Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death

Abstract

Purpose of Review This provides up-to-date epidemiology of adolescent suicide and risk factors for suicide and highlights the overlap of risks for suicide and injury. It reviews signs and symptoms, and the up-to-date evidence on screening for depression, post-traumatic stress disorder (PTSD), suicide, substance abuse, and lethal means, and offers strategies of implementation in trauma centers. Recent Findings The incidence of adolescent suicide has continued to rise in the USA to 6.5 per 100,000, with notable racial disparities. The risk factors are complex, but many pre-existing risk factors and sequela after injury such as exposures to violence, suicidal behaviors, substance abuse, depression and post-traumatic stress disorder, and specific injuries including traumatic brain injury and spinal cord injury have further emerged as risks. Studies show rates of suicidality as high as 30% in the acute care setting. There are short screening instruments that can be used to universally screen for depression and suicidality in adolescent trauma patients. Step-up models of care for PTSD are promising to increase screening and services after injury. Lethal means counseling, secure firearm storage practices, and firearm safety policies can reduce the risk of suicide. Summary Suicide is the second leading cause of death in US adolescents, and trauma patients have significant risk factors for mental illness and suicidality before and after injury. Trauma centers should strongly consider screening adolescents, establish strategies for mental health support and referrals, and provide lethal means counseling to help prevent suicide.

Prevalence of mental health symptoms in children and adolescents during the COVID‐19 pandemic: A meta‐analysis

“…30,31 Undetected and untreated disorders may also lead to self-harm via increased risks of suicidal ideation, which became the second leading cause of mortality among adolescents aged 10-19 in the United States based on prepandemic data from 2019. 32 Additionally, youths struggling with emotional problems may adopt unhealthy coping strategies, such as substance abuse. 33,34 In the long-term, adults who have experienced mental health problems during childhood or adolescence may be at risk of developing substance dependence, having reduced earning potentials, or having difficulty forming long-lasting social relationships.…”

CBT4Depression: A Cognitive Behaviour Therapy (CBT) Therapeutic Game to Reduce Depression Level among Adolescents

“…This is, perhaps, not surprising that the statistics of suicide and homicide also increased in line with the numbers of depression, and have become the third-leading cause of death in 15-19-year-olds as reported by WHO. According to Hink et al, [2], this age group is 4 times more likely to die by committing suicide compared to other older adolescents.…”

“…As for the treatment, disturbed adolescents need to undergo a number of sessions in psychotherapy but the limitations in the current talk-based treatment may lead to negative experiences among the adolescents [3]. They also face difficulty expressing their feeling verbally and may also deny that they are suffering from depression [2]. Adolescents with depression also may have limited knowledge regarding depression, such as the differences between normal sadness and depression, early symptoms and impacts that could affect their daily life.…”

COVID-19 impacts and adolescent suicide: The mediating roles of child abuse and mental health conditions

“…According to estimates from the World Health Organization (WHO), suicide was the fourth leading cause of death for youth between aged 15 to 29 globally in 2019 ( WHO, 2021 ). Data from the United States in 2019 indicated that suicide was the second leading cause of death for children aged 10 to 19 ( Centers for Disease Control and Prevention, n.d. ; Hink, Killings, Bhatt, Ridings, & Andrews, 2022 ). Children and adolescents are one of the most vulnerable groups to suicide during COVID-19 pandemic ( Efstathiou et al, 2022 ; Farooq, Tunmore, Wajid Ali, & Ayub, 2021 ), and thus the ongoing COVID-19 pandemic provides a unique opportunity to identify factors that might shape suicide ideation and behavior in children and adolescents, having implications for suicide prevention and intervention.…”