A Public Health Framework for Youth Suicide Prevention

To reverse this trend, we need more large-scale methodologically-rigorous studies that develop and test new approaches. Finally, we acknowledge that a number of relevant studies have been published since the search was conducted. It was also often unclear if measures had been validated among young people. For example, methods to assess self-harm included self-report instruments, hospital data and clinician-rated interviews. There was also heterogeneity in the control conditions and in the outcome measures used SPRC Recover Together resources between studies, limiting our ability to be confident that studies measured the same constructs.

Preventing Youth Suicide: Intervention Strategies and Community Resources

Until recently, however, most studies of screening instruments were either cross-sectional, reporting screen sensitivity and sensitivity in terms of concurrent suicidal ideation (e.g. ), or they reported outcome data only on those who screened positive, limiting the possibility of examining predictive validity (e.g. ). Many scientists, including clinical investigators, are working to inform the development and implementation of evidence-based suicide prevention strategies. 1, the number of adolescents reporting suicidal thoughts and behaviors has risen significantly over the past 20 years . Designated a national priority in the United States nearly a quarter century ago , suicide prevention continues to be a public health imperative.

• Second, type of intervention was categorized as psychotherapy, brief contact, or educational.
• Deaths from firearms and suffocation have been relatively stable in the past few years, although firearm deaths outnumbered other mechanisms 20 years ago; firearms accounted for 49% suicide deaths in 2001 compared to 38% which were due to suffocation/asphyxiation .
• Healthcare providers, especially those caring for high-risk populations such as trauma patients, need to be able to identify risk factors, signs of suicidal ideation, and know what screening and management strategies exist.
• DMHA employed a state suicide prevention coordinator tasked with developing a state suicide prevention plan that included educational opportunities, suicide risk identification training, coordination of county and regional advisory groups, and recommendations for improved data collection.
• Suicide risk is well established for traumatic brain injury in children and adults, as suicide rates among individuals with a history of TBI are twice that of those who have not experienced TBI, and the risk is increased with TBI severity, long hospitalizations, and frequent medical encounters .

Studies were then classified by study design (i.e. RCTs and non-RCTs) and then by intervention approach (i.e. universal, selective, indicated). Two authors (SH and KW) undertook double data entry of all outcome data. In the first instance study titles and abstracts were screened by five of the review authors (EB, JR, SH, NS, KW). In addition, we hand-searched the reference lists of all previous reviews retrieved via the search. As such, studies of firearm regulations implemented with the expressed and primary purpose of preventing homicide were excluded under this criterion. Additionally, many concentrate on particular settings (e.g., schools) , or types of intervention (e.g., gatekeeper training programs) , and as such do not cover the full spectrum of approaches.

Associated Data

Developed using feedback from youth and suicide prevention experts , the guidelines address a variety of issues, including, among others, what to consider before sharing your own thoughts/experience with suicidal behavior and responding to someone who may be experiencing suicidal thoughts/behaviors . These recent studies of proximal risk for adolescent suicidal ideation and suicide attempts provide important information for caregivers, school personnel and healthcare providers. In this study, adolescents, who had been hospitalized for acute suicide risk, completed daily, text-based, surveys for four weeks following hospitalization. Czyz et al.’s particularly noteworthy study focused on the prediction of next day suicidal ideation among adolescents following psychiatric hospitalization for suicide risk , which is a high-risk time with observed variability in day-to-day suicidal thinking 17, 19. Though relatively infrequently tested in the suicide prevention literature , examining treatment moderators as part of RCTs could avoid prematurely discounting interventions that do not show overall effects and may inform how to personalize treatments .

Changing behavior, such as:

In addition, living in a home with a firearm increases the risk of suicide by firearm, which has a fatality rate of up to 85% . Experiencing a major life stressor or crisis such as a breakup with a dating partner or having a fight with a parent increases the risk of suicide as they increase impulsivity to act, even if never considering suicide previously . History of adoption, physical abuse and neglect, intimate partner violence (IPV), experience and perpetration of bullying, and pathologic Internet use are noted risk factors 8•, 16 ,17, 18, 19.