Abstract
BackgroundReducing suicidal behaviour is a major public health goal. Expanding access to care has been identified as a key strategy. In Australia, a national network of primary-care based services (headspace) has been established for young people with mental ill-health. This study determines the socio-demographic, psychopathological and illness-stage correlates of suicidal ideation in young persons attending headspace services.MethodsSuicidal ideation was recorded using the specific suicide item of the Hamilton Depression Rating Scale (HDRS) in a cohort of subjects aged 12-30 years (N = 494) attending headspace services.ResultsOf the 494 young persons assessed, 32% (158/494) had a positive response to any level of the HDRS suicide item, consisting of 16% (77/494) reporting that life was not worth living and a further 16% (81/494) reported thoughts of death or suicidal ideation. Young women (19%; 94/494) were more likely to report any positive response as compared with young men (13%; 64/494) [χ2(2,494) = 13.6, p < .01]. Those with ‘attenuated syndromes’ reported positive responses at rates comparable to those with more established disorders (35% vs. 34%; χ2(1,347) = 0.0, p = 0.87). However, more serious levels of suicidal ideation were more common in those with depressive disorders or later stages of illness. In multivariate analyses, the major predictors of the degree of suicidal ideation were increasing levels of clinician-rated depressive symptoms (beta = 0.595, p < .001), general psychopathology (beta = 0.198, p < .01), and self-reported distress (beta = 0.172, p < .05).ConclusionsFeelings that life is not worth living, thoughts of death or suicidal ideation are common in young people seeking mental health care. These at-risk cognitions are evident before many of these individuals develop severe or persistent mental disorders. Thoughts of death or suicidal ideation may well need to be a primary intervention target in these young people.
Highlights
Reducing suicidal behaviour is a major public health goal
In previous work [11], we have demonstrated that many single episode or uncomplicated DSMdefined anxiety or depressive disorders are staged as 1a or 1b respectively, while established psychotic, bipolar or severe depressive disorders are likely to be rated as stage 2 or above
Across the entire sample (i.e. 12 to 30 years), females (19.0%; 94/494) were more likely to report any positive response as compared with males (12.9%; 64/494) [χ2(2,494) = 13.6, p < .01]
Summary
Reducing suicidal behaviour is a major public health goal. Expanding access to care has been identified as a key strategy. In Australia, a national network of primary-care based services (headspace) has been established for young people with mental ill-health. In Australia, access to appropriate mental health care is less likely to occur in males and young people, and is adversely affected by lower socioeconomic status and living outside of the major metropolitan centres [6,7,8]. The development of the new national youth mental health services framework, headspace [10,11], has as one of its goals easier and earlier access to care for young people who are experiencing mental ill-health. The aims of this study are to assess data collected from a large, representative headspace population and to evaluate the relationships between selfreported suicidal ideation and key risk factors, such as gender and substance use. The potential relationships between suicidal risk factors and other demographic, diagnostic or illness-stage variables have not been explored in this unique youth cohort who are presenting for care early in the course of mental ill-health
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