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The Citizen of East Alabama
Young people oftentimes haven’t yet developed coping mechanisms to deal with emotional turmoil and other problems, such as problems at home or school. They may suffer from low self-esteem, depression, substance abuse, and depression. When someone is depressed, what might seem like an insignificant problem to others can seem huge them.
- Warning signs to look for in teens are:
- Noticeable changes in eating or sleeping habits
- Unexplained or unusually severe, violent, or rebellious behavior
- Withdrawal from family or friends
- Sexual promiscuity, truancy, and vandalism
- Drastic personality change
- Agitation, restlessness, distress, or panicky behavior
- Talking or writing about committing suicide, even jokingly
- Giving away prized possessions
- Doing worse in school
If you notice any of these warning signs in your child, you should take these steps (from Stanford Children’s Health):
- Offer help and listen. Don’t ignore the problem. What you’ve noticed may be the teen’s way of crying out for help.
- Offer support, understanding and compassion. Talk about feelings and the behaviors you have seen that cause you to feel concerned. You don’t need to solve the problem or give advice. Sometimes just caring and listening, and being nonjudgmental, gives all the understanding necessary.
- Take talk of suicide seriously, and use the word “suicide.” Talking about suicide doesn’t cause suicide—but avoiding what’s on the teen’s mind may make that teen feel truly alone and uncared for. Tell the youngster that together you can develop a strategy to make things better. Ask if your child has a plan for suicide. If he or she does, then seek professional help immediately.
- Remove lethal weapons from your home, such as guns. Lock up pills, and be aware of the location of kitchen utensils, as well as ropes, which can be used as means to commit suicide.
- Get professional help. A teen at risk of suicide needs professional help. Even when the immediate crisis passes, the risk of suicidal behavior remains high until new ways of dealing and coping with problems are learned.
Don’t be afraid to take your child to a hospital emergency room if it is clear that he or she is planning suicide. You may not be able to handle the situation on your own.
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Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016 — (Journal of the American Medical Association)
May 17, 2019
Donna A. Ruch, PhD; Arielle H. Sheftall, PhD; Paige Schlagbaum, BS; Joseph Rausch, PhD; John V. Campo, MD; Jeffrey A. Bridge, PhD
IMPORTANCE Suicide is a leading cause of death among youth aged 10 to 19 years in the United States, with rates traditionally higher in male than in female youth. Recent national mortality data suggest this gap may be narrowing, which warrants investigation.
OBJECTIVE To investigate trends in suicide rates among US youth aged 10 to 19 years by age group, sex, race/ethnicity, and method of suicide.
DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study using period trend analysis of US suicide decedents aged 10 to 19 years from January 1, 1975, to December 31, 2016. Data were analyzed for periods defined by statistically significant changes in suicide rate trends. Suicide rates were calculated using population estimates.
MAIN OUTCOMES AND MEASURES Period trends in suicide rates by sex and age group were assessed using joinpoint regression. Incidence rate ratios (IRRs) were estimated using negative binomial regression comparing male and female suicide rates within periods.
RESULTS From 1975 to 2016, we identified 85,051 youth suicide deaths in the United States (68,085 male [80.1%] and 16,966 female [19.9%]) with a male to female IRR of 3.82 (95% CI, 3.35-4.35). Following a downward trend until 2007, suicide rates for female youth showed the largest significant percentage increase compared with male youth (12.7% vs 7.1% for individuals aged 10-14 years; 7.9% vs 3.5% for individuals aged 15-19 years). The male to female IRR decreased significantly across the study period for youth aged 10 to 14 years (3.14 [95% CI, 2.74-3.61] to 1.80 [95% CI, 1.53-2.12]) and 15 to 19 years (4.15 [95% CI, 3.79-4.54] to 3.31 [95% CI, 2.96-3.69]). Significant declining trends in the
male to female IRR were found in non-Hispanic white youth aged 10 to 14 years (3.27 [95% CI, 2.68-4.00] to 2.04 [95% CI, 1.45-2.89]) and non-Hispanic youth of other races aged 15 to 19 years (4.02 [95% CI, 3.29-4.92] to 2.35 [95% CI, 2.00-2.76]). The male to female IRR for firearms increased significantly for youth aged 15 to 19 years (χ2 = 7.74; P = .02 for sex × period interaction). The male to female IRR of suicide by hanging or suffocation decreased significantly for both age groups (10-14
years: χ2 = 88.83; P < .001 for sex × period interaction and 15-19 years: χ2 = 82.15; P < .001 for sex × period interaction). No significant change was found in the male to female IRR of suicide by poisoning across the study period.
CONCLUSIONS AND RELEVANCE A significant reduction in the historically large gap in youth suicide rates between male and female individuals underscores the importance of interventions that consider unique differences by sex. Future research examining sex-specific factors associated with youth suicide is warranted.
|Table. Trends in Suicide Rates (Per 100 100) Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016a|
|Age-Yrs||Sex||Segment 1||Annual Chge %||Segment 2||Annual Chge %||Segment 2||Annual Chge %|
|10-14||F||1975-1992||5.42 (3.25-7.63)||1992-2007||−2.65 (−4.74- −0.51)||2007-2016||12.73 (8.81-16.80)|
|M||1975-1993||4.54 (3.42-5.68)||1993-2007||−4.21 (−5.69- −2.70)||2007-2016||7.08 (4.21-10.03)|
|15-19||F||1975-1988||2.37 (1.13-3.62)||1988-2007||−2.22 (−2.98- −1.46)||2007-2016||7.91 (5.84-10.02)|
|M||1975-1991||2.84 (2.34-3.34)||1991-2007||−3.36 (−3.89- −2.83)||2007-2016||3.49 (2.28 – 4.72)|
|All||F||1975-1988||2.78 (1.48-4.10)||1988-2007||−2.17 (−2.94- −1.40)||2007-2016||8.93 (6.87- 11.04)|
|M||1975-1990||3.10 (2.55-3.66)||1990-2007||−3.11 (−3.58- −2.64)||2007-2016||3.83 (2.63 – 5.04)|
|a Suicide rate trends by age group were determined using joinpoint regression. The number and year of joinpoints associated with trends are defined statistically, and the periods for each linear segment may vary. The annual percentage change describes the rate of change for each linear segment trend.|
DISCUSSION: The core finding of this study is that the ratio of male to female suicide rates for children and adolescents has declined over the past 40 years. These results expand on previous reports of a disproportionate increase in the suicide rate among female relative to male youth, and highlight a significant reduction in the historically large gap in suicide rates between sexes. Following a downward trend in suicide rates for both sexes in the early 1990s, increasing rates of youth suicide since 2007 have been associated with an accelerated narrowing of the gap between male and female, with the largest percentage increase in younger female individuals. These trends were observed across all regions in the United States. Consistent with earlier studies, our findings provide evidence of racial/ethnic disparities in youth suicide rates among male and female individuals. The male to female IRR of suicide decreased for all racial/ethnic categories since 2007, with a significant declining trend across the study period in younger non-Hispanic white youth and older non-Hispanic youth of other races. Future research to identify sex-specific risk factors for youth suicide and distinct mechanisms of suicide in male and female individuals within racial/ethnic groups could lead to improved suicide prevention strategies and interventions. A particularly important finding relates to changes in method of suicide, with hanging or suffocation showing a greater increase as the cause of death among female relative to male youth.
Consistent with previous reports of increasing rates of suicide by hanging or suffocation in female youth, the male to female IRR of suicide by hanging or suffocation declined significantly for both age groups. It is troubling that a growing proportion of female youth are choosing this more violent and lethal method, as it is well documented female individuals have higher rates of attempted suicide. Most youth suicide decedents actually die on their first attempt, with the likelihood of death on first attempt being associated with lethality of method.14 Consequently, a sustained shift a highly lethal method such as hanging or suffocation by female youth could have grave public health implications and drive elevations in the rates of female suicide.
The increasing trend in differences between male and female suicide rates by firearms across the study period highlights the continuing need for prevention strategies aimed at restricting access to lethal means. The importance of poisoning as a means of suicide in female youth has been well established, and no significant changes were observed in the proportion of female individuals dying by self-poisoning across the study period. The narrowing gap between male and female rates of suicide was most pronounced among youth aged 10 to 14 years, underscoring the importance of early prevention efforts that take both sex and developmental level into consideration. Results from this study potentially challenge the existing paradox of suicidal behavior where female individuals have higher rates of suicidal ideation and attempted suicide than male individuals, while death by suicide is lower in female individuals than male individuals.
This may be especially true within some demographic groups. Differential increases over time in risk factors for suicide among female compared with male youth could contribute to the observed increase in female suicide rates. A history of suicidal behavior is a leading predictor of future suicide in youth and although rates of hospitalization for suicidal ideation and suicide attempts in youth have increased over time in both sexes, this increase has been greatest among female youth. Similarly, trends from the 2007 to 2017 national Youth Risk Behavior Survey19 revealed a significantly larger percentage increase in female youth who seriously considered attempting suicide (18.7% to 22.1%) compared with male youth (10.3% to 11.9%).
The percentage of female youth who made a suicide plan also increased significantly from 13.4% to 17.1%, while no significant change was found in male youth. Research has also identified a strong link between youth suicide and mental health, most commonly depression. The Youth Risk Behavior Survey found that the percentage of female youth who experienced persistent feelings of sadness or hopelessness increased significantly between 2007 and 2017 (from 35.8% to 41.1%), with no significant changes seen in male youth. In addition, our results that show an increase in female suicide rates by hanging or suffocation support evidence linking direct access or proximity to more lethal means with increased rates of suicide.