First suicide attempts in young people are more deadly than previously thought, according to a new study published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
The findings show that 71 percent of youth ages 10 to 24 who died by suicide did so on their first attempt, also known as the “index” attempt. The researchers also found that guns were implicated in 85 percent of youth dying on first-attempt.
“Suicide is a major public health problem affecting American youth and is the second most common cause of death for those between the ages of 10 and 24 years old,” said lead author Alastair McKean, MD, a child and adolescent psychiatrist at the Mayo Clinic in Minnesota.
“Our findings show the high lethality of index attempt suicides in youth and their close relationship to firearms. This combined with the fact that index suicide attempts are often the first intersection with mental health care is very concerning. Future prevention efforts need to focus on youth before they make their first attempt.”
For the study, the researchers looked at data from the Rochester Epidemiology Project (REP), a database of medical records and autopsy reports that stretches back to the 1960s. Results from the REP have been shown to be generalizable to the United States as a whole. The analysis included 1,490 subjects, 813 of whom were youth between the ages of 10 and 24.
In the subsample of young people, 3.6 percent of the individuals died by suicide during the study period. Though males only comprised 31.7 percent of index attempts in youth, they accounted for almost 80 percent of the suicide completions.
Firearms were heavily implicated in suicide completions, accounting for 85 percent of index attempt deaths. Previous mental health concerns were absent from the records in 41.2 percent of youth index attempters. Comparison between the youth and overall cohort found that a higher percentage of youth had a lethal index attempt.
The new findings have significant implications for efforts to reduce suicide in youth, highlighting the limitations of current approaches that seek to provide interventions following an initial episode of unsafe behavior. Seeing as the majority of suicides occur without a previous attempt, most of these young people will have had no prior contact with mental health services at all.