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Show fortunately every Utah agency asked to participate gave full cooperation. The state medical examiner plays a vital role, first in determining the cause of death, then in notifying the research team of each youth suicide. Finally, funding was provided by the Utah Department of Health for the study of all suicides occurring in one year. Methods This is a study of Utah residents, ages 13 to 21, who completed suicide between August 1996 and August 1997. The study was approved by the Institutional Review Boards of both the State Department of Health and the University of Utah. Ethical considerations included protecting the confidentiality of the deceased and surviving family members, respecting the rights of those who choose not to participate in the study, and monitoring the emotional demands of the interviews. The study consists of three phases: Phase I Data are collected from four government agencies: 1) Office of the Medical Examiner, 2) The Juvenile Justice System, 3) The Division of Child and Family Services (Department of Human Services), 4) The Department of Education. The Utah Department of Health has the authority to collect the data from government agencies. Each agency has a statewide data system, except the Department of Education, where data is collected from individual school districts. Care is taken not to identify the cause of death. Interviews do not occur during this phase. Phase I Medical Examiner's determination of suicide. Every suicide in Utah aged 13-21 years. Within 3 months Gather government agency data Juvenile Justice Education! Human Services Medical Examiner Phase II After consent from the "Next of Kin" is obtained, face-to-face interviews are conducted, where applicable, with parents, step-parents, and spouse. Mental health professionals from the research team go to their homes and gather information about the deceased using questionnaires designed for the study. If consent to interview "community contacts" is obtained, the "community contacts" of the deceased are identified for phase III. After each interview, families were surveyed regarding their response to the research process. This provided information on the emotional reactions to the interview and allowed us to redesign questions during the pilot study. Phase II Letter to Next of Kin introducing study 3 months after death Refuse consent Accept consent NOK completes demographic data NOK identifies | community contacts Medical and mental health records NOK interviewed as a community contact Phase III "Community contacts" of the suicide victim are interviewed, including family, friends, school counselors, employers and coworkers, clergy, romantic relationships, medical and mental health care providers, probation officers, coaches, and others. The community contacts are selected for interview according to specific protocols. Each community contact is interviewed with a standard questionnaire covering three areas: 1) An intimacy scale, to evaluate the relationship between the contact and the deceased. 2) A checklist of psychiatric symptoms, in specific categories, exhibited by the deceased. 3) A section reviewing specific barriers to mental health care experienced by the deceased. The goals of phase III are to determine which community contacts are able to recognize risk 12 |
