Adolescent Suicide Rates Research Articles

Study on the Emergence and Intervention of Mental Health Problems among Chinese Adolescents

The mental health of Chinese adolescents has received widespread attention due to the rising rate of adolescent suicide. Although previous studies have focused on the causal analysis of such problems, there is still room for further improvement. This study examines the impact of mental health problems from four distinct perspectives in Chinese society. Specifically, cognitive, psychological, behavioral, and physical effects. Then, this study analyzes the causality of mental health problems from three different aspects of adolescents’ daily lives: school-related causality, family-related causality, and peer-related causality. On this basis, the paper makes the following recommendations: Students can develop time management and self-control skills to reduce stress in a high-pressure educational system. Parents and peers can provide emotional support and counseling to help students experiencing emotional distress. Parents, in particular, can aim to create a harmonious family environment to ensure the mental well-being of adolescents Schools can create a harmonious school environment and build healthy peer relationships to prevent bullying behavior.

The School Suicide Policy Evaluation Tool (SSPET): A proof‐of‐concept for assessing school suicide prevention policies

AbstractBackgroundAs adolescent suicide rates have increased, there has been a nationwide increase in legislation requiring schools to create suicide prevention policies. In Utah, school districts must implement a youth suicide program for grades 7–12. Currently, there have been no systematic analyses of Utah school district suicide prevention policies. Thus, we developed a new evaluation instrument, the School Suicide Policy Evaluation Tool (SSPET).MethodsThe SSPET was derived from the “Model School District Policy” and evaluates criteria on prevention, intervention, re‐entry, and postvention. Four raters used the SSPET in a systematic analysis of suicide prevention policies for all school districts in the state of Utah.ResultsAnalysis revealed a right‐skewed distribution of policy scores, and a median total score was 2.25/36. The mean percentage of inclusion of the four subsections in policies was less than 20% for most criteria. Median scores were totaled for the four subsections as follows: Prevention score was 1/9, intervention score was 1/14, re‐entry score was 0/4, and postvention score was 0/9.ConclusionThis proof‐of‐concept study demonstrates the utility of the SSPET in identifying shortcomings of school district policies on suicide while generating specific recommendations for improvement. With further validity testing, we expect this tool to be useful to school district administrators, education policymakers, and those studying suicide interventions and outcomes in school‐aged children and adolescents.

Did Inequalities in Mothers' and Children's Health and Well-Being in Japan Increase through the Pandemic? Evidence from Nationwide Surveys and Routinely Collected Data.

Marginalised families faced significant challenges during the COVID-19 pandemic. This study explores inequalities in Japanese mothers' and children's health and well-being and family economic stability before and during the pandemic. Data sources were as follows: nationwide surveys in 2019 and 2021 of families with children using medical institutions across Japan; infant mortality and adolescent suicide rates between 2018 and 2021 from publicly available sources. Outcomes by poor and non-poor families were compared for 2019 and 2021 using simple descriptive statistics. Poor mothers' part-time working increased from 41% to 61% and regular employment was reduced by two thirds. The well-being of poor mothers worsened from 39% to 55%. Employment opportunities and well-being did not change for non-poor mothers. School subsidies among poor families increased from 23% to 55%. The infant mortality rate (IMR) among unemployed families increased significantly from 12.9/1000 to 18.2/1000 between 2018 and 2021 compared with a decreasing overall IMR from 1.9/1000 to 1.7/1000. Suicide rates in 10-19-year-olds increased over the same period although no socio-economic indicators were available. Inequalities in mothers' and children's health and well-being indicators and family economics increased between 2019 to 2021 in Japan. This study cannot attribute causes but suggests a possible role of the pandemic.

Informing Equitable Prevention Practices: A Statewide Disaggregated Analysis of Suicide for Ethnoracially Minoritized Adolescents

The increase in adolescent suicide rates in the United States is a pervasive public health issue, and ethnoracial youth with diverse identities are disproportionately impacted, yet less studied. National planning efforts reinforce state-level approaches to suicide prevention through an equitable lens to prevent adolescent suicide. This study examined disaggregated state-level data over time to determine changes to suicide outcomes based on race/ethnicity, sex, sexual orientation, and the intersection of these identities and determined which sub-groups had higher odds of suicide outcomes. Data from the 1991–2019 Centers for Disease Control and Prevention Youth Risk Behavioral Surveillance System were analyzed for 17,419 ethnoracially minoritized high school adolescents in North Carolina. Descriptive analyses and multinominal logistic regression models were employed. Findings indicated that subgroups within categories of ethnoracial populations, specifically Black female adolescents unsure of their sexual orientation, reported higher rates of suicide attempts. Additionally, Multiracial adolescents reported higher means for suicide consideration and attempts over time. Recommendations for investigating state-level suicide data by focusing on diverse intersecting identities to illuminate areas for potential prevention efforts and support health equity are provided.

Research, practice, and data informed investigations of child and youth suicide: A science to service and service to science approach

Background: Suicide rates for children and adolescents have been increasing over the past 2 decades. In April 2023, the National Institute of Mental Health (NIMH) convened a two-day workshop to address child and youth suicide. Purpose: The workshop focus was to discuss the state of the science and stimulate a collaborative response between researchers, death investigators, and data collection teams to build a science to service and service to science approach toward understanding - and ultimately preventing – this growing problem of child and youth suicide. Highlights: Topics that meeting participants highlighted as worthy of further consideration for research and practice were: increasing awareness among death investigators, medical examiners, and coroners that child suicide deaths under age 10 years do occur and should be investigated and documented accordingly; emphasizing the value of science based protocols for child and youth death investigations to enhance consistency of approaches; and articulating needs for postvention services to suicide loss survivors. Outcomes: The importance of collecting an accurate and complete cause and manner of death (i.e., unintentional, suicide, homicide, undetermined) among all child decedents, and demographic information such as race, ethnicity, and sexual/gender minority status was underscored as critical for enhanced surveillance. For prevention efforts, approaches to assessing and understanding suicidal thoughts and behaviors among diverse groups of children, and the variability in proximal and distal risk factors are needed to inform opportunities for preventive interventions for diverse communities. The need for consistent measures and processes to improve death investigations, fatality review committees, and coordination between data collection systems and agencies was also raised. Practical applications: Collaborations among researchers, death investigators, and data collection teams can help to fully describe the child and youth suicide crisis and provide actionable information for new research, and prevention and response efforts.

Exploring the Potential of Artificial Intelligence in Adolescent Suicide Prevention: Current Applications, Challenges, and Future Directions

Objective The global surge in adolescent suicide necessitates the development of innovative and efficacious preventive measures. Traditionally, various approaches have been used, but with limited success. However, with the rapid advancements in artificial intelligence (AI), new possibilities have emerged. This paper reviews the potentials and challenges of integrating AI into suicide prevention strategies, focusing on adolescents. Method: This narrative review assesses the impact of AI on suicide prevention strategies, the strategies and cases of AI applications in adolescent suicide prevention, as well as the challenges faced. Through searches on the PubMed, web of science, PsycINFO, and EMBASE databases, 19 relevant articles were included in the review. Results: AI has significantly improved risk assessment and predictive modeling for identifying suicidal behavior. It has enabled the analysis of textual data through natural language processing and fostered novel intervention strategies. Although AI applications, such as chatbots and monitoring systems, show promise, they must navigate challenges like data privacy and ethical considerations. The research underscores the potential of AI to enhance future suicide prevention efforts through personalized interventions and integration with emerging technologies. Conclusion: AI possesses transformative potential for adolescent suicide prevention by offering targeted and adaptive solutions, while they also raise crucial ethical and practical considerations. Looking forward, AI can play a critical role in mitigating adolescent suicide rates, marking a new frontier in mental health care.

Gender differences in prevalence and clinical risk factors of suicide attempts in young adults with first-episode drug-naive major depressive disorder.

Suicide rates in adolescents with major depressive disorder (MDD) change with age and gender. Early adulthood is an important transitional stage between late adolescence and adulthood, in which an individual's mind gradually matures. However, there are fewer studies on prevalence and variables linked to the suicide attempts of young adults with MDD. To explore gender differences in the prevalence and risk factors associated with suicide attempts in young adults with first-episode drug-naive MDD. The Hamilton Rating Scale for Depression (HRSD), Hamilton Rating Scale for Anxiety (HRSA) and Positive Subscale of the Positive and Negative Syndrome Scale (PANSS) were used to assess depression, anxiety and psychotic symptoms respectively and various biochemical indicators were assessed. Among 293 young adults with first-episode drug-naive MDD, the prevalence of suicide attempts was 15.45% (19/123) for males and 14.12% (24/170) for females. Males with suicide attempts had higher levels of thyroid-stimulating hormone (TSH) and higher PANSS Positive Subscale scores, whereas females with suicide attempts had higher TSH, serum total cholesterol, fasting blood glucose and diastolic blood pressure levels and higher scores on the HRSD, HRSA, PANSS Positive Subscale (all Bonferroni corrected P < 0.05). In males, PANSS Positive Subscale score (B = 0.17, P = 0.03, OR = 1.19, 95% CI 1.02-1.38) was a risk factor for suicide attempts. There were significant gender differences in the risk factors for suicide attempts in young adults with first-episode drug-naive MDD.

Food Insecurity, Adolescent Suicidal Thoughts and Behaviors, and Country-Level Context: A Multi-Country Cross-Sectional Analysis

PurposePreventing adolescent suicide is a global priority. Inequalities in adolescent suicide and attempt rates are reported across countries, including a greater risk in adolescents experiencing food insecurity. Little is known about the extent to which country-level contextual factors moderate the magnitude of socio–economic inequalities in suicidal thoughts and behavior. We aimed to examine the cross-country variability and national moderators of the association between food insecurity and suicidal thoughts and behavior in school-attending adolescents. MethodsWe analysed data on 309,340 school-attending adolescents from 83 countries that participated in the Global School-based Student Health Survey between 2003 and 2018. We used Poisson regression to identify whether suicidal thoughts and behavior were more prevalent in adolescents experiencing food insecurity compared to food-secure adolescents. Meta-regression and mixed-effects regression were used to determine whether country-level indicators moderated the magnitude of inequality. ResultsSuicidal ideation, suicide planning, and suicide attempts were more prevalent in food-insecure adolescents compared to food-secure adolescents in 72%, 78%, and 90% of countries respectively; however, the magnitude of these associations varied between countries. We observed wider inequalities in countries with greater levels of national wealth and universal health coverage and lower prevalence of adolescent food insecurity. Economic inequality had no moderating role. DiscussionFood insecurity could contribute to the development of adolescent suicidal thoughts and behavior, and this association is likely to be moderated by country-level context. Food insecurity may be a modifiable target to help prevent adolescent suicide, especially in countries where food insecurity is less common.

Application of the multiple dependent state sampling strategy to late adolescent suicide rates

A multiple dependent state sampling plan (MDSSP) is designed when the lifetimes of the variables follow New Lomax Rayleigh Distribution (NLRD). The decision to accept or reject a lot in the proposed methodology is based on the quality of the given present or previous lots. A binomial model-based operating characteristic curve (OC curve) for continuous lots of variables under similar settings in healthcare is used in finding the probability of acceptance, acceptance number, rejection number, and the number of preceding (succeeding) lots to consider. Time truncated life test based on the specified median of the NLRD is used in designing the current acceptance sampling plan. For specified values of the parameters of NLRD, quantile ratios, consumer’s risk and producer’s risk, average sampling number (ASN) and probability of acceptance of a lot are reported in tables. Real data on worldwide suicide rates of 15–19 years in the year 2019 from the World Health Organization (WHO) website is considered to illustrate this methodology. The minimum sample size required from the selected data to comment on worldwide suicide rates in late adolescents is explained with MDSSP. The results of the proposed acceptance sampling method are compared with the single-stage sampling plan.

Association Between Antidepressant Use and the Risk of Suicide in Children and Adolescents

In recent years, the prescription of antidepressants for children has come under serious scrutiny, as some studies have shown an increased risk of suicide among those treated in this way. The main aim of this study is to investigate the causal relationship between antidepressant use and suicidal behaviour in children and adolescents. We reviewed the literature on the Google Scholar, pubmed, science direct database. The data in the literature were contradictory; while it has now been demonstrated that SSRIs very moderately increase the risk of suicide ideation and attempts, with venlafaxine, paroxetine and sertraline in particular showing a higher risk than other SSRIs such as fluoxetine and citalopram, several studies show that their use is associated with a significant reduction in suicide rates in children and adolescents. There is currently no certainty of a causal relationship between antidepressants and suicidality in children and adolescents, so the mechanisms are still poorly understood.

Identifying latent themes in suicide among black and white adolescents and young adults using the National Violent Death Reporting System, 2013–2019

Suicide rates for adolescents and young adults (AYA) have risen dramatically in recent years – by almost 60% for Americans aged 10–24 years between 2007 and 2018. This increase has occurred for both whites and Blacks, with the rise in suicide among Black youth of particular note. Blacks historically exhibit lower rates of suicide relative to whites and thus, less is known about the etiology of Black suicide. To gain insight into the underlying causes of suicide among AYA, we examine medical examiner reports from the National Violent Death Reporting System (NVDRS) from 2013 to 2019 for over 26,000 Black and white suicide decedents ages 10–29. We apply structural topic modeling (STM) approaches to describe the broad contours of AYA suicide in the United States today. Our findings reveal distinct patterns by race. Guns, violence and the criminal justice system are prominent features of Black suicide, whether through the mechanism used in the suicide, either by firearm or other violent means such as fire or electrocution, the existence of criminal or legal problems/disputes, the location of death in a jail, or the presence of police. In contrast, the narratives of white AYA are more likely to reference mental health or substance abuse problems. Access to resources, as measured by county median household income, overlay these patterns. Themes more prevalent among Blacks are more common in poorer counties; those more prevalent among whites tend to be more common in wealthier counties. Our findings are consistent with other studies that suggest Black people experience greater exposure to violence and other traumas, systemic racism and interpersonal discrimination that may elevate the risk for suicidal behavior.

Review on Data Mining and Data Analysis Method for Adolescent Suicide Problem

This paper suggested that both positive and negative family factors can impact adolescent suicide rates. Supportive relationships with parents, siblings, and other family members can provide a sense of belonging, connection, and emotional support that can help to protect adolescents from suicidal thoughts and behaviors. Studies have found that adolescents who are exposed to these types of adverse family experiences are more likely to experience depression, anxiety, and other mental health problems, which can increase their risk of suicide. The research presented in this article suggests that family environment continues to be one of the most important factors influencing adolescent suicide rates, with the two groups most at risk for suicide having much higher levels of exposure to domestic violence and substance abuse. No significant changes were found in age, academic achievement, race, or family structure. This suggests that the most influential determinants of adolescent suicide rates are family environment, followed by gender and prior exposure to suicide. The purpose of this literature review on adolescent suicide is to provide a comprehensive overview of existing research on the influence of relationships and family on adolescent suicide rates, highlight key findings and identify areas for further research.

Regional clozapine, ECT and lithium usage inversely associated with excess suicide rates in male adolescents

Advanced psychiatric treatments remain uncertain in preventing suicide among adolescents. Across the 21 Swedish regions, using nationwide registers between 2016–2020, we found negative correlation between adolescent excess suicide mortality (AESM) and regional frequencies of clozapine, ECT, and lithium (CEL) usage among adolescents (β = −0.613, p = 0.0003, 95% CI: −0.338, −0.889) and males (β = −0.404, p = 0.009, 95% CI: −0.130, −0.678). No correlation was found among females (p = 0.197). Highest CEL usage among male adolescents was seen in regions with lowest quartile (Q1) AESM (W = 74, p = 0.012). Regional CEL treatment frequency in 15–19-year-olds was related to lower AESM in males, reflecting potential treatment efficacy, treatment compliance or better-quality mental health care. Suicide prevention may benefit from early recognition and CEL treatment for severe mental illness in male adolescents. The results indicate association but further research, using independent samples and both prospective and observational methodologies, is needed to confirm causality.

Evaluating the Utility of a Psychoeducational Serious Game (SPARX) in Protecting Inuit Youth From Depression: Pilot Randomized Controlled Trial.

Inuit youth in Northern Canada show considerable resilience in the face of extreme adversities. However, they also experience significant mental health needs and some of the highest adolescent suicide rates in the world. Disproportionate rates of truancy, depression, and suicide among Inuit adolescents have captured the attention of all levels of government and the country. Inuit communities have expressed an urgent imperative to create, or adapt, and then evaluate prevention and intervention tools for mental health. These tools should build upon existing strengths, be culturally appropriate for Inuit communities, and be accessible and sustainable in Northern contexts, where mental health resources are often scarce. This pilot study assesses the utility, for Inuit youth in Canada, of a psychoeducational e-intervention designed to teach cognitive behavioral therapy strategies and techniques. This serious game, SPARX, had previously demonstrated effectiveness in addressing depression with Māori youth in New Zealand. The Nunavut Territorial Department of Health sponsored this study, and a team of Nunavut-based community mental health staff facilitated youth's participation in an entirely remotely administered pilot trial using a modified randomized control approach with 24 youths aged 13-18 across 11 communities in Nunavut. These youth had been identified by the community facilitators as exhibiting low mood, negative affect, depressive presentations, or significant levels of stress. Entire communities, instead of individual youth, were randomly assigned to an intervention group or a waitlist control group. Mixed models (multilevel regression) revealed that participating youth felt less hopeless (P=.02) and engaged in less self-blame (P=.03), rumination (P=.04), and catastrophizing (P=.03) following the SPARX intervention. However, participants did not show a decrease in depressive symptoms or an increase in formal resilience indicators. Preliminary results suggest that SPARX may be a good first step for supporting Inuit youth with skill development to regulate their emotions, challenge maladaptive thoughts, and provide behavioral management techniques such as deep breathing. However, it will be imperative to work with youth and communities to design, develop, and test an Inuit version of the SPARX program, tailored to fit the interests of Inuit youth and Elders in Canada and to increase engagement and effectiveness of the program. ClinicalTrials.gov NCT05702086; https://www.clinicaltrials.gov/ct2/show/NCT05702086.

Corporal punishment bans and adolescent suicide rates: An international ecological study

BackgroundExposure to corporal punishment during childhood is associated with suicidal behaviors during adolescence. To date, the protective effects of national policies governing the use of corporal punishment have rarely been studied for adolescent suicide outcomes. ObjectiveTo investigate contemporaneous and lagged associations between national legislation banning corporal punishment and adolescent suicide rates. Participants and settingWe used population-level administrative and mortality data from 97 countries spanning the years 1950 to 2017. MethodsNegative binomial models were used to investigate the relationship between the existence of official corporal punishment bans in countries and national adolescent suicide mortality rates and the potential time lag between the enactment of such bans and reductions in adolescent suicide rates. ResultsNational policies that permitted corporal punishment in all settings (homes, schools, daycares, and alternative care) were associated with a higher relative risk (RR) for suicide in females aged 15–19 (RR = 2.07, p = .03), as were policies allowing corporal punishment in schools specifically (RR = 2.01, p = .02). Partial bans of corporal punishment and bans of school corporal punishment showed lagged effects on suicide rates which peaked after 12 years for females aged 15–19 and after 13 years for males aged 15–19. ConclusionsStudy findings add to a body of evidence that suggests that official policies banning corporal punishment may promote adolescent health and well-being. The benefits of such policies in terms of reduced risk for adolescent suicide appear to peak approximately 12 to 13 years after enactment of the legislation.

Trends in Adolescent Completed Suicide in Croatia for the Period of 2000 to 2020.

Croatia belongs to the countries with a medium mortality rate due to suicide in youths. Previous epidemiological reports indicated a decreasing trend of suicide rates in adolescents. However, recent trend analysis in youth suicide rates in Croatia are missing. This study aimed to describe recent trends in child and adolescent completed suicide in Croatia and to compare the rates and methods of suicide ("means") across demographic groups. Data from the Croatian Committed Suicide Registry were used to calculate age-specific rates of suicide from 2000 to 2020 among 0 to 24 year olds, overall and by age, gender, and means of suicide. The total average suicide rate for Croatian children and adolescents during the study period was 4.12 per 100,000. The male-female ratio was 4.1:1. The total youth suicide rate and male suicide rate significantly declined from 2000 to 2020; however, the decrease in female rates did not reach statistical significance. Nearly half of all suicides among Croatian youth of both gender occurred through hanging, whereas using firearms was the second-most common suicide method in males and jumping from a height in females. Suicide rates among children and adolescents in Croatia continue to decrease. High-risk groups include adolescents aged 20-24 years and male youth, so these data should be considered when designing prevention programmes for youth suicide.

32.1 The Impact of COVID-19 on the Mental Health of Black Youth and Available Resources

The participant will: 1) discuss how the pandemic has impacted mental health and suicide rates for Black adolescents; and 2) identify available crisis support resources for patients at risk of suicidal ideation or mental health crisis. The suicide rate has increased by more than 30% in the United States since 1999, and it is now the second leading cause of death among people ages 10 to 24 years. In particular, research has shown that the rate of suicide among Black youth has risen, with Black children between the ages 5 and 12 years now being twice as likely to die by suicide when compared to their White counterparts.

2.84 Longitudinal Results of a School-Based Screening of Adolescent Students at Risk for Depression

Adolescent suicide and depression rates have increased rapidly in the past decade. In response, the AAP has called for universal screening in youth ages 12 to 19 years. Schools have been identified as a prime environment for screening. School-based screenings effectively identify youth with depressive symptoms, but few longitudinal studies exist. We present data from multiyear school screenings to monitor adolescent depressive symptoms and treatment utilization over time.

청소년의 사이버불링피해가 자살생각에 미치는 영향: 자아존중감의 조절효과를 중심으로

Objectives: In Korea, the rising rate of adolescent suicide is a serious social issue. Although cyberbullying victimization is a critical determinant of suicidal behaviors, the relationship between cyberbullying victimization and suicidal behaviors has not been well studied. The current study aims to examine the association between cyberbullying victimization and suicidal ideation employing Selye’s general adaptation syndrome and investigate the moderating effect of self-esteem based on Baumeister’s escape theory. Methods: Data from the 2019 Survey on Human Rights of Children and Adolescents were employed for the analysis. The study used 2,028 adolescents’ data selected using Mahalanobis Distance Matching. Polynomial regression was used as the primary analysis method, and the response surface method was employed for result visualization. Results: The analysis results are as follows: First, cyberbullying victimization and suicidal ideation were curvilinearly associated with suicidal ideation. Second, self-esteem was negatively associated with suicidal ideation. Third, self-esteem moderated the effect of cyberbullying victimization on suicidal ideation. Conclusion: The results empirically and partially confirm Selye’s general adaptation syndrome and Baumeister’s escape theory. Implications were discussed for theories concerning suicidal behaviors and social work practices for the prevention of suicidal behavior among adolescents.

Clinical, psychological, social, and family characterization of suicidal behavior in Chilean adolescents: a multiple correspondence analysis.

Introduction Suicide is the second leading cause of premature death in people between 15 and 29 years old and the third in young people between 15 and 19 years old. Adolescence is a critical period concerning mental health disorders since there is greater vulnerability to suicidal behaviors. The situation in Latin America is worrying, with Chile being one of the two countries where suicide rates of children and adolescents increase yearly. This study aims to analyze clinical, psychological, family, and social risk factors associated with suicidal behavior in a clinical sample of adolescents treated in the public health system of the Maule region. Methods The study design is cross- sectional. We used a sample of 388 adolescents between 10 and 21 years old admitted to the health system of the Maule Region. The participants were evaluated by applying five measuring instruments (The Barrat Impulsivity Scale, The Difficulties in Emotional Regulation Scale, The Depression, Anxiety and Stress Scale, The General Help-Seeking Questionnaire for mental health problems in adolescents, and The Columbia Suicide Severity Rating Scale) in addition to collecting social and family information and relevant clinical history from the medical records. Results The analysis allowed us to identify distinctive characteristics of adolescent suicidal behavior by describing clinical, psychological, and family social factors. Conclusions Adolescents with a history of suicide attempts are characterized by having suicidal ideation, anxious-depressive symptoms, stress, insomnia, and impulsiveness. Likewise, they report being non-religious, belonging to sexual minorities, and victims of sexual harassment and/or abuse.