Citation

Horowitz LM, Kahn G, Wilcox HC. Pediatrics 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, American Academy of Pediatrics)

DOI

10.1542/peds.2020-043471

PMID

unavailable

Abstract

Youth suicide is a global public health crisis. The National Action Alliance for Suicide Prevention and the National Institute of Mental Health aim to reduce the suicide rate 20% by 2025.1 To reach this goal, it will be important to implement universal policies and programs and tailor suicide prevention strategies to ensure mental health professionals are meeting the needs of groups at highest risk. In this issue of Pediatrics, Ruch et al2 present data on an understudied, high-risk population of abused and neglected youth. This is the first study in which authors characterize youth in the child welfare system (CWS) who die by suicide and compare them with living CWS controls. These results have potential to inform proactive and integrated approaches to suicide prevention in the CWS, a boundaried setting that serves youth at 3.5-fold higher risk for suicide than the general youth population.3 There is minimal suicide research on youth served in the CWS, a "protected" population, hindering our ability to identify the unique needs and opportunities for suicide prevention in this population.

The Ruch et al2 study was a retrospective matched case-control design that included 120 suicide decedents aged 5 to 21 years who had an open case in Ohio's Statewide Automated Child Welfare Information System between 2010 and 2017, as well as 1200 CWS controls matched on demographics and year the case opened. The 2 main findings were that suicide decedents in the CWS were more likely to have experienced out-of-home placement and to be diagnosed with mental and chronic physical health conditions compared with controls. Of the suicide decedents, 59.2% had at least 1 diagnosable mental health condition compared with 31.2% of controls. Consequently, they were more likely to present in health care settings in the months before their suicide. Ruch et al2 found that 90% and 48% of decedents had contact with a health care provider within 6 months and 1 month, respectively of dying by suicide, a rate slightly higher than the general youth population...

Language: en