Children and Young People Who Die by Suicide: Childhood-Related Antecedents, Gender Differences and Service Contact
26 Pages Posted: 3 Oct 2019More...
Background: Suicide rates in young people are rising. We sought to understand the stresses young people face before they take their lives, their contact with services that could be preventive and whether these factors differ in girls and boys.
Methods: We identified a three-year UK national consecutive case series of deaths by suicide in people aged 10-19, based on national mortality data. We extracted information on factors preceding suicide from official investigations, primarily inquests.
Outcomes: There were 595 suicides by young people during the study period, almost 200 per year; most were male (425, 71%). Suicide rates increased significantly from the mid-teens. We obtained data on factors preceding suicide for 544 (91%). A number of previous and recent stresses were reported including witnessing domestic violence, bullying, self-harm, bereavement (including by suicide), and academic pressures. These factors were generally more common in girls while drug misuse and workplace problems were more common in boys. 42 (8%) were looked after children. 28 (5%) young people had identified as LGBT. We found suicide-related internet use in 128 (24%), most often searching for information on suicide method. 329 (60%) had been in contact with specialist children's services at some time, and this was more common in girls.
Interpretation: Several stressors precede suicide by young people, particularly girls, and are important in a multi-agency approach to prevention in education, social care, health services, and the third sector. Some of these factors may also have contributed to the recent rise.
Funding Statement: The Healthcare Quality Improvement Partnership
Declaration of Interests: LA chairs the National Suicide Prevention Strategy Advisory Group at the Department of Health and Social Care in England; NK is a member of the Group. NK chaired the guideline development group for the 2012 National Institute for Health and Clinical Excellence (NICE) guidelines on the longer term management of self-harm and currently chairs the guideline development group for the NICE depression in adults’ guidelines. All other authors declare no competing interests.
Ethical Approval Statement: The study received approval from the National Research Ethics Service (NRES) Committee North West (Greater Manchester South, UK). Exemption under Section 251 of the NHS Act 2006, enabling access to confidential and identifiable information without informed consent in the interest of improving care, was obtained from the Health Research Authority Confidentiality Advisory Group (HRA-CAG) and the Public Benefit and Privacy Panel for Health and Social Care (PBPP).
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