In this video, Janet Lee, MD, FAAP, takes you through a three-step clinical pathway to identify young people 12 and older who are at risk for suicide. It has been shown that sensationalized stories about suicide can result in SPRC Recover Together resources copycat suicide in vulnerable adolescents. In contrast, some studies show antidepressants do not increase the risk of suicide.
Strategies for prevention of suicide in young people in clinical settings
Studies were then classified by study design (i.e. RCTs and non-RCTs) and then by intervention approach (i.e. universal, selective, indicated). Two authors (SH and KW) undertook double data entry of all outcome data. In the first instance study titles and abstracts were screened by five of the review authors (EB, JR, SH, NS, KW). In addition, we hand-searched the reference lists of all previous reviews retrieved via the search. As such, studies of firearm regulations implemented with the expressed and primary purpose of preventing homicide were excluded under this criterion. Additionally, many concentrate on particular settings (e.g., schools) , or types of intervention (e.g., gatekeeper training programs) , and as such do not cover the full spectrum of approaches.
- In the clinical studies this was more prominent than in those conducted in educational settings (76.9% compared to 67.7%), suggesting that the findings from the clinical trials may be most applicable to young people aged 18 and under.
- Although there is no way to know whether these factors had any role in these adolescents’ suicides, these informants’ perspectives may provide important clues.
- Three of the five studies evaluating multimodal interventions reported generally positive impacts on rates of suicide and/or suicide-related behaviour , , .
- Five studies tested universal educational programs , , , , , two evaluated selective interventions , , five evaluated indicated interventions , , , , and four evaluated multimodal interventions , , , , , , , , .
- The state is using findings from the analysis to inform the development of Vermont’s first suicide prevention strategic plan and improve identification and support of individuals at risk for suicide.
Added Value of This Study
In a survey completed by 23 suicide prevention professionals and 43 young people, participants provided feedback on a range of social media considerations. Although there is no way to know whether these factors had any role in these adolescents’ suicides, these informants’ perspectives may provide important clues. The only time informants drew a direct relation between social media and the teen’s suicide was for youth who had been cyberbullied, with cyberbullying including the encouragement of suicidal behaviors, unsolicited proposals, or sexual coercion. Moving beyond proximal risk for suicidal thoughts to proximal risk for suicide attempts, recent research has identified the 24-hour warning signs for adolescent suicide attempts . Additional research is needed that examines the effectiveness in relation to youth mental health and behavioral outcomes.
Associated Data
Building on the evidence reviewed, Figure 3 presents a stepped-care framework for adolescent suicide prevention, outlining how screening, risk assessment, and tailored interventions can be integrated with long-term community and school support. Table 2 shows interventions with evidence for reducing future suicidal behavior in young people who have attempted suicide, an important target population given the especially heightened risk of suicide in the first three to six months after an attempt.128 Dialectical behavioral therapy (DBT) for adolescents is the only intervention that meets criteria for a well established treatment, with two RCTs showing efficacy in reducing suicide risk.129 DBT for adolescents includes a family training component for parents.130 Common elements of effective interventions include comprehensive assessment to inform treatment, safety planning, family involvement, coping skills training to match the needs identified in the assessment, and promotion of continuity of care.131 Increased efforts to tackle suicide risk in settings where young people frequently engage, such as pediatric primary care and schools, are vital.99 This section will review specific strategies and interventions for youth suicide prevention, including selective and indicated strategies. Numerous studies globally have shown that school-based, community-based and primary-care centered interventions across a range of settings and populations lead to a significant reduction in both suicide risk and suicide attempts in adolescents .
The general clinical consensus is that after acute treatment, longer term care to tackle any comorbidities or ongoing functional impairment is warranted. More examinations into the effectiveness of treatment with specific young populations are needed. Recently, ketamine has shown promise in adults and trials are ongoing in young people.