By David N. Miller, Ph.D. Associatie Professor of School Psychology at the University at Albany, SUNY

Youth suicidal behavior is a significant and world-wide public health problem. According to the World Health Organization (WHO), suicide is the second-leading cause of death among young people ages 10-24 in the world. In the U.S., although death rates of children and adolescents have decreased substantially during the last several decades as a result of continuing medical advances, the youth suicide rate has remained persistently high. Despite some encouraging declines in the rate of youth suicide in recent years, the rate of youth suicide is still approximately 300% higher than it was in the 1950s, and there are indications it will increase further in the future. On average, approximately five children and adolescents between the ages of 10 and 19 die by suicide every day in the U.S.

Unfortunately, youth suicide is only one aspect of the broader domain of youth suicidal behavior. For example, it has been estimated that for every youth who dies by suicide, 100 to 200 young people will make a suicide attempt, and thousands more will engage in serious thoughts about suicide (i.e., suicidal ideation) or in suicide-related communication (i.e., threats or plans). According to the most recent (2009) data available from the national Youth Risk Behavior Survey, during the previous 12-month period, 6.3 percent of youth self-reported having attempted suicide one or more times, 1.9 percent reported having made a suicide attempt that resulted in the need for medical intervention, 10.9 percent reported having made a plan for a suicide attempts, and 13.8 percent reported having seriously considered attempting suicide.

There are a variety of demographic factors that affect the prevalence of youth suicide. Among the larger ethnic groups in the U.S., European Americans have the highest rate of youth suicide, followed by African American youth and Latinos. Proportionally, however, Native American youth have the highest rate of youth suicide. In regards to gender, research has consistently found a strong but paradoxical relationship between gender and youth suicidal behavior. Specifically, although adolescent females report much higher rates of suicidal ideation than adolescent males, and females attempt suicide at rates two to three times the rate of males, adolescent males die by suicide at a rate five times more often than females. In regards to age, the probability of suicide increases for both males and females as children grow older and reach adolescence. For example, adolescents who are 15 years of age or older are at much higher risk than pre-adolescents ages 10 to 14, who are at much higher risk for suicide than children under 10, where suicide is an extremely rare occurrence.

As with adults, youth suicide rates are highest in the Western states and Alaska and lowest in the Northeastern states. It has been suggested that the proportionally larger suicide rates in Western states may be due to their greater physical isolation, decreased opportunities for social interaction, fewer mental health facilities, and greater prevalence of guns is comparison to other areas of the country. In regards to sexual orientation, there is increasing evidence that gay, lesbian, and bisexual youth may be at higher risk for suicidal behavior than heterosexual youth, particularly in regards to suicidal ideation and suicide attempts. Incidents involving gay and lesbian youth who were victims of bullying and later died by suicide has recently received significant media attention.

There are many myths and misconceptions in regards to youth suicide. Perhaps the most dangerous of these myths is that talking about suicide with children and adolescents may increase the probability that suicide that will occur, because it will “put ideas in their heads.” Despite fears to the contrary, there is no evidence for this belief. In fact, research suggests that children and adolescents have better outcomes when they are provided with the opportunity to openly and candidly discuss suicide with trusted adults. Other prominent myths or misconceptions associated with youth suicide include:

Parents/caregivers are aware of their child’s suicidal behavior
Youth who attempt suicide usually receive medical attention or some other kind of treatment for it
Most children or adolescents who die by suicide leave suicide notes
Youth who are suicidal are impulsive, often dying by suicide “on a whim”
Youth suicide is caused primarily by family and social stress
Youth who talk about suicide are not “serious” about it and are “only looking for attention”
Youth who are suicidal are “crazy,” “insane,” or “out of their mind”
Youth suicide follows a lunar cycle and is more frequent during a full moon
Once a child or adolescent decides to die by suicide there is little or nothing that can be done to prevent it
There are a variety of risk factors for youth suicide, as well as protective factors that may decrease suicide risk. Risk factors are characteristics and other variables established through research that distinguish those who engage in suicidal behavior from those who do not. Risk factors do not establish a cause for suicidal behavior; they only describe an association to it. Protective factors are characteristics or variables associated with youth who do not engage in suicidal behavior. Some established risk and protective factors are listed below.

Risk factors:

mental health problems, particularly the presence of depression
previous suicide attempts
substance abuse
presence of firearms in youth’s household
nonsuicidal self-injury
exposure to a friend’s or family member’s suicidal behavior
low self-esteem
hopelessness
Protective factors:

family connectedness
school connectedness
reduced access to firearms
safe schools
academic achievement
self-esteem
Recommended Books:

Berman, A.L., Jobes, D.A., & Silverman, M.M. (2006). Adolescent suicide: Assessment and intervention, second edition. Washington, DC: American Psychological Association.
Miller, D.N. (2011). Child and adolescent suicidal behavior: School-based prevention, assessment, and intervention. New York: Guilford.
Wagner, B.M. (2009). Suicidal behavior in children and adolescents. New Haven, CT: Yale University Press.

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