Suicide Prevention Month: 1 in 5 American youths have seriously considered death by suicide, reveals CDC
Suicidal behavior presents a major challenge to public health in the US and globally. Approximately one in five youths (18.8%) in the US have seriously considered attempting suicide, one in six (15.7%) made a suicide plan, one in 11 (8.9%) made an attempt, and one in 40 (2.5%) made a suicide attempt requiring medical treatment in 2019, according to the US Centers for Disease Control and Prevention (CDC).
The report includes data from the 2009-2019 cycles of the Youth Risk Behavior Survey (YRBS), a cross-sectional, school-based survey conducted biennially since 1991. Each survey year, CDC collects data from a nationally representative sample of public and private school students in grades 9-12 across 50 US states and the District of Columbia. The analysis reveals that during 2009-2019, the prevalence of suicide attempts increased overall and among female, non-Hispanic white, non-Hispanic black, and 12th-grade students.
September is National Suicide Prevention Awareness Month as well as National Suicide Prevention Week (September 6-12) in the US. “Suicide is the second leading cause of death among high school-aged youths 14-18 years after unintentional injuries. While fatal (suicide) and nonfatal (for example, suicide attempts) suicidal behaviors are a public health concern across the life span, they are of particular concern for youths and young adults aged 10-24 years,” write authors.
According to the analysis, data from 2019 reflect substantial differences by demographics regarding suicidal ideation and behaviors. Prevalence estimates of suicidal ideation, suicide plans, attempts, and attempts requiring medical treatment were highest among sexual minority youths, those who identified as lesbian, gay, or bisexual, and youths who reported having had sexual contact with the same or with both sexes during 2019.
The findings
During 2019, 18.8% of students nationwide reported seriously considered attempting suicide, with prevalence significantly higher among female (24.1%) than male (13.3%) students. Among students across the US, 15.7% of students had made a plan about how they would attempt suicide, and again prevalence was significantly higher among female (19.9%) than male (11.3%) students). The team found that 8.9% of students had attempted suicide at least once or more, and the prevalence was significantly higher among female (11.0%) than male (6.6%) students). Further, 2.5% of students had made a suicide attempt requiring medical treatment, with a prevalence greater among female (3.3%) than male (1.7%) students. “Overall, a significant difference occurred in having seriously considered attempting suicide by race/ethnicity (White: 19.1%, Black: 16.9%, Hispanic: 17.2%). There was a significant difference by race/ethnicity among male students (White: 13.8%, Black: 10.7%, Hispanic: 11.4%) but not among female students. No significant differences (overall or by sex) occurred in having seriously considered attempting suicide by grade,” say researchers.
Among students reporting having made a suicide plan, a significant difference occurred by race and ethnicity overall (White: 15.7%, Black: 15%, Hispanic: 14.7%) but not among male or female students. No significant difference occurred in having made a suicide plan by grade overall or among female students. “But a significant difference was identified among male students (9th grade: 9.5%, 10th grade: 10.4%, 11th grade: 12.1%, and 12th grade: 13.6%). Students who had attempted suicide were significantly different by race/ethnicity overall (White: 7.9%, Black: 11.8%, Hispanic: 8.9%) and among female students (White: 9.4%; Black: 15.2%, Hispanic: 11.9%) but not among male students. No significant differences existed in having attempted suicide by grade (overall or by sex). In addition, no significant difference in having made a suicide attempt requiring medical treatment was noted by race/ ethnicity or grade, overall or by sex,” the findings state.
The analysis shows that a significant difference occurred in having seriously considered attempting suicide by sexual identity overall -- heterosexual: 14.5%, lesbian, gay or bisexual (LGB): 46.8%, not sure: 30.4%, and among both female (heterosexual: 18%, LGB: 49%, not sure: 35.9%) and male (heterosexual: 11.4%, LGB: 40.4%, not sure: 21.7%) students. Overall, a significant difference also occurred in having made a suicide plan by sexual identity -- heterosexual: 12.1%, LGB: 40.2%, and not sure: 23.9%. There was also a considerable difference in having made a suicide plan among both female (heterosexual: 14.6%, LGB: 42.4%, not sure: 28.1%) and male (heterosexual: 9.9%, LGB: 33%, not sure: 17.4%) students.
“A significant difference existed in having attempted suicide by sexual identity, overall (heterosexual: 6.4%, LGB: 23.4%, not sure: 16.1%) and among both female (heterosexual: 7.9%, LGB: 23.6%, not sure: 15.2%) and male (heterosexual: 5.1%, LGB: 23.8%, not sure: 16.4%) students,” the findings state. It adds, “Finally, a significant difference occurred in having made a suicide attempt requiring medical treatment by sexual identity, overall (heterosexual: 1.7%, LGB: 6.3%, not sure: 5.2%) and among both female (heterosexual: 2.3%, LGB: 6.6%, not sure: 3.8%) and male (heterosexual: 1.3%, LGB: 5.9%, not sure: 7.6%) students.”
Future directions
The authors have recommended a comprehensive suicide prevention to address the differences and reduce the prevalence of suicidal ideation and behaviors by implementing programs, practices, and policies that prevent suicide (parenting programs), supporting persons currently at risk (psychotherapy), preventing reattempts (emergency department follow-up), and attending to persons who have lost a friend or loved one to suicide. According to them, such an approach addresses the range of risk and protective factors occurring across the individual, relationship, community, and societal levels
“More research is needed to better understand the risk and protective factors to determine which suicide prevention strategies might best serve each group. The findings in this report underscore the importance of a comprehensive approach to suicide prevention, which would provide the necessary support to those at risk, decrease suicidal ideation and behaviors, and ultimately prevent suicide among youths and save lives,” emphasize researchers.
Preventing adverse childhood experiences (such as child maltreatment) can help reduce suicide risk among adolescents through strategies that promote safe, stable, nurturing relationships and environments in childhood, suggests the team. Other strategies in a comprehensive approach to suicide prevention include supporting families by strengthening economic supports and teaching coping and problem-solving skills among children, adolescents, and their parents, promoting connectedness between youths and their schools, teachers, peers, and family, and creating protective environments in schools and at home. Reducing stigma, and training teachers and adults in recognizing signs of suicide and responding effectively through referrals to evidence-based treatment, are other recommendations.