who have a lot of stuff that’s not well organized don’t get upset if someone occasionally cleans up and puts things away. But children who hoard do. “A hoarder is going to believe, on some level, that either they were violated — how dare someone touch their stuff? — or they feel like they lost a sibling,” Dr. Bubrick explains. “A possession is like a loved one.”

Dr. Bubrick gives an example of a child who saves cardboard tubes from rolls of paper towels. “I’ve seen kids hoard 50 or 100 of those things under the couch. They might think they’re fun to play with or they might think they would use one later. Parents might say, ‘Well, listen. You can keep two, but we’re going to throw away 98.’ Most kids would be okay with that. The kids who are hoarders are going to be devastated.”

Kids who develop hoarding disorder may not only become severely anxious and distressed if things are taken away, they may have tantrums, crying and yelling, or they may even lash out in a panic, kicking or hitting parents or breaking things.

‘Here for now’ thinking

Kids who are hoarders tend to pick up and pocket things on the street — coins and sticks and acorns, etc. — that end up in piles at home. Dr. Bubrick describes the pattern of making piles as “here for now.”

The child, he explains, thinks, “I’m not sure what I’m going to do with it. I don’t know where it goes, so I’ll put it here for now.” Eventually, there may be hundreds of things in those piles.

Things have feelings, too

Part of the reason for keeping things “here for now” is that kids who are hoarders worry that if they put things in a drawer, they’ll forget about them. And that might upset the things, which have feelings, too. “If something is locked up in a drawer,” Dr. Bubrick adds, “it might get lonely and it might miss me or it might miss the other possessions.”

Some objects are cherished because they are reminders of a happy experience. “This rock reminds me of the time I went on the walk in the park with my dad,” Dr. Bubrick notes. Or “This pizza box reminds me of the sleepover I had with my friends. If I throw away the pizza box, it’s like throwing away the memory.”

Hoarding vs. collecting

Experts note that children begin collecting things at a young age — typically things like stuffed animals, stickers, toy cars, dolls, action figures, or cards — and collecting can play a positive role in development. It helps children learn to categorize, develop expertise in a subject, practice organizational skills, develop a sense of control and mastery, and build identity. Children who collect show pride in their collections. They like to share them with others, and talk about them.

Children who hoard, on the other hand, do not organize their possessions, and they often feel embarrassed or uncomfortable letting others see or touch their things. Since their ability to purchase things is limited by parental spending limits, they acquire large quantities of things that have no perceived value to other people or are considered waste. And kids who are hoarders often don’t understand why they’re doing it.

Hoarding is related to OCD but, unlike OCD, kids aren’t compelled to hoard in order to alleviate anxiety. “The feeling they have when they pick something up is a sense of desire. That thing looks cool. I really want it. Or I need it. This could help me in some way,” Dr. Bubrick explains. “The anxiety comes when they’re forced to get rid of it. Or when someone moves it around, or touches it without their permission.”

When does hoarding develop?

When hoarding, which is an anxiety disorder, appears in children as young as 6 or 7, it’s usually alongside OCD or some other anxiety disorder. Children who develop hoarding disorder alone are usually tweens or older.

It’s not unusual for kids who hoard to be children of hoarders. About 50 percent of individuals who hoard, according to the DSM-5, have a relative who also hoards. When treating children for hoarding, clinicians often find that even if parents may not be diagnosed, they meet the criteria for hoarding. “Sometimes,” says Dr. Bubrick, “we have to treat parents to help the kids.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Treatment for children who hoard

The first-choice treatment for hoarding, as with OCD, is a form of therapy called exposure with response prevention, orERP. Children bring in things they have been saving (or have collected in their pockets on the way to therapy) and rate them, on a scale from zero to 10, by how much they feel they need them. Then, beginning with the least cherished, they work on letting them go.

In the beginning, Dr. Bubrick suggests that he hold onto the chosen items in his office, and the child tries living without them for a week to see how they will feel. “Most kids, in the beginning, will say, ‘That’s going to be too hard! I can’t do it! No way!’ Then, they do it and it’s hard for a day or two, and then they realize they can do it.”

These exposures help weaken the child’s belief that they can’t live without these things. A reward system gives kids points towards something valuable to them — including an activity they particularly enjoy — if they’re able to discard a certain number of things a day.

The goal is to slow down the acquisition and help kids to understand that an object could be attractive or possibly valuable, but still not something they have to own. “That’s the difference between need and want,” Dr. Bubrick notes. “With hoarders, we have to add on ‘Do I have room for it?’ Sometimes we’ll make deals with kids that if you really believe that you want this thing and/or that you need it, then you have to make room for it by getting rid of something else.”

No shaming or judgments

One important aspect of treatment is that, despite what you see on misleading hoarding shows on television, therapists don’t judge the value (or lack of same) of what patients collect. There is already a lot of shame in hoarding.

“We would never say, ‘What are you holding onto this for? This is ridiculous. Just throw this away,’ ” Dr. Bubrick notes, “because the patients already know that what they believe about their possessions is not what other people believe.” Shaming them further is not going to help.

The end goal of therapy is for the need to hoard to diminish, and for the kids to develop flexibility, to be able to throw things away, limit how much new stuff they acquire, and keep their rooms livable.

But it helps if parents are flexible too, Dr. Bubrick adds, “to give kids some latitude, short of being cluttered and dangerous. After all, we’re not looking to have kids be living in museums.”

Frequently Asked Questions

What does hoarding look like in children?

Hoarding in children can look like extreme anxiety about losing their possessions. They may even throw tantrums or become violent if their parents try to clean up or get rid of things. It’s common for kids who hoard to have parents who also hoard.

Why do children hoard?

What is the therapy for hoarding in children? https://standingabovethecrowd.com/james-donaldson-on-mental-health-hoarding-in-children/

These acute warning signs include substance abuse, purposelessness, anxiety and withdrawal, among others, and typically appear a week before a suicide attempt, the study found

Warning: This story contains references to suicideSINGAPORE: Anger, purposelessness, recklessness and anxiety – if a person exhibits four or more “acute warning signs” such as these, they could be at risk of suicide, a new study by the Institute of Mental Health released on Wednesday (Sep 17) found.

These signs appear a week before the person attempts suicide, said the Ministry of Health-funded study touted to be the first of its kind in Singapore.

In comparison, individuals who are not at suicide risk would display only one of the 10 warning signs.

The 10 warning signs are based on a framework developed by the American Association of Suicidology to assess suicide risk.

Put together, the first letters of each warning sign form the mnemonic “Is Path Warm”: Ideation, substance abuse, purposelessness, anxiety, (feeling) trapped, hopelessness, withdrawal, anger, recklessness and mood changes.

The study is the first in Singapore to use the “psychological autopsy” method, in which researchers carry out a detailed retrospective examination of the life and state of mind of someone who had died from suicide.

This involves gathering information from people who knew them, such as family and friends, as well as from coroner’s reports.

In total, the study involved 73 cases of deaths from suicides as well as 73 control cases which do not involve suicide – with ages ranging from 11 to 76 years for the suicide cases and 10 to 76 for the control group.

Face-to-face interviews were carried out between May 2021 and February 2024.

“The aim is to get a clear and accurate picture of the individual’s circumstances, personality and health to better understand what could have led to their death and provide locally relevant insights,” IMH said.

Based on provisional data provided by the Samaritans of Singapore, there were 314 deaths by suicide in Singapore in 2024, a decline from 434 in 2023 and 476 in 2022.

The study is significant as much existing research on suicide comes from Western contexts.

IMH said while core risk factors that led to death by suicide may be similar to those in Western countries, the way people experience distress and seek help can differ across cultures and social contexts.

Apart from the warning signs, the study also looked into the factors in a person’s life that are associated with suicide.

For example, the study found that those who died from suicide faced challenges such as unemployment, were smoking and drinking, and had relationship problems.

Associate Professor Mythily Subramaniam, the assistant chairman of the medical board (research) at IMH who led the study, said: “Suicide is never the result of just one factor, but it is a perfect storm when the struggles converge and become too much.

“It is important to understand that these overwhelming moments can happen in anyone’s life,” he added.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

FACTORS ASSOCIATED WITH SUICIDE

By comparing between the suicide cases and those from the control group, the study’s researchers found statistically significant differences in lifestyle, personal relationships, socioeconomic and academic background, and mental and physical health factors.

For instance, more than half of those who died by suicide - 52.1 per cent - did not have an education qualification beyond a diploma from the Institute of Technical Education (ITE), compared to only 13.7 per cent of those not at risk.

They were also more likely to be unemployed in the year before they died, at 30.6 per cent of cases versus 5.5 per cent.

In addition, 38.5 per cent of those who died by suicide were known to have a change in the level of participation in religious activities over the year before death, compared to 18 per cent of the control group. This change includes both an increase or a decrease in level of participation.

In terms of lifestyle and relationships, the two groups also had significant differences, the study found.

Those who died by suicide were more likely to smoke, at 22.8 per cent compared to 11 per cent of the control group.

Almost 24 per cent of suicide cases were more likely to drink alcohol on a weekly basis compared to just 2.7 per cent of the control group.

IMH also highlighted that 70 per cent of suicide cases had hobbies, interests or participated in other activities, compared to 91.8 per cent of the control group.

Victims of suicide were also more likely to have experienced relationship difficulties, such as break-ups, threatened separations or instability in their significant relationships.

In addition, almost 12 per cent of those who died by suicide were reported to have uploaded posts on social media that seemed different than usual, compared to just 1.4 per cent in the control group. 

MENTAL HEALTH

The IMH study also affirmed past research that most, but not all, suicide cases are likely to have been diagnosed with mental health conditions.

Around 71 per cent of suicide cases were more likely to have been diagnosed with mental health conditions, compared to 13.9 per cent in the control group.

Major depressive disorder was the most common condition reported (40 per cent of cases), followed by schizophrenia and other psychotic disorders (17.1 per cent), and bipolar disorder (8.6 per cent).

Moderate to severe symptoms of depression were also more likely to be reported in those who died by suicide in the month preceding their demise - 54 per cent - compared to 8.2 per cent in the control group.

“These factors may reflect the severity of their mental health concerns,” IMH said.

Individuals who ended their lives were more likely to have reported poorer health compared to the previous year and experienced greater limitations in their daily functioning. They were also significantly more likely to have suffered from insomnia in the weeks leading up to their death.

Loved ones of those who died by suicide shared in the study that they often could not tell the difference between ordinary stress and serious mental health conditions like depression or psychosis.

As a result, treatment was often delayed, as families focused on easing the stress rather than recognising the need for the distressed individual to seek care or continue treatment.

Among those to have lost an older adult who had been treated for pain or other conditions, mental health problems of the older adult were often overlooked.

Professor Chong Siow Ann, IMH senior consultant of the research division and department of psychosis, said the warning signs such as withdrawal, hopelessness or mood changes can sometimes be subtle or mistaken for normal stress.

“It is not always straightforward but this means that there were opportunities to notice changes if people around them were aware of what to look for,” she said. https://standingabovethecrowd.com/james-donaldson-on-mental-health-having-any-4-of-these-10-warning-signs-may-signal-higher-suicide-risk-imh-study-finds/

These acute warning signs include substance abuse, purposelessness, anxiety and withdrawal, among others, and typically appear a week before a suicide attempt, the study found

Warning: This story contains references to suicideSINGAPORE: Anger, purposelessness, recklessness and anxiety – if a person exhibits four or more “acute warning signs” such as these, they could be at risk of suicide, a new study by the Institute of Mental Health released on Wednesday (Sep 17) found.

These signs appear a week before the person attempts suicide, said the Ministry of Health-funded study touted to be the first of its kind in Singapore.

In comparison, individuals who are not at suicide risk would display only one of the 10 warning signs.

The 10 warning signs are based on a framework developed by the American Association of Suicidology to assess suicide risk.

Put together, the first letters of each warning sign form the mnemonic “Is Path Warm”: Ideation, substance abuse, purposelessness, anxiety, (feeling) trapped, hopelessness, withdrawal, anger, recklessness and mood changes.

The study is the first in Singapore to use the “psychological autopsy” method, in which researchers carry out a detailed retrospective examination of the life and state of mind of someone who had died from suicide.

This involves gathering information from people who knew them, such as family and friends, as well as from coroner’s reports.

In total, the study involved 73 cases of deaths from suicides as well as 73 control cases which do not involve suicide – with ages ranging from 11 to 76 years for the suicide cases and 10 to 76 for the control group.

Face-to-face interviews were carried out between May 2021 and February 2024.

“The aim is to get a clear and accurate picture of the individual’s circumstances, personality and health to better understand what could have led to their death and provide locally relevant insights,” IMH said.

Based on provisional data provided by the Samaritans of Singapore, there were 314 deaths by suicide in Singapore in 2024, a decline from 434 in 2023 and 476 in 2022.

The study is significant as much existing research on suicide comes from Western contexts.

IMH said while core risk factors that led to death by suicide may be similar to those in Western countries, the way people experience distress and seek help can differ across cultures and social contexts.

Apart from the warning signs, the study also looked into the factors in a person’s life that are associated with suicide.

For example, the study found that those who died from suicide faced challenges such as unemployment, were smoking and drinking, and had relationship problems.

Associate Professor Mythily Subramaniam, the assistant chairman of the medical board (research) at IMH who led the study, said: “Suicide is never the result of just one factor, but it is a perfect storm when the struggles converge and become too much.

“It is important to understand that these overwhelming moments can happen in anyone’s life,” he added.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

FACTORS ASSOCIATED WITH SUICIDE

By comparing between the suicide cases and those from the control group, the study’s researchers found statistically significant differences in lifestyle, personal relationships, socioeconomic and academic background, and mental and physical health factors.

For instance, more than half of those who died by suicide - 52.1 per cent - did not have an education qualification beyond a diploma from the Institute of Technical Education (ITE), compared to only 13.7 per cent of those not at risk.

They were also more likely to be unemployed in the year before they died, at 30.6 per cent of cases versus 5.5 per cent.

In addition, 38.5 per cent of those who died by suicide were known to have a change in the level of participation in religious activities over the year before death, compared to 18 per cent of the control group. This change includes both an increase or a decrease in level of participation.

In terms of lifestyle and relationships, the two groups also had significant differences, the study found.

Those who died by suicide were more likely to smoke, at 22.8 per cent compared to 11 per cent of the control group.

Almost 24 per cent of suicide cases were more likely to drink alcohol on a weekly basis compared to just 2.7 per cent of the control group.

IMH also highlighted that 70 per cent of suicide cases had hobbies, interests or participated in other activities, compared to 91.8 per cent of the control group.

Victims of suicide were also more likely to have experienced relationship difficulties, such as break-ups, threatened separations or instability in their significant relationships.

In addition, almost 12 per cent of those who died by suicide were reported to have uploaded posts on social media that seemed different than usual, compared to just 1.4 per cent in the control group. 

MENTAL HEALTH

The IMH study also affirmed past research that most, but not all, suicide cases are likely to have been diagnosed with mental health conditions.

Around 71 per cent of suicide cases were more likely to have been diagnosed with mental health conditions, compared to 13.9 per cent in the control group.

Major depressive disorder was the most common condition reported (40 per cent of cases), followed by schizophrenia and other psychotic disorders (17.1 per cent), and bipolar disorder (8.6 per cent).

Moderate to severe symptoms of depression were also more likely to be reported in those who died by suicide in the month preceding their demise - 54 per cent - compared to 8.2 per cent in the control group.

“These factors may reflect the severity of their mental health concerns,” IMH said.

Individuals who ended their lives were more likely to have reported poorer health compared to the previous year and experienced greater limitations in their daily functioning. They were also significantly more likely to have suffered from insomnia in the weeks leading up to their death.

Loved ones of those who died by suicide shared in the study that they often could not tell the difference between ordinary stress and serious mental health conditions like depression or psychosis.

As a result, treatment was often delayed, as families focused on easing the stress rather than recognising the need for the distressed individual to seek care or continue treatment.

Among those to have lost an older adult who had been treated for pain or other conditions, mental health problems of the older adult were often overlooked.

Professor Chong Siow Ann, IMH senior consultant of the research division and department of psychosis, said the warning signs such as withdrawal, hopelessness or mood changes can sometimes be subtle or mistaken for normal stress.

“It is not always straightforward but this means that there were opportunities to notice changes if people around them were aware of what to look for,” she said. https://standingabovethecrowd.com/?p=15741