Strong student-adult relationships lower suicide attempts in high schools
Innovative study of social groups shows trusted adults, as well as peers, can help with prevention
September 9, 2019
Science Daily/University of Rochester Medical Center
Study of social networks in 38 high schools shows evidence that clearly identified, competent adult mentors that are connected to many students can help prevent suicide attempts.
High schools where students are more connected to peers and adult staff, and share strong relationships with the same adults, have lower rates of suicide attempts, according to a new study published by the Journal of Child Psychology and Psychiatry.
The study, "Peer-adult network structure and suicide attempts in 38 high schools: implications for network-informed suicide prevention," surveyed 10,291 students from 38 high schools to determine social integration through the relationship network structure of each school.
Students were asked to name up to seven of their closest friends at their school. In a novel approach, students were also asked to name up to seven adults in their school they trust and feel comfortable talking to about personal matters. Researchers used the friendship and adult nominations submitted to build comprehensive social networks for each school.
Researchers used this data to determine whether differences in social networks between schools resulted in different rates of suicide attempts and suicidal ideation (thinking about or planning suicide). Their findings revealed the following:
• Rates of suicide attempts and ideation were higher in schools where students named fewer friends, friendship nominations were concentrated in fewer students, and students' friends were less often friends with each other.
• Suicide attempts specifically were higher in schools where students were more isolated from adults, and student nominations of adults were concentrated among fewer students (i.e. a few students had disproportionately more trusted adults vs. other students).
• Schools in which 10 percent more students were isolated from adults correlated to a 20 percent increase in suicide attempts.
• Conversely, suicide attempts were lower in schools where students and their close friends shared strong bonds with the same adult, and where a smaller number of adults were nominated by a larger share of students.
Schools in which many students name the same trusted adults "may reflect the presence of clearly identified, competent adults being connected to many students," said the study.
This focus on social networks had been relatively unexplored in previous research on suicide, according to lead author Peter A. Wyman, PhD, professor in the Department of Psychiatry at the University of Rochester School of Medicine and Dentistry. "Most suicide prevention is centered on the high-risk individual," Wyman said. "We wanted this study to provide us with new ways of thinking on how to intervene to strengthen protective relationships on a broader school-level, and even on a community level."
The number of children and teens who have been brought to the emergency room for suicide attempts or suicidal ideation has nearly doubled in recent years, according to a recent study published by JAMA Pediatrics. There were 1.12 million emergency room visits for suicide attempts or suicidal ideation by children ages 5 to 18 years old in 2015, up from 580,000 in 2007.
In addition, suicide is the second leading cause of death among young people in the U.S. age 10 to 18 and rates have been increasing by nearly 2 percent per year.
Wyman hopes these study results could potentially help schools develop more effective, comprehensive interventions. "Despite a great deal of effort, suicide rates continue to rise. This study identifies protective schoolwide network factors, such as cohesion between adolescents' peer and adult networks. This network-informed perspective gives us some new concepts for suicide prevention," he said. "Strengthening inter-generational cohesion so that more friendship groups share a trusted adult could make it easier for youth to close the circle through that connection if a friend is at-risk."
Participating schools had wide differences in the percentage of students who nominated trusted adults. In the lowest ranked school, only 8.3 percent of students named a trusted adult, while 53.4 percent of students named a trusted adult in the highest ranked school. Authors of the study recommended looking at characteristics of school staffs, such as diversity and attitudes about youth, and the school leadership climate to better understand why these differences exist. In addition, the study recommended developing strategies to strengthen protective social networks, including training student peer group leaders to promote positive social behaviors, and working to prepare responsive adults and connect those adults into student social groups.
"The time has come for our field to think more broadly about suicide prevention," said Anthony R. Pisani, PhD, associate professor at the University of Rochester School of Medicine and Dentistry. "Individual risk factors, like depression, substance use or traumatic history, are important, but we also need to think about the health of the social ties and systems in which we are all interwoven." Wyman and Pisani have used these strategies to guide two intervention programs -- Sources of Strength and Above the Influence of Vaping -- that they have helped implement in 60 high school and middle schools across New York state. Sources of Strength, which was developed in North Dakota in the 1990s, utilizes preventative, population-based approaches by identifying peer leaders of social groups throughout schools and preparing them to become positive influences on their friends' coping behaviors. Above the Influence of Vaping is a substance abuse prevention program targeting middle schoolers developed by Wyman and Pisani that uses similar peer leader engagement methods combined with science-based peer-to-peer messaging.
Both programs have successfully worked to increase student connections with adults, and this study reinforces the need to strengthen those bonds, according to Wyman. "One of the most important predictors of lower suicide attempt rates in this study was positive youth-adult connections widely spread across the school," said Wyman, "we have to be thinking about the broader population to make sure more students are connected to adults prepared to support them."
https://www.sciencedaily.com/releases/2019/09/190909170800.htm
Suicide attempts by self-poisoning have more than doubled in teens, young adults
May 2, 2019
Science Daily/Nationwide Children's Hospital
A new study from Nationwide Children's Hospital and the Central Ohio Poison Center found rates of suicide attempts by self-poisoning among adolescents have more than doubled in the last decade in the U.S., and more than tripled for girls and young women.
The study, published online today in the Journal of Pediatrics, evaluated the incidence and outcomes from intentional suspected-suicide self-poisoning in children and young adults ages 10 to 24 years old from 2000-18. In the 19-year time period of the study, there were more than 1.6 million intentional suspected-suicide self-poisoning cases in youth and young adults reported to U.S. poison centers. More than 71% (1.1 million) of those were female.
"The severity of outcomes in adolescents has also increased, especially in 10- to 15-year-olds," said Henry Spiller, MS, D.ABAT, director of the Central Ohio Poison Center at Nationwide Children's Hospital, and co-author of the study. "In youth overall, from 2010-2018 there was a 141% increase in attempts by self-poisoning reported to U.S. poison centers, which is concerning."
Previous research has shown that suicide is the second leading cause of death among young people aged 10 to 24 years, and that while males die by suicide more frequently than females, females attempt suicide more than males. Self-poisoning is the most common way that someone attempts suicide and third most common method of suicide in adolescents, with higher rates in females.
"Suicide in children under 12 years of age is still rare, but suicidal thoughts and attempts in this younger age group do occur, as these data show," said John Ackerman, PhD, clinical psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children's Hospital, and co-author of the study. "While certainly unsettling, it's important that parents and individuals who care for youth don't panic at these findings, but rather equip themselves with the tools to start important conversations and engage in prevention strategies, such as safe storage of medications and reducing access to lethal means. There are many resources and crisis supports available around the clock to aid in the prevention of suicide, and suicide prevention needs to start early."
According to the Big Lots Behavioral Health experts at Nationwide Children's, parents should check in regularly with their children, ask them directly how they are doing and if they have ever had thoughts about ending their life. These direct questions are even more critical if warning signs of suicide are observed.
"There is no need to wait until there is a major crisis to talk about a plan to manage emotional distress. Actually, a good time to talk directly about suicide or mental health is when things are going well," said Ackerman, whose suicide prevention team provides comprehensive programming to more than 120 central and southeast Ohio schools and delivers suicide prevention training to community organizations that serve youth. "A helpful starting point for any parent to increase the dialogue is OnOurSleeves.org, which has resources about beginning this important conversation as a family. The American Association of Suicidology and American Foundation for Suicide Prevention also have many resources."
Data for this study were collected by the National Poison Data System (NPDS) from January 2000 to November 2018.
If you or your child need immediate help due to having suicidal thoughts, go to your local emergency room immediately, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or you can reach the Crisis Text Line by texting "START" to 741-741. If you believe an overdose has occurred, call the national Poison Help hotline 1-800-222-1222.
About On Our Sleeves
Because kids don't wear their thoughts on their sleeves, we don't know what they might be going through. That's why Nationwide Children's Hospital launched On Our Sleeves to build a community of support for children living with mental illness through advocacy, education and fundraising for much-needed research. For more information about children's mental health and to help break the silence and stigma around mental illness, visit OnOurSleeves.org.
About The Central Ohio Poison Center
The Central Ohio Poison Center provides state-of-the-art poison prevention, assessment and treatment to residents in 64 of Ohio's 88 counties. The center services are available to the public, medical professionals, industry, and human service agencies. The Poison Center handles more than 42,000 poison exposure calls annually, and confidential, free emergency poisoning treatment advice is available 24/7. To learn more about the Poison Center, visit http://www.bepoisonsmart.org.
https://www.sciencedaily.com/releases/2019/05/190502075817.htm