Suicide is so muy caliente now

Crying Out For Help
Suicide Attempts Reveal Strains on Young Latinas
By Laura Sessions SteppWashington Post Staff Writer
Tuesday, January 22, 2008; HE01

The second time Michelle, 16, swallowed sleeping pills, she collapsed on the living room floor.
It was late at night, and her mom, Maribel, jumped up from her chair, managed to pick up her skinny, 5-foot-10-inch eldest daughter, slapped her a couple of times hoping to bring her back to consciousness, and let go. Michelle fell down again and her eyes rolled back.

Maribel, who's from Puerto Rico, says she thought Michelle was drunk. She grabbed a blanket and a pillow and lay down next to Michelle, thinking her daughter would eventually wake up.
A few hours later, the sun rose over their small home in a working-class section of New York City and, unable to rouse Michelle, Maribel yelled at someone in the house to call 911.
An ambulance arrived along with a couple of police officers, one of whom suggested Michelle was faking unconsciousness. "You're daughter's probably just joking," he told her.

It was no joke. Michelle had swallowed an entire bottle of Ambien and didn't wake until she had been checked into a nearby hospital in the Bronx. She spent two days there. She then was transferred to a psychiatric unit inManhattan -- one young Latina among approximately 2 million in the United States who have attempted suicide.

Latinas ages 12 to 17 are the largest minority group of girls in the country, and growing. They are more likely to try to take their lives than any other racial or ethnic group their age. Twenty-five percent say they've thought about suicide, according to the Centers for Disease Control and Prevention, and about 15 percent attempt it, compared with approximately 10 percent of white and black teen girls. Other studies put the proportion of attempters at 20 percent -- slightly less than the fraction who smoke cigarettes.

In most cases, a girl swallows pills at home, according to Luis Zayas, a psychologist and professor of social work at Washington University in St. Louis. Zayas is in the middle of a five-year study of more than 150 young Latina girls who have attempted suicide. He says cutting is also finding a following among Latinas.

The physical pain of cutting helps to mask their emotional pain, says Carolina Hausman, a social worker who assists Zayas. "These adolescents have intense emotions and no tools to process them," she adds. "Their body has to be calmed down somehow. They talk about seeing blood go down their wrist as a release."

Suicide attempts can spread like a virus, from girlfriend to girlfriend. Michelle -- whose last name, like some others in this article, has been withheld to protect her privacy -- says she knew of two girls who had made attempts before she did. A friend of one girl Hausman works with not only told the girl how to cut herself but advised her to minimize the pain by putting Vaselineon the area.

Zayas and other experts suggest that suicide attempts like these are more a cry for help than evidence of a will to die. Were these girls living in the countries they or their parents were born in -- where they might enjoy strong ties to relatives, communities and familiar customs -- there's a good chance they wouldn't feel a need to act out, Zayas says. But here they struggle with feelings of powerlessness and frustration, torn between an American popular culture that encourages them to be sexy and assertive, and family expectations that they be modest and submissive.

Add to that the isolation they may feel in school and you get some pretty depressed teenagers, Zayas says. They rarely seek help partly because they and their parents are suspicious of mental health services and believe in keeping family troubles in the family.

"Crossing the border," Zayas says, "can be hazardous to Latinas' health. Until we understand the cultural conflict, we will not be able to prevent this."
* * *
Jocelyn Garay's parents, who fled the war in El Salvador in the early 1980s, always demanded a lot of their bubbly, dark-haired daughter: that she excel in school, help out with housework, be attentive to her younger sister and attend church. Her father, who, true to Hispanic custom, considered himself the boss of the family, had a hard time understanding why she wanted to do anything else. He considered some common teen social activities to be unnecessary, even dangerous. She says he forbade her from going to sleepovers at her friends' houses until she was 18. He said no when she asked to try out for the cheerleading team. He opposed dance lessons and put her in taekwondo instead, wanting her to learn to defend herself in what seemed to him (though not to his daughter, who was born here) a strange land.

The high school senior in Northern Virginia says has never tried to kill herself. But she has thought about it.

Washington psychologist Lillian Comas-Diaz, who counsels immigrants, says parents often don't understand that for many adolescents here, social success inspires motivation and academic success.

What parents do know is that by moving to the United States they left behind the relatives, friends and neighbors who would have watched out for their daughter. They may be more rigid than they would have been back home -- and meanwhile their daughter is hearing from her non-Latino friends, "Think about yourself and what you want. Forget your parents."'

The daughter, then, tries to be dutiful at home and to fit in at school, what Comas-Diaz calls being "of the divided heart."

The phrase describes Jocelyn in middle school and early high school. She spent much of that time being angry both at her father for having what she considered unrealistically high academic expectations and at herself for failing to meet them.

She joined a Hispanic gang in seventh grade and alienated her white friends. In the spring of ninth grade, her father finally let go of his opposition to cheerleading and she made the team, only to be chastised by her Hispanic friends as being "whitewashed. "

"I don't want to live anymore," she remembers telling her younger sister. "If I'm not comfortable at home or school, what's the point?"

"Don't do it," she recalls her sister saying. "Please, don't leave me alone."

Jocelyn never acted on her thoughts. Her mother has an intuitive sense of the pull between family and classmates, Jocelyn says, and helped her navigate her father's demands. Last year, Jocelyn joined a Girl Scout troop, where she found encouraging adults and new, upbeat friends. She now considers her father her biggest champion and her mom her closest friend.
* * *
Hispanics have the highest unmarried birth rate in the country, according to the CDC, and experts say many youths who have attempted suicide have witnessed a parade of boyfriends move in and out of their homes. Abuse is not infrequent and can contribute to feelings of worthlessness, as Yadasmarie knows.

Yadasmarie, 17, is a blond, blue-eyed Puerto Rican living in New York . She has never met her father, who she says is in prison, and rarely sees her mother anymore. In her early years, she lived with her mother, her mother's children by another man and her mother's boyfriend. Her mother and the boyfriend fought regularly, she says. The boyfriend would occasionally turn on Yadasmarie; once, when he caught her biting her nails, he punished her by putting her hand on the hot burner of the kitchen stove.

She got along well with her mom's next boyfriend, whom she called "Dad," and when Mom decided to leave that man a year ago, Yadasmarie insisted on staying with him. The man's father was bothered that Yadasmarie was living with his unmarried son, though. "It looks bad," he told Yadasmarie's mother, who then insisted that she live with this "grandfather" and his wife. "Dad" was told not to contact her.

A year ago, Yadasmarie cut her right arm with a razor blade. She is now in therapy and living with the "grandparents. " She rarely sees her mother and wishes she could move back with her "dad."

"I'm basically by myself right now," she says.
* * *
A Latina 's relationship with her mother is the single biggest factor in whether that girl copes well with stress, according to a study published by Fordham University 's Graduate School of Social Service. "It's not just being loved, but knowing they're loved," says Edgardo Menvielle, a psychiatrist at Washington 's Children's Hospital who also works at the Cliniqua de Pueblo in Adams Morgan.

Zayas can spot the difference quickly by listening to a girl talk. "It's the difference between 'My mother doesn't understand' and 'My mother is old-fashioned but she listens.' "

Some Latina mothers -- exhausted by fighting with boyfriends, raising children and working several jobs, or burdened by their own emotional problems -- have trouble showing mother love. Paula, a petite high school senior with curly black hair and a big smile, says her mother used to be that way.

The two of them immigrated to New York from Ecuador four years ago, in part to escape Paula's violent father. Paula's relationship with her mother was strained after their arrival, and she believed her aunt, whose home they moved into, resented her presence.

Paula knew no English as she started high school. At home, she was expected to keep her aunt's house clean, wash the dishes and do the laundry. Overwhelmed early one evening that first year, she sought out a bottle of high-dose Motrin, a painkiller, and took one pill. This past September, it was two pills. She was looking at the bottle, wondering whether to take more, when a good friend called and she told him what she was doing. The friend came over, took her to the emergency room and stayed with her until her mom arrived.

Therapists see this pattern frequently: A girl chooses something a parent wouldn't notice -- a pill or two, a light scratch with a sharp instrument. The next time it's two or three pills or a deeper cut, then more. With each attempt, the girl is more likely to die, which is why early intervention is critical.

Though not foolproof.

Paula found a counselor early. Her mother and aunt made efforts to talk to her more. Her boyfriend, currently a student at Montgomery Community College , started visiting more often and has plans to move to New York in June. Yet like the other girls, Paula remains very aware of her own vulnerabilities.
* * *
Social worker Hausman, herself a Latina , worries about girls like Paula who come from lower-income homes. She wonders about their mental health long-term, given the continuing conflict in their families and lack of outside resources. Their schools and neighborhoods need preventive mental health services more attuned to Hispanic culture, she says -- starting with parenting classes.

"In middle- and upper-class families, success is expected," she says. "If a child's mental health interferes with success, it tends to be noticed earlier. Low-income parents don't expect anything of their girls. Every middle-class mother tells me she wants her daughter to be a professional at 24, married with three children. These mothers want their girls to do the laundry." ¿

News researcher Magda Jean-Louis contributed to this report. Comments:steppl@washpost. com.