Relationship of Some Easily Assessed Factors with Suicidality in Children and Adolescents

Background: Mental health needs often go unmet in children and adolescents. Suicide is in the top three leading causes of death in the United States for young people ages 10-34 (CDC, 2015). Although, the number of completed suicides remains relatively low, the number of youth reporting suicidality continues to increase. Youth experiencing suicidality may be present in our physicians’ offices more often than the numbers of completed suicides would lead us to believe.

Objective: Identify suicidality related factors that can be assessed in a clinical setting.

Methods: The study used responses of 5918 high school students from one mid-size urban school district on the Youth Risk Behavior Survey (YRBS), an online survey, to assess relationships between specific items and suicide attempts. Among the items included were some from the Adverse Childhood Experiences (ACE) questionnaire. Logistic regressions were performed the relationships of 10 of the items from the YRBS with attempted suicide.

Results: In the 12 months prior to the survey, 16% of students reported they had thought about suicide and 7.4% reported attempting suicide. Results showed that females were more likely than males to attempt a suicide. The logistic regressions showed feelings of hopelessness, dating violence, and being cyber bullied were the strongest predictors of a subsequent suicide attempt. All five of the ACE items also showed strong relationships with a suicide attempt. (see Table 1).

Conclusion: Youth who experience violence, assault and abuse are likely to be seen in clinical settings by Pediatricians. Identifying factors related to suicidality among patients and providing screening, assessment, intervention and support may assist in filling the unmet mental health needs of our youth. Directing conversation throught these topics during standard practice visits with adolescents is unobtrusive and may serve to both identify suicidality and improve Dr/patient relationships. The intersection of physical and mental health remain an important avenue for intervention.