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Suicide in young people
Abstract
Purpose
The purpose of this paper is to relate the health services’ prevention imperative to a new priority area, youth suicide.
Design/methodology/approach
The content is based on the latest UK policy documents and participation in recent events for policy-makers.
Findings
Suicide among young people is increasing, and traditional approaches are not reducing these deaths. Involving young people as researchers or trainers has been helpful, and policy-makers need to address the present social and cultural risk factors.
Research limitations/implications
Evidence differs between countries, and a local context may be important.
Practical implications
In the UK, local profiles are being developed and there is an increasing need identified for relevant training for a wide range of professionals.
Social implications
The participation of young people in developments may be emancipatory, for all concerned.
Originality/value
Because this year, young persons’ mental health will be an international priority, this may be the time to galvanise action for improved planning and resources for the prevention of youth suicide.
... Nearly 45 million people were diagnosed with depressive syndrome in 2015. Approximately 2.6 million (22.5%) people across the world will be affected with the problem of depression due to population expansion and ageing by 2025 (Charlson et al., 2016) Adolescents today are not only involved in delinquencies such as stealing, robbing, bullying, gangsterism, smoking (Ahmad, 2013), and going against teachers' words, but they are also involved in incidents of violence such as killing, prostitution, baby-dumping and risk-taking behaviours (Nejati, Alipour, 2017) and suicide (Caan, 2019). These social problems are dramatically increasing and have become a national issue which has raised serious concerns. ...
The above statement is of a well-known researcher of the subject of suicide. Suicide points to consider the phenomenon of various perspectives: philosophical, theological , sociological, clinical, psychological, and psycho-pedagogical. The choice of this direction of analysis depends on the theoretical and methodological assumptions adopted by the researcher. My study, focus on psycho-pedagogical. I will try to combine the phenomenon of suicide with the so-called "Young people with difficulties." My analysis will be carried out in the area of bio-psycho-ecological theory, which allows me to approach this subject in a multidimensional way, because I am of the opinion of multidimensional approach brings the best results.
Warto pamiętać, że ludzie nie zabijają się dlatego, że nie chcą żyć. Raczej dlatego, że nie wiedzą, jak dalej żyć(Brunon Hołyst)
Powyższe stwierdzenie znanego badacza problematyki samobójstw pozwala na rozpatrywanie tego zjawiska z różnych perspektyw: filozoficzno-teologicznej, socjologicznej, klinicznej, psychologicznej, i psychopedagogicznej. Wybór
kierunku analizy zależy od przyjętych przez badacza założeń teoretycznych i metodologicznych. W moim opracowaniu uprzywilejowanym kierunkiem rozważań
będzie ten ostatni, czyli psychopedagogiczny.
Spróbuję połączyć zjawisko samobójstwa z problematyką tzw. „młodzieży
z trudnościami” (potocznie określanej „młodzieżą trudną”). Moja analiza przebiegać będzie przez obszar teorii biopsychoekologicznej, która pozwala mi na
wielowymiarowe podejście do tej tematyki, gdyż uważam, iż taką ona właśnie jest.
Background
Childhood poverty is associated with elevated later risks for self-directed and externalised violence, but how risks are modified by parental socioeconomic mobility remains unclear. We investigated parental income trajectories during childhood and subsequent risks of self-harm and violent criminality in young adulthood.
Methods
Using Danish national registers, we delineated a nested case-control study of Danish citizens born from Jan 1, 1982, to Dec 31, 2000, with first hospital-treated self-harm episodes and first violent crime convictions at ages 15–33 years. Each case was matched on age and gender to 25 randomly selected controls. Parental income was assessed in birth-year and at ages 5 years, 10 years, and 15 years. We considered parental age, the child's number of siblings, parental mental health, and parental education to be covariates. We estimated incidence rate ratios (IRRs) by conditional logistic regression inherently adjusted for age, gender, and calendar year; we then made additional adjustments for the covariates considered.
Findings
We identified 21 267 first episodes of hospital-treated self-harm, to which we matched 531 675 controls, and 23 724 first violent crime convictions, to which we matched 593 100 controls. We observed inverse relationships between parental income and risks for the two outcomes for each of the ages parental income was measured. The longer a child lived in poorer circumstances, the higher their subsequent risks for self-harm and violent criminality, and vice versa for time spent living in affluent conditions. Associations were stronger for violent criminality than for self-harm. Compared with individuals who were born and remained in the most affluent families, all other income trajectories were associated with elevated risks for both outcomes. Those who remained in the least affluent quintile showed the highest risks for self-harm (IRR 7·2, 95% CI 6·6–7·9; 1174 [6%] cases) and for violent criminality (IRR 13·0; 95% CI 11·9–14·1; 1640 [7%] cases). The risk patterns were attenuated, but essentially persisted, after covariate adjustment. For any parental income level at birth, being upwardly mobile was associated with lower risk compared with downward mobility.
Interpretation
Parental income represents a multitude of unmeasured familial sociodemographic indices. Tackling the causes of inequality and associated psychosocial and sociocultural challenges to enable upwards socioeconomic mobility could potentially reduce risks for self-directed and externalised violence.
Funding
European Research Council.
Objective
To examine the relation between childhood adversity, the role of school performance, and childhood psychopathology and the risk of suicide.
Design
Cohort study of register based indicators of childhood adversity (at ages 0-14) including death in the family (suicide analysed separately), parental substance abuse, parental psychiatric disorder, substantial parental criminality, parental separation/single parent household, receipt of public assistance, and residential instability.
Setting
Swedish medical birth register and various Swedish population based registers.
Participants
548 721 individuals born 1987-91.
Main outcome measures
Estimates of suicide risk at ages 15-24 calculated as incidence rate ratios adjusted for time at risk and confounders.
Results
Adjusted incidence rate ratios for the relation between childhood adversity and suicide during adolescence and young adulthood ranged from 1.6 (95% confidence interval 1.1 to 2.4) for residential instability to 2.9 (1.4 to 5.9) for suicide in the family. There was a dose-response relation between accumulating childhood adversity and risk: 1.1 (0.9 to 1.4) for those exposed to one adversity and 1.9 (1.4 to 2.5) and 2.6 (1.9 to 3.4) for those exposed to two and three or more adversities, respectively. The association with increased risk of suicide remained even after adjustment for school performance and childhood psychopathology.
Conclusion
Childhood adversity is a risk factor for suicide in adolescence and young adulthood, particularly accumulated adversity. These results emphasise the importance of understanding the social mechanisms of suicide and the need for effective interventions early in life, aiming to alleviate the risk in disadvantaged children.
Death by suicide is a significant cause of mortality among youth. However, there is limited information on the demographic and clinical factors associated with youth suicide deaths. The objective of this study was to link large statewide databases to describe demographic, clinical, and cause of death characteristics among youth who died by suicide. We examined 1,218 decedents under age 26 who died by suicie between 2000 and 2014. Eighteen died before age 12, 53 died between ages 12 and 14, 292 died between ages 15 and 18, and 855 died between ages 19 and 25. Most were male (83%), and firearm was most common cause of death; 28% previously attempted suicide, 31% had a mental health diagnosis, and 17% were prescribed psychotropic medication. Younger children died by hanging/smothering (89% of all 7- to 11-year olds), and overdose/poisoning increased progressively with age. Adolescents had a higher proportion of females than young adults (23% vs. 14%, p = .002). Combining data from the medical examiner and large hospital systems allows examination of youth suicide from a developmental perspective. Differences between age groups included gender, method, diagnosed mental illness, and diagnosis of attention deficit hyperactivity disorder. These data point to missed opportunities for effective interventions for specific developmental stages.
In planning, designing, procuring and ensuring delivery of improved services ('commissioning') for the school age population, the outcomes should be students who are healthy to learn and who learn to be healthy. Intuitively, linking education and health development together within the wider learning environment seems a good start to planning school health. However there has been a shortage of either theoretical models that can span different settings or experimental research that demonstrates improved community health. Is there evidence that the wider learning environment provided in a school is valuable in improving health? An initial scoping exercise identified domains of health where there was a promise of health gain. International literature on school health outcomes using the framework of Asset-Based Community Development (ABCD) has been reviewed. It was found that research on a variety of interventions was relevant to schools as an asset for public health. Effective areas for health gain were identified for local planning and evaluation using this community model. However, none of the studies reviewed was originally designed to test schools as assets and most of the research lacked methodological rigour, especially regarding children in low income countries. The ABCD model could help national governments develop resources for both education and health, but there is a global need to generate better quality evidence. Then people who commission for their local communities can make more effective use of these multifaceted assets to improve health and education outcomes for children.
Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Reimagining youth suicide prevention
- J White
Suicide prevention profile
- Public Health England