2031 - that is how many suicide attempts were made in Poland in 2022 by children and adolescents under 18—150 ended in death. The youngest children who attempted to take their own lives were seven-year-olds. The main reasons for such decisions are mainly mental disorders and problems at home and the experience of bullying at school. February 23 - on the National Day for Combating Depression, we encourage you to read a conversation with dr Agata Rudnik from the Institute of Psychology of the Faculty of Social Sciences at UG and the Academic Psychological Support Centre at UG about her latest book entitled. 'Suicide risk prevention among children and adolescents. How were we supposed to know?'.

Elżbieta Michalak-Witkowska: - What inspired you to write this book?

Dr Agata Rudnik: - The book was inspired by a report prepared for the City Hall of Gdańsk in 2022 entitled 'Suicidal Events in Gdańsk Educational Institutions', developed with prof. dr hab. Mariola Bidzan, dr Marcin Szulc, prof. UG, and dr Aleksandra Szulman-Wardal from the Institute of Psychology at the University of Gdańsk. In Pomerania, the number of suicides among young people under 18 has increased the most, compared to other voivodeships. In May and June 2022, we conducted nearly 30 interviews with teaching staff, psychologists and educators, parents, pupils and students in secondary schools where suicides occurred in 2021. Excerpts from the interviews, quotes, our findings and recommendations appear in all five chapters and are an endless source of inspiration, but also of unknowns - what can we do so that we are not left at the end with the question - 'How were we supposed to know?'

- The publication offers the latest statistics on suicide among children and adolescents and guidance on what to do if we suspect depression in a child.

- This book is a compendium of knowledge. It is divided into five sections, each containing information taken from reports, books and scientific journals, but also practical tips and comments. The first chapter takes statistics under the microscope, and together we look at what might be behind the fact that the problem of mental health crises and suicide attempts among children and adolescents continues to grow. The second chapter is a signpost to help us pay close attention to worrying signals. The third section gives practical advice on how to help a person in crisis, while the fourth section suggests when to seek specialist help and what to look for when seeking such support. In the last chapter, I have included valuable contacts for free advice, places to turn to, and links to interesting psycho-educational materials.

- You have written this book as a dialogue with your male and female readers. Why?

- I wanted to interact with the audience. I wanted the book's topics to stimulate conversations within our four walls and on a broader level. We all must acknowledge that we (adults) still have a lot of work ahead of us to help those lacking the most resources to deal with change, feelings and emotions.

- The statistics you cite give food for thought. The scale of the problem is enormous. What are the causes of depression and the suicide attempts made as a result?

- As many as 2031 - this is how many suicide attempts were made by children and adolescents under 18 in Poland in 2022, of which 150 ended in death. According to information from the GrowSpace Foundation, the youngest children who wanted to take their own lives were between 7 and 12 years old. In turn, the police indicate that the main reasons for such difficult decisions are mainly mental disorders and troubles at home and the experience of bullying (harassment) at school. This is not helped by the pandemic, distance learning, the war in Ukraine, the vast amount of material to be covered at school, the plethora of extracurricular activities, climate change, or the precarious financial situation.

According to WHO data, suicide is the fourth most common cause of death among 15-19 year-olds worldwide (and the second in Europe, just after that due to injuries sustained in traffic accidents). The American Psychiatric Association (APA) indicates that a person who takes their own life does so as a result of experiencing a major depressive episode but also as a result of using psychoactive substances or other mental disorders. It is also the case that this final step is taken despite the absence of any disorder, but in a situation that is perceived as 'one with which nothing can be done'. This is where I still remember a sentence from a teacher at a secondary school in Gdańsk - 'A problem is like a ball; if you don't solve it, a whole snowman is created'. This is why it is so important to catch the moment, to notice that something wrong is happening in a young person.

- How can a parent, teacher or friends recognise depression in a loved one? What should worry them?

- Suicide is usually the consequence of a whole process; it rarely occurs due to an impulse.

What should particularly worry us: alarming statements, e.g. talking about disappearing, ending oneself, a behaviour change - so that an active person suddenly becomes apathetic and withdrawn or, conversely, a calm teenager suddenly engages in provocative or risky behaviour. An image change, new company, relationship problems and accompanying low self-esteem, sleep and appetite issues, difficulties at school, pain complaints, and self-harm are also clear signs.

I started with the disturbing statements because a damaging stereotype accompanies them - 'people who say they want to take their own life are only threatening and blackmailing, but they won't actually do it'. Meanwhile, over 80% of suicidal people have previously told others about their plans.

Behavioural changes that should draw our particular attention may include, among others. : problems with memory and difficulty concentrating, loss of interest in things that used to be essential and enjoyable, feelings of helplessness, problems with decision-making, feelings of helplessness, chronic fatigue, change in diet, change in sleep routine (difficulty falling asleep, waking up during the night, sleeping more than usual), lack of energy, loss of self-confidence, hypersensitivity and increased crying (sometimes also the feeling of not being able to feel feelings and emotions), the sense that the person is absent, use of psychoactive substances. It can also happen that a previously sad, withdrawn person suddenly becomes calm and even smiling. We may then get the impression that things are better, there has been an improvement, everything is back to normal, and we no longer need to worry. It is then that the red light should come on for us. This is because it may be a sign that the person has already made up their mind that they want to take their own life and they are feeling a kind of relief. Often this is a critical moment when the attempt is made (the person has enough drive to do it). So let's remember that such a sudden exit should definitely concern us.

- Can mental health and resilience be built up somehow? How can we improve our mental state? Therapy is one thing, but the rest?

- What we can give most of ourselves is our attention, time and commitment. Let's create a safe space for young people. One where they want to share their problems, where they can cry (crying is necessary!). Let's attach importance to the (seemingly) small things, the shared rituals, such as daily tea or Sunday scrambled eggs, that give a sense of security. Such time together also allows us to spot 'red flags' and worrying signs that something wrong is happening. In the surveys conducted by our team, the kids often indicated that it was hugely important for them to have support from their classmates. They also spoke out about how much they would love to learn how to help people in crisis. And let's remember that children learn by modelling, i.e. imitating adult behaviour, so let's consider how we deal with our friends and acquaintances. When was the last time we asked - 'how are you?' and were genuinely interested in the answer? Let's observe, let's ask, let's listen, let's talk. Let us be. Above all, let's show a willingness to talk by saying, for example, 'I can see that you've been having a hard time lately'. Let's gather as much information as possible, not ridicule or ignore.

- What makes up the mental toughness of children and young people?

- First of all, we are talking about factors such as self-control, self-knowledge, initiative, as well as problem-solving, (constructive) stress management and social skills, and the critical word is so-called resilience - mental resilience, which means functioning as well as possible despite experiencing a difficult situation.

Factors supporting mental resilience include sociability and temperament, positive self-image, family cohesion and compatibility. Resilience is mainly influenced by sensitive care, close relationships, social support, a sense of belonging to a group, a sense of agency, active coping, planning and problem-solving, hope, optimism and belief in a better future, purpose and a sense of meaning, a positive view of self, family or group, positive habits, routines, rituals, and traditions or celebrations. Mindfulness practices - mindfulness - can also work well in supporting mental resilience. This is not surprising, given the importance of mindfulness, a growth mindset and belief in mental strength. Mindfulness is an exercise of our mind to consciously direct our attention to what we are experiencing at the moment, without thinking about the past or the future, i.e. the famous being 'here and now'.

- Thank you for the interview.