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Show Utah Youth Suicide Study: Preliminary Results by Doug Gray, M.D.; T. Keller R.N., M.P.H.; L. Haggard, Ph.D.; B. Rolfs, M.D.; J. Achilles, M.A.; D. Tate, M.S.; C. Cazier, M.P.H.; and W. McMahon, M.D. Abstract Objective: State agency records of all Utah suicide victims, age 13-21 were reviewed for risk factors and prevention opportunities. Method: Data were reviewed from 4 state agencies. Results: Medical Examiner's records (n=54) indicate a 4:1 maleifemale ratio, and methods: firearms 51%, hanging 26%; Juvenile Justice records (n=49) show 65% had contact, and by age 18 (n=24) 75% have contact, and significantly more offenses than controls; School records (n=31) show 47% with record of suspension or expulsion, and 39% with special education evaluation; Child Protective Services review (n=51) show 21% with a family referral. Conclusions: Preliminary results suggest this approach contributes to the understanding of youth suicide. Referral to Juvenile Justice is an important risk factor. Introduction U.S. suicide rates have remained steady since the 1950s, but the rate of youth suicide has increased dramatically. For example, the U.S. rate for 15-24 year old youth has risen from 3.5 per 100,000 in 1950, to 7.5 in 1970, and 13.5 in 1990. The trend is to see suicide at younger ages, with the U.S. suicide rate for individuals less than 15 years old increasing 121% from 1980 to 1992 (Kachur, Potter, James, Powell, 1995). There are distinct gender differences in choosing lethal and non-lethal methods. Eighty percent of suicide attempters are female and 80% of suicide completers are male (Canetto, 1997). Suicide rates are generally higher in the western states than in the rest of the country. Recent theories, such as regional differences in age, sex, racial/ethnic mix, and firearm availability, have failed to explain this pattern (Centers for Disease Control, 1997). In Utah, suicide is the leading cause of death for males ages 15 to 44 (Rolfs, unpublished Utah data, 1997). Firearms are the most common method of suicide across the nation, among all age groups, and for both males and females (Kachur et al., 1995). Psychological autopsy studies allow researchers to study suicide and can guide future suicide prevention efforts. Studies to date have focused on the diagnoses of youth suicide victims and have found that more than 90% had a psychiatric disorder (Brent et al., 1988). Both male and female suicide completers have high rates of mood disorders. Males frequently have additional diagnoses, most commonly substance abuse or conduct disorder. The studies to date find that only 5-20% of suicide completers are in psychiatric treatment at the time of their death (Brent et al., 1988; Shaffer et al., 1996); current methods of prevention, such as school education programs and teen hotlines, have not been shown to be effective (Hazell and King, 1996; Grossman, 1992). Nationally, suicide experts suggest that we focus our efforts on finding youth who are at risk for suicide and get them into treatment. Unfortunately, the best mechanism to accurately find these young people who are at risk for suicide is unclear. Where are these individuals connected in our community, and how can they be identified? For example, do these youth completers attend school or are they involved with the justice system? Do they seek help from primary care doctors, counselors, or clergy? Which community contacts recognize known suicide risk factors, or try to intervene? When community members try to prevent an individual suicide, and fail, what are the barriers they face? Statewide Effort The Utah Child Fatality Review Committee (CFRC) identified a need to fight the rising epidemic of youth suicide in Utah. Based on the recommendation of the CFRC, the Utah Department of Health organized a committee with representatives from multiple government agencies to study the problem. Due to gaps in the available information and understanding of youth suicide, it became clear that research was necessary before appropriate prevention programs could be developed. Once the study was designed, it was reviewed by national suicide experts who supported the need for this type of research. The study methodology has been presented at local, regional, and national conferences. Cooperation among government agencies was crucial, and 11 |