With 1,400 serious suicide attempts in Hawai'i last year — 260 by teenagers — a number of state, city and private agencies worked together to create a suicide prevention task force to educate the community.

According to state Health Department statistics, Hawai'i teenagers are more likely to attempt suicide than Mainland teenagers and one of the task force's goals will be to come up with a state action plan.

"Suicide is the number one cause of injury death in Hawai'i, surpassing motor vehicle crashes and homicides," said Dan Yahata, chair of the suicide prevention steering committee through the Health Department.

"Our concern is the attempts are higher," Yahata said. "More teens in Hawai'i than across the nation are reporting suicide attempts and ideation."

For every child who takes his or her life in Hawai'i, there are 25 others who are hospitalized and 25 more who are treated in emergency rooms for attempting suicide.

Of the 127 successful suicides last year, five were by teenagers.

According to the 2003 Youth Risk Behavior Surveillance System survey of 8,791 Hawai'i high school students, female students have twice the risk of considering, planning and attempting suicide than male students although male students are more likely to take their lives.

The task force, with members from the state Department of Health, Department of Education, Honolulu Police Department, University of Hawai'i, the military and faith-based groups, hopes to come up with recommendations to heighten community awareness and increase intervention.

At the same time a bill moving through the Legislature calls for the establishment of a statewide youth suicide prevention program in the state Health Department.

"In 99 percent of cases there are warning signs," said Dr. Ramya Sundararaman of the nonprofit national Suicide Prevention Resource Center in Massachusetts, who is assisting the task force. "(But there need to be) people around who can recognize the warning signs and know what to do — tie them in with treatment."

With treatment, second attempts drop dramatically, she said.

The steering committee has had assistance from families who have lost children to suicide and say if they had known what to look for they may have been able to prevent it.

"The number one thing you don't do when someone is in crisis is to let him go," said Pua Kanihau, whose 18-year-old son took his life in 2003. "You hook them up to mental healthcare right then and there and don't leave them."

Kanihau said that when she looks back at her son's behavior, including seeing his grades slip, not turning in homework assignments, staying up all night with insomnia, even becoming somewhat aggressive, "there were plenty of clues."

"But I labeled all of it teenage rebellion when it was really risk factors," Kanihau said.

Healthcare workers are careful to point out, however, that it takes a constellation of factors to put someone at risk for suicide — and that it's not simply school stress, a bad grade or the breakup of a relationship, although those may be part of the picture.

Reach Beverly Creamer at bcreamer@honoluluadvertiser.com.