Trends In Suicide Rates Research Articles

The annual trend of suicide rates from 2010 to 2021 in patients with cannabis use disorder – a national registry study

Abstract Purpose The temporal trend of suicide in patients with cannabis use disorder (CUD) is important to investigate, considering the recent increases in THC concentration in cannabis products. This study describes the annual suicide rates in patients with CUD from 2010 to 2021. To investigate if any change in suicide rate was specific to CUD, we compared these suicide rates with corresponding data for patients with alcohol use disorders (AUD) and other substance use disorders (SUDs). Method The study used a time series design. We used a national registry linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry from 2010 to 2021, including patients with CUD (ICD-10 code F12), AUD (F10), or other SUDs (F11; F13-F16; F18-F19) who died by suicide, supplemented with the total number of patients treated with specific disorders to estimate the suicide rates. The trend was analyzed by comparing the annual suicide rate to 2010 and using Poisson regression, adjusting for gender, age, and mental disorders. Results We found increased annual incidence rate ratios for patients with CUD in 2018 (IRR = 2.14 (95% CI 1.14–3.99)) and onwards and an increasing time trend over the study period (IRR = 1.08 (1.05–1.12)). No increases in trends were found for AUD or other SUDs. The time trend for CUD was attenuated when adjusting for depressive or anxiety disorders (aIRR = 1.00 (0.92–1.08)) or other SUDs (aIRR = 0.96 (0.87–1.06)). Conclusions Increasing suicide rates were found in patients with CUD. Comorbid anxiety and depression or other SUDs, but not other mental disorders, could partly explain these results.

Suicide in people prescribed opioid-agonist therapy in Scotland, United Kingdom, 2011-2020: A national retrospective cohort study.

Opioid dependence is associated with an increased risk of suicide. Drug-related mortality among people with opioid dependence in Scotland has more than tripled since 2010; less is known about changes in suicide risk. We aimed to determine if opioid agonist therapy (OAT) in Scotland is protective against suicide and to measure trends in suicide rates in those with opioid dependence over time. Retrospective cohort study. Scotland, UK. 46 453 individuals in Scotland who received at least one prescription for OAT between 2011 and 2020 with over 304 000 person-years (pys) of follow-up. We calculated standardised mortality ratios (SMR) using the age- and sex-specific suicide rates in Scotland for years 2011-2020. We fitted multivariable competing-risk regression models to estimate suicide rates by OAT exposure and to estimate trends over time, adjusting for potential confounders. There were 575 deaths classed as suicide among the cohort and the overall suicide rate was 1.89 (95% confidence interval [CI] = 1.74-2.05) per 1000 pys. Age and sex SMR for suicide was 7.05 times (95% CI = 6.50-7.65) higher than in the general population. After adjustment, OAT was shown to be highly protective against suicide, with rates more than three times greater (adjusted hazard ratio: 3.07; 95% CI = 2.60-3.62) off OAT compared with on OAT. Suicide rates decreased over time, falling from 2.57 (95% CI = 2.19-3.02) per 1000 pys in 2011-12 to 1.48 (95% CI = 1.21-1.82) in 2019-20. People with opioid dependence in Scotland appear to have a greater risk of suicide than the general population. Treatment is protective, with rates of suicide lower among those on opioid agonist therapy. Suicide rates have decreased over time, during a period in which drug-related death rates in Scotland have risen to globally high levels.

Trajectory of suicide among Indian children and adolescents: a pooled analysis of national data from 1995 to 2021

BackgroundSuicide is a major public health concern in India especially among children and adolescents. The yearly national statistics show a concerning trend of rising suicide deaths in these age groups.MethodsThe present study, taking 26 years of national data from the National Crime Record Bureau during 1995–2021, examined the trend, patterns, means, and modes of children/adolescent suicides in India. We also undertook a time series analysis by using ARIMA (0,2,1) model to forecast the expected suicide rate for the next one decade.ResultsA rising trend of suicide rate among children and adolescents was observed in India over the last 26 years. The forecast indicates a continuance of rising suicide cases for the upcoming decade in India. A substantially different trend of suicide rate was observed among early and late adolescents indicating significantly high vulnerability of late adolescents. Among children /adolescents, the most common causes of suicide were family problems, academic failure, illness, and unemployment. Illness has emerged as one of the leading causes of suicide, with a significant rise over time. Poverty and unemployment were also found as the important contributors with a steadily increasing trend of suicide among children and adolescents facing these problems in recent years.ConclusionThe study provides important analysis and information on suicide among children/adolescents in India, by providing useful insights for parents, teachers, policymakers, healthcare practitioners, and stakeholders aiming to prevent and control children and adolescent suicide and boost mental health. The study also provides important leads on risk factors with a forecast of suicide trends for the next 10 years.

Suicide in China: The Trends and Differentials From 2002 to 2021

ABSTRACTObjectiveThe objective of this study was to provide an updated analysis of suicide characteristics in China from 2002 to 2021, with the aim of informing the development of evidence‐based suicide prevention strategies.MethodsThe Ministry of Health‐Vital Registration System (MOH‐VR) provided the data on suicide mortality, which enabled us to examine the average annual percentage change (AAPC) in suicide rates using a Poisson regression model.ResultsNotably, there has been a significant decline in suicide rates observed in both urban and rural areas. In the early years of the study period, higher suicide rates were observed among females compared to males; however, a shift occurred after 2005, with male suicide rates surpassing those of females. Except for 2005, rural areas consistently exhibited higher suicide rates than urban areas. Furthermore, suicide rates exhibited an increasing trend with age, irrespective of gender or region.ConclusionThese findings highlight a decreasing trend in suicide rates in China over the past two decades, although gender and regional disparities persist. Going forward, sustained efforts in suicide prevention, with a specific focus on mental health, are warranted.

Unravelling the threads: understanding the interplay of Cultural values, female workforce engagement, human development index and suicide rates.

Suicide is a major public health problem across the world. Extensive research on the field shows that suicide is affected by several sociological, economic, and cultural risk factors. Over the last century, social changes have driven the reshaping of traditional gender roles, often in an uneven fashion, strongly depending on context. This study proposes updated findings on the impact that changes in traditional gender roles could have on suicide rates METHODS: It will do so by examining the correlation between female labor force participation (FLPR) and sex-specific suicide rates. Moreover, it will examine this association depending on human development (HDI) and Hofstede's individualism index. To do so, data from 2010 to 2019 from 47 countries is collected from the WHO, ILOSTAT and UN agencies' websites. Analysis show a significant interaction between FLPR, HDI and individualism index scores on male suicide rates (p = 0.002). There is a negative association between FLPR and male suicide rates in relatively lower HDI countries, while in very high HDI countries an increase in FLPR is correlated with an increase in male suicide rates. Similar trends but no significant interaction is observed for female suicide rates. This study suggests that female participation is beneficial for male population as it reduces male suicide rates. However, this association appears to be context dependent. In countries where institutional adjustment is already established, and human development is very high, other factors might be of interest in examining the trends of suicide rates among men and women.

Different trends in suicide rates among foreign residents in Japan and Japanese citizens during the COVID-19 pandemic

BackgroundSuicide rates in Japan have increased during the COVID-19 pandemic, and foreign residents may be more vulnerable to mental stress during such crises. Therefore, we aimed to compare the trends in suicide rates during the COVID-19 pandemic between foreign residents and Japanese citizens.MethodsVital statistics of Japan data from January 1, 2016 to December 31, 2021 were used to calculate quarterly sex-specific suicide rates for foreign residents and Japanese citizens. An event-study analysis was conducted to evaluate whether suicide rates during the COVID-19 pandemic increased compared to pre-pandemic estimates; foreign residents and Japanese citizens were compared using difference-in-difference-in-differences estimates.ResultsBetween 2016 and 2021, 1,431 foreign residents and 121,610 Japanese citizens died from suicide in Japan. Although the suicide rate for foreign residents was lower than that for Japanese citizens, Korean residents, who comprise approximately half of the foreign decedents, had largely higher suicide rates than Japanese citizens. The event-study analysis indicated that suicide rates increased among foreign residents for both men and women, and continued for men by the end of 2021. In Japanese citizens, after a decline in suicide rates in the second quarter of 2020, suicide rates increased both among men and women, and lasted for women until the fourth quarter of 2021. The difference-in-difference-in-differences analyses confirmed the initial decline in the second quarter of 2020 in suicide rate only in Japanese men and women, and the persistent increase through 2021 in foreign men.ConclusionsWe found differential trends in suicide rates between foreign and Japanese men and women during the COVID-19 pandemic featuring a persistent increase in foreign men. Suicide prevention measures should be focused on these high-risk subpopulations.

Suicide in US Preteens Aged 8 to 12 Years, 2001 to 2022

This cross-sectional study investigates characteristics and trends in suicide rates among US preteens using national mortality data from 2001 to 2022.

Updated information concerning trends in suicide rates in elderly in China, 2002-2020.

The aim of this study was to investigate trends in suicide rates (SRs) among the elderly in China. Annual data on SRs among Chinese people ≥ the age of 65 were collected from China's Health Statistics Yearbook from 2002 to 2020. Then, data were stratified by age, region, and sex. Standardized SRs were calculated and analyzed using a conventional joinpoint regression model. Results revealed that overall, SRs among the elderly in China tended to decline from 2002-2020. Fluctuations in SRs, including in 2004-2005 due to the SARS epidemic, in 2009-2010 due to the economic crisis, and in 2019-2020 due to the COVID-19 pandemic, were also observed. Data suggested a relatively greater crude SR among the elderly (vs. young people), in males (vs. females), and in people living in a rural area (vs. those living in an urban area). SRs tended to rise with age. Joinpoint regression analysis identified joinpoints only for males ages 65-69 and over the age of 85 living in a rural area, suggesting that individuals in these groups are more sensitive to negative stimuli and more likely to commit suicide, necessitating closer attention. The findings from this study should help to make policy and devise measures against suicide in the future.

The association between county-level mental health provider shortage areas and suicide rates in the United States during the COVID-19 pandemic

ObjectivePrior literature has shown that mental health provider Health Professional Shortage Areas (MHPSAs) experienced a greater increase in suicide rates compared to non-shortage areas from 2010 to 2018. Although suicide rates have been on the rise, rates have slightly decreased during the COVID-19 pandemic. This study sought to characterize the differences in suicide rate trends during the pandemic by MHPSA status. MethodWe used generalized estimating equation regression to test the associations between MHPSA status and suicide rates from 2018 to 2021. Suicide deaths were obtained from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research. ResultsMHPSA status was associated with higher suicide rates (adjusted IRR:1.088 [95% CI, 1.024–1.156]). Furthermore, there was a significant interaction between MHPSA status and year (adjusted IRR:1.056 [95% CI, 1.022–1.091]), such that suicide rates did not significantly change among MHPSAs but slightly decreased among non-MHPSAs from 2018 to 2021. ConclusionsDuring the COVID-19 pandemic, there was a slight decrease in suicide rates among non-MHPSAs, while those with shortages experienced no significant changes in suicide rates. It will be important to closely monitor MHPSAs as continued at-risk regions for suicide as trendlines return to their pre-pandemic patterns.

The effectiveness of a suicide prevention program in primary care clinics supported by community public health resources: A difference-in-differences analysis

The importance of appropriate and intensive follow-up management for individuals identified with suicide risk through screening is highlighted. The Link between Primary Care Clinic and Public Health Resources Intervention(LinkPC-PH), a suicide prevention program in primary care clinics supported by community public health resources, was implemented at the district level in 2017. The purpose of the present study is to evaluate the effectiveness of the LinkPC-PH intervention by comparing suicide rates before(2014-2016) and after(2017-2019) implementation of the intervention using a difference-in-differences design. The LinkPC-PH comprises several dimensions of intervention including screening, risk assessment of suicidality, and referral in primary care clinics and crisis contact within 24 hours, case management, and safety planning led by public health professionals. After adjustment for district-level confounders, an intervention-implemented district had 2.87 fewer suicide deaths per 100,000 people in a population sample at post-intervention than would have been expected from the same trend in suicide rates as non-implemented intervention districts. In other words, the suicide rate in the intervention area decreased by 25% following the intervention. These results empirically substantiate suicide prevention programs in primary care clinics by community public health resources for reduced suicide rates to support effective community-based suicide prevention interventions.

Examining the Spread of Charcoal-Burning Suicide in Taiwan.

Background: Charcoal-burning has become a predominant method of suicide in many East-Asian countries since the 1990s. Aims: To explore charcoal-burning suicide trends from 1996 to 2020 in Taiwan. Methods: Joinpoint regression models were applied to identify suicide trends over the study period. Decompositional analyses quantified the contributions of age, sex, suicide method, and area of residence to suicide rate trends, accounting for age and geographical distribution of the general population, with a focus on charcoal-burning suicide. Results: There were three stages of suicide rate trends: increasing (1996-2006), descending (2006-2011), and levelling-off (2011-2020). Suicide by charcoal-burning accounted for 70% of the increasing suicide rates between 1996 and 2006 and 50% of the decreasing rates in the descending stage (2011-2020). During the levelling-off stage, suicide by charcoal-burning continued to decrease, albeit slowly. During the descending stage, there was a partial "substitution" of jumping for charcoal-burning. During the levelling-off stage, suicide by hanging partially "substituted" for suicide by charcoal-burning. Limitations: The variables included were limited by data availability. Conclusions: Charcoal-burning remains the second most common method of suicide in Taiwan today. Charcoal-burning has been partially replaced in the last 10 years by jumping and hanging. Monitoring suicide methods and trends is essential for suicide prevention interventions.

Understanding the Fluctuations in Korea's Suicide Rates: A Change-Point Analysis and Interrupted Time Series Analysis.

Korea has witnessed significant fluctuations in its suicide rates in recent decades, which may be related to modifications in its death registration system. This study aimed to explore the structural shifts in suicide trends, as well as accidental and ill-defined deaths in Korea, and to analyze the patterns of these changes. We analyzed age-adjusted death rates for suicides, deaths due to transport accidents, falls, drowning, fire-related incidents, poisonings, other external causes, and ill-defined deaths in Korea from 1997 to 2021. We identified change-points using the 'breakpoints' function from the 'strucchange' package and conducted interrupted time series analyses to assess trends before and after these change-points. Korea's suicide rates had three change-points in February 2003, September 2008, and June 2012, characterized by stair-step changes, with level jumps at the 2003 and 2008 change-points and a sharp decline at the 2012 change-point. Notably, the 2003 and 2008 spikes roughly coincided with modifications to the death ascertainment process. The trend in suicide rates showed a downward slope within the 2003-2008 and 2008-2012 periods. Furthermore, ill-defined deaths and most accidental deaths decreased rapidly through several change-points in the early and mid-2000s. The marked fluctuations in Korea's suicide rate during the 2000s may be largely attributed to improvements in suicide classification, with potential implications beyond socio-economic factors. These findings suggest that the actual prevalence of suicides in Korea in the 2000s might have been considerably higher than officially reported.

Suicide trends in Denmark-An ecological study exploring suicide methods from 1995 to 2019.

Suicide is a major public health problem and complex phenomenon, affecting many people around the world. However, the incidence of suicide varies by sex and age, which includes differences in the means used. Therefore, to implement effective preventative interventions, it is important to study these differences to design effective, preventative interventions. This study investigates the trends in suicide rates in Denmark from 1995 to 2019 by analysing changes based on sex, age, and the means used for suicide. Data on all suicide deaths in the study period were extracted from the Danish Register of Causes of Death, and data on the background population were obtained from Statistics Denmark. We used negative binomial regression models to analyse the data, and the obtained estimates as a logarithm of the rate ratios allowed us to compare the results across groups and years. An overall decline in Danish suicide rates was observed during the study period, with the exception of young females aged 15-29 years. The demographic composition did not change significantly, and suicide rates are still highest for males and the elderly aged 60+. Hanging, self-poisoning and firearms remain the most prevalent means of suicide. Suicide prevention initiatives are required, especially interventions targeting males and the elderly. Restricting access to the means of suicide for these groups with high fatality rates may help reduce the overall suicide rate. Moreover, more research is needed to understand the factors that lead to suicide and affect the choice of means, which should also include studying the effects of different suicide prevention strategies on males and females from different age groups.

Trends in Suicide Rates Among Post-9/11 US Military Veterans With and Without Traumatic Brain Injury From 2006-2020

This cohort study examines trends in suicide rates for veterans with and without traumatic brain injury compared with the US adult population.

Suicide rates in the Slovak Republic in 2011–2020

PurposeSuicide is a serious public health problem leading to premature mortality. The aim of the present study is to describe and analyze the trends of suicide rates in the Slovak Republic in 2011–2020.MethodsTrends of age-standardized suicide rates were described and incidence rate ratios of suicide were analyzed by negative binomial regression. The age-standardized rates of death by the undetermined intent and its ratio to suicide rate were calculated.ResultsThe overall suicide rate for the Slovak population was 7.58 per 100,000. Age-standardized suicide rate had a declining trend in the reported period, from 10.24 in 2011 to 6.65 per 100,000 in 2020. The highest suicide rate was in the oldest age groups. The male to female ratio was 6.09. The most common method of suicide in the Slovak population was hanging. The age-standardized rate of deaths by undetermined intent increased from 15.72 in 2011 to 18.46 per 100,000 in 2020.ConclusionWe observed the overall declining annual suicide mortality trends in the Slovak Republic in 2011–2020. Further investigation is necessary to understand the exceptionally high undetermined intent mortality.

The suicides in the Russian Federation: review of national studies

The epidemiological data of suicide rate, protective and risk factors is required to evaluate suicide losses, to develop appropriate interventions and to determine their effectiveness. Despite stable decreasing trend in suicide rates over the past three decades, the burden of suicides is determined by loss of young working-age population. In the post-Soviet Russia, fluctuations in suicide mortality indicators are associated with complicated periods of social economic transformations and radical changes of public policy. The risk factors also include economically depressive territories of residence, unemployment, psychoactive substance abuse, childhood and adolescence, family ill-being, incarceration, particular professional groups, physical illnesses, etc. The review established researchers' aspirations for topics improving understanding of suicide risk factors in population of Russia and needs of vulnerable groups. Such works are to result in better strategies of suicide prevention and development of new crisis care technologies. They identify problems in program implementation and provide important stimulus for determining global priorities in research and development areas.

Suicide among health professionals in Australia: A retrospective mortality study of trends over the last two decades.

To examine the relative risk of suicide among healthcare professionals compared to other occupations and examine changes in suicide rates over time. Suicide cases were identified using the National Coronial Information System and were included if they were recorded as a death by intentional self-harm between 2001 and 2017 and were by an employed adult aged 20-69 with a known occupation at the time of death. Suicide methods were reported descriptively. Workforce data at the population level was extracted from the Australian Bureau of Statistics 2011 Census. Age-standardised suicide rates per 100,000 person-years for each of the four occupational groups were calculated using direct standardisation and using the Australian Bureau of Statistics population-level data from the 2011 Census. Negative binomial regression was used to estimate suicide risk by healthcare employment status and profession, to investigate differences by sex and to examine trends in suicide rates over time, using rate ratios and 95% confidence intervals. Healthcare professionals were at increased risk of suicide compared to other occupations (rate ratio = 1.30, 95% confidence interval = [1.19, 1.42], p < 0.001), controlling for age, sex and year of death. Nurses and midwives were identified as being at significantly increased risk of suicide (rate ratio = 1.95, 95% confidence interval = [1.73, 2.19], p < 0.001). Suicide rates among female medical practitioners increased substantially over time (p = 0.01). Health professionals are at significantly increased risk of suicide, though the relative risk of different groups is changing over time. There has been a substantial increase in the risk of suicide among female medical practitioners with rates of suicide in this group more than doubling over the last two decades. Findings highlight the need for targeted suicide prevention initiatives for healthcare professionals.

Trends in suicide rates by race and ethnicity among members of the United States Army.

Efforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was conducted using an existing longitudinal database, the Substance Use and Psychological Injury Combat Study (SUPIC). Demographic (e.g., race and ethnicity) and military data from the Department of Defense compiled within SUPIC, as well as Department of Veterans Affairs data were linked with National Death Index records (through 2018) to identify deaths by suicide including those that occurred after military service. The cohort included 860,930 Army Service members (Active Duty, National Guard, and Reserve). Age-adjusted (using the direct standardization method) and age-specific suicide rates per 100,000 person years were calculated and rate ratios (RR) were used for comparisons. Trends were evaluated using hazard rates over time since the end of individuals' index deployments. Among those aged 18-29 at the end of their index deployment, the suicide rate for American Indian/Alaskan Native (AI/AN) individuals was 1.51 times higher (95% confidence interval [CI]: 1.03, 2.14) compared to White non-Hispanic individuals (WNH), and lower for Hispanic and Black non-Hispanic (BNH) than for WNH individuals (RR = 0.65 [95% CI: 0.55, 0.77] and RR = 0.71 [95% CI: 0.61, 0.82], respectively). However, analyses revealed increasing trends in hazard rates post-deployment (≤ 6.5 years) within groups of Hispanic and BNH individuals (Average Annual Percent Change [APC]: 12.1% [95% CI: 1.3%, 24.1%] and 11.4% [95% CI: 6.9%, 16.0%], respectively) with a smaller, increase for WNH individuals (APC: 3.1%; 95% CI: 0.1%, 6.1%). Findings highlight key subgroups at risk for post-deployment suicide (i.e., WNH, AI/AN and younger individuals), as well as heterogeneous trends overtime, with rates and trends varying within race and ethnic groups by age groups. Post-deployment suicide prevention efforts that address culturally relevant factors and social determinants of health associated with health inequities are needed.

Trends of suicide rates by gender and residence in China from 2002 to 2019

ObjectiveChina has undergone tremendous social changes in the last few decades. This study aimed to research the trends of the suicide rates from 2002 to 2019, and to differentiate effects attributable to age, period, and cohort by gender and residence in China. MethodsSuicide mortality data were obtained from China's Ministry of Health Vital Registration System. Joinpoint regression model was used to estimate the average annual percentage change (AAPC) of the suicide rates and ratios by gender and residence. The age-period-cohort framework was performed to analyze the underlying mechanisms for suicide mortality trends. ResultsOver the observation period, the significant decrease in suicide mortality rates in China for the economic development and urbanization was observed but to different degrees across gender and regional subgroups. The male-to-female ratio of suicide rates increased year by year (AAPC: 1.9%, 95% CI: 0.2% to 3.7%) while the urban-rural ratio changed little (AAPC: 0.9%, 95% CI: −1.8% to 3.7%). The age-period-cohort analysis revealed a marked increased effect of age and overall decreased effect of both period and cohort on suicide mortality rates. However, the recent cohort has presented an inversely increasing effect. ConclusionThe suicide rate has fallen sharply in China which has undergone tremendous socioeconomic changes. The varied changes in the suicide rate of different residence-, gender-, and age-groups as well as the age, period, and cohort effect on suicide risk further indicate the relationship of development and the suicide rates may be neither static nor identical on different subgroups in a rapidly changing society.

The Experience of the Crisis Clinic at the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva.

Suicidal behavior by children and adolescents has been and remains one of the most intractable of our social ills. Despite the general downward trend in suicide rates, children and adolescents remain one of the most at-risk groups. Suicidal behavior in all its manifestations is a biopsychosocial problem in which the superiority of one approach or the other cannot be unambiguously justified. It flows from this that strategies that aim to prevent suicide should weave together not just the medical and psychological aspects of the issue, but the social, legal, pedagogical, and other dimensions as well. To develop an integrated approach that could provide primary, secondary, and tertiary prevention of suicidal behavior in children, provide the routing of patients, and coordinate actions both between the outpatient link and inpatient specialized care and between different departments, primarily between the Moscow Department of Healthcare and the Department of Education. We analyzed the dynamics of the number of admissions to the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva of Moscow Health Department (Sukhareva Center) with suicidal manifestations in 2019-2022. Organization of the Crisis Care Clinic (Crisis Clinic), which specializes in helping children and adolescents aged 11 to 17 who find themselves in a situation of psychological crisis, have suicidal tendencies, display self-injurious behavior, experience grief, violence, or have suffered abuse. A comprehensive multi-disciplinary approach is identified as the most efficient way to treat and prevent suicidal behavior in children and adolescents. Psychopharmacotherapy is used to influence severe depressive symptomatology, reduce anxiety, moderate sedation, correct behavioral disorders, etc. In addition to medication, comprehensive psychotherapeutic assistance is recommended. The leading therapeutic approaches are cognitive-behavioral, including DBT, and family therapy, with the efforts of therapists concentrated on alleviating post-traumatic stress, depression, and behavioral problems, as well as resolving intrafamily conflicts. The need to remedy severe crisis conditions and their associated psychopathological repercussions (including suicidal and self-harming behavior) calls for coordinated efforts on the part of specialists from different fields of knowledge related to childhood and adolescence. Our analysis of the experience of working with children and adolescents in the Crisis Clinic at the Sukhareva Center shows that there is high demand for such highly specialized institutions and that the basic principles laid down at its creation, urgency, stage, and continuity of care, poly-professionalism with a focus on non-drug treatment methods, orientation towards the patient's family are relevant.