Pressure to be thin is the main reason vulnerable teenage girls contemplate suicide, a leading adolescent psychotherapist says.
Over the last two years, Pieta House - the suicide and self-harm crisis centre - has witnessed a marked increase in the number of 13- to 17-year-old girls presenting with suicidal ideation.
The most consistent issue they are presenting with is their struggle to obtain "the perfect body".
Last week, a new report from the Children's Rights Alliance (CRA) revealed that Ireland had the highest rate of female youth suicides and the second-highest rate of male youth suicides in the EU between 2009 and 2011.
Marguerite Kiely, clinical director for child and adolescent services at Pieta House, said suicidal thoughts sparked by image pressure are particularly acute among schoolgirls in second to fifth year.
"It's about looking thin. Teenage girls are comparing themselves a lot to their peers. They're at a stage of development where confidence is quite low and in order to be acceptable to the group, they believe they need this 'ideal body'," said Ms Kiely.
She said young girls regularly name social media sites, reality TV and other popular television shows as the trigger of their weight obsession.
The problem also manifests due to pressure from peers, sexual identity issues, cyber-bullying, negative online comments and relationship troubles.
"The sense of belonging and loyalty to their friends is huge to that age group and sometimes they find it difficult to create boundaries in their relationships," said Ms Kiely.
"They are talking to friends all the time. Some friends are calling them at 4am. They are having their chats and girls can be quite dramatic and this can create anxiety," she said.
"They feel a sense of responsibility that they have to be there for them at all hours. They're taking on their friends' problems with the best of intentions but they get very overwhelmed with it," Ms Kiely said.
The stress of repeatedly "looking perfect" on social outings is also impacting on vulnerable teens.
"We've noticed that girls tend to spend up to two or three hours prepping and focusing on their image before they go out because they want to look a certain way and that creates a lot of anxiety," said Ms Kiely.
Over the past 12 months, the charity, which has supported more than 17,000 children, adolescents and adults since 2006, is seeing more teenage boys presenting with body image issues.
"Boys are looking at six packs and think it's the perfect body," Ms Kiely said. "There is nothing wrong with wanting to be fit but if they are over-indulgent and are on steroids or taking protein supplements to build themselves and bulk up, that's not healthy."
Although body insecurities and suicidal ideation tend to be more associated with female clients, Ms Kiely believes eating disorders among boys are on the rise.
The charity also said boys and girls as young as seven years are presenting with self-harm issues.
However, Pieta House believes this is also a good sign and that young people are reaching out.
"There has been a very positive focus between schools and organisations in promoting mental health and providing a clear pathway for young people without feeling ashamed to come in," said Ms Kiely.
Meanwhile, the CRA is calling for the new national strategy to reduce suicide to be implemented in a standardised way.
If you have been affected by any issues raised in this article, please contact The Samaritans free helpline on 116 123 or contact Bodywhys on LoCall helpline 1890 200 444