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Abstract This paper examines the case of D.R., a 15-year-old male exhibiting significant suicide risk factors following a traumatic, widely publicized bullying incident. Key warning signs include profound social withdrawal, expressed hopelessness, and verbal cues of suicidal ideation, such as stating, “I don’t think I can do this anymore.” The case is contextualized by recent international studies demonstrating that bullying victimization is significantly correlated with a heightened prevalence of suicidal ideation and attempts among adolescents. To address D.R.’s acute risk, a multifaceted intervention strategy is proposed. This includes the immediate implementation of a Safety Planning Intervention (SPI) to manage crises, the establishment of comprehensive school-based anti-bullying programs to create a safe environment, and the application of trauma-informed psychotherapy, such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT), to address the underlying psychological distress and build resilience. This approach integrates immediate safety with long-term therapeutic and environmental support. Keywords: adolescent suicide, bullying, cyberbullying, safety planning, trauma-informed care, school mental health, suicide prevention.
Preventing Suicide Case Scenario D.R., a 15-year-old male with a six-month history of ADHD treatment, presents to follow-up with concerning changes following a traumatic peer assault. According to his mother, D.R. was attacked by a group of students in the school gym, an incident that was captured on video and widely disseminated via TikTok and local news. Since the incident, D.R. has become socially withdrawn, spending most of his time in his room and avoiding school. During the session, he appears visibly distressed, avoids eye contact, and expresses hopelessness, stating, “No one can protect me, and nobody cares. They’re all back in school already and I don’t think I can do this anymore.” Possible Signs of Suicide Risk D.R.'s current presentation shows some concerning signs that could indicate he is considering suicide. Firstly, D.R. displays a marked change in his emotional state and behavior. His appearance is "forlorn," and he "avoids eye contact," which can be indicators of depression, sadness, and withdrawal. His mother's observation of a "drastic change in his personality at home," including "staying in his room so much" and "refusal to go to school most days," points to significant social withdrawal and a loss of interest in usual activities. Depressive symptoms and social withdrawal are common red flags frequently associated with suicidal ideation and attempts in young individuals (Hua et al., 2024). D.R.'s verbal statements are highly indicative of suicidal ideation and a profound sense of hopelessness and isolation. His declaration, "I don’t want to go back," reflects an overwhelming feeling of being trapped and an inability to cope with his current circumstances. The statements
The connection between bullying and adolescent suicide is supported by recent global research. One 2024 study in Indonesia found that bullying increases the likelihood of suicide, especially for teens who are both victims and perpetrators (Yosep et al., 2024). Another 2024 study in Kenya, where daily bullying is common, showed that both physical and cyberbullying significantly increase the chances of suicidal thoughts, plans, or attempts (Ndetei et al., 2024). This is consistent with findings from Nigeria in 2024, where bullying victims were at a much greater risk of attempting suicide, a serious issue given that over 13.5% of students there reported suicidal ideation in the past year (Jegede et al., 2024). The impact of bullying goes out to various forms, including electronic bullying. Multiple studies confirm the dangers of bullying for high schoolers. Frequent social media use is linked to higher rates of bullying, sadness, and suicide risk in the United States (Young et al., 2024). Bullying itself, whether at school or online, is directly associated with feelings of hopelessness and suicidal thoughts (Sutter et al., 2022). The risk of negative outcomes like anxiety and suicide attempts is even greater for students who experience both face-to-face and cyberbullying, as opposed to only one or the other (Pengpid & Peltzer, 2022). Intervention for Suicide Prevention Safety Planning Intervention (SPI) D.R.'s statement, "I don’t think I can do this anymore," indicates suicidal ideation and calls for the immediate use of a Safety Planning Intervention (SPI). An SPI is a brief, proven technique that establishes a personalized list of coping strategies and supports to manage a suicidal crisis. For D.R., this plan will provide concrete actions to take when he feels overwhelmed, thus increasing his sense of control. The plan will specify his personal warning
signs, internal coping methods, people to contact for support, professional help lines, and strategies for reducing his access to lethal means (Nuij et al., 2021). Research confirms that SPIs are effective, showing an association with decreased suicidal behaviors (Garbacka & Bzowska,
- and being endorsed as a functional, evidence-based practice in diverse clinical settings (Melhem et al., 2023). Comprehensive School-Based Anti-Bullying and Mental Health Programs Addressing the school environment is fundamental to D.R.'s recovery, as his trauma and school refusal comes from a bullying incident. It is essential to implement comprehensive school programs that combine anti-bullying interventions with mental health support to create a safer atmosphere (Hikmat et al., 2024). Key components of these programs include clear policies and educational efforts that build resilience and coping mechanisms, which are known protective factors against the consequences of bullying (Gabrielli et al., 2021). Specific interventions like the Signs of Suicide (SOS) program have proven effective at improving student well-being, increasing help-seeking, and reducing suicidal thoughts (Nadeem Parpio et al., 2025). For D.R., the school must take concrete steps to ensure his safety, plan his return, and provide accessible psychological support. Trauma-Informed Psychotherapy D.R.'s experience with trauma has led to symptoms of post-traumatic stress, depression, and hopelessness, needing trauma-informed psychotherapy. Interventions such as Cognitive Behavioral Therapy (CBT) can help him challenge and reframe negative thought patterns related to the trauma, with school-based CBT being proven to reduce suicidal ideation and anxiety (Low & Lee, 2024). Additionally, Dialectical Behavior Therapy (DBT) offers practical skills for
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