Characteristics and precipitating circumstances of suicide among youth involved with the U.S. child welfare system

Abstract

Suicide is the second leading cause of death among youth aged 10–21 years in the United States. Evidence suggests rates of suicide are particularly concerning among youth involved with the child welfare system. Approximately 618,000 children in the U.S. were involved with the child welfare system in 2020, however, little is known about factors associated with suicide in these vulnerable youth. This retrospective study uniquely examines characteristics and precipitating circumstances of suicide in youth involved with the child welfare system using integrated data from a state’s child welfare and violent death reporting systems from 2011 to 2017. Participants included 499 youth suicide decedents with (n = 191) and without (n = 308) child welfare system involvement. Most decedents were male (n = 370), White (n = 377), non-Hispanic (n = 477), aged 10–18 years (n = 274), and died by hanging/suffocation (n = 258). No significant differences were found between suicide decedents for precipitating circumstances associated with other relationship problems, interpersonal trauma, or life stressors. A current mental health problem was present in 55.5 % of all suicide decedents with child welfare system involvement, compared to 47.8 % of youth with no system involvement. The presence of alcohol, opioids, or marijuana at time of death was significantly higher for youth suicide decedents involved with the child welfare system. Youth decedents with a history of suicide attempts were also significantly more likely to be involved with the child welfare system. (AOR = 2.16, 95 % CI 1.32–3.55, p =.002). Findings underscore the need for more effective suicide risk detection and targeted prevention initiatives for youth involved with the child welfare system.