Why is youth suicide rate in Michigan so high?

2009 Michigan:

See also important Michigan historical study:

A Brighton boy's hanging death led to special legislation, but problem remains

On a February evening in 2003, while his dad fixed dinner, 12-year-old Chase Edwards hanged himself in an upstairs bathroom.

His father, Jeff Edwards of Brighton, said no one -- friends, family or teachers -- had realized Chase was not just a moody kid. In hindsight, Edwards said, the artistic boy, who would have turned 19 last Thursday, had left several clues no one connected.

"People were surprised and shocked, thinking it must have been a mistake," he said.



Michigan youths are more likely than the average American youth to attempt suicide, according to the U.S. Centers for Disease Control and Prevention. In its last survey in 2007, 9% of Michigan youths surveyed admitted attempting suicide (compared to a national average of 7%) and 27% said they had been depressed.

The Edwards family fought for a law in their son's name encouraging Michigan schools to teach about depression and suicide awareness, but it's largely unenforced -- even as federal officials say suicide is the third leading killer of teens in the United States.

In March, a federal task force made a landmark recommendation that all youths be screened for depression.

But the Edwards family and others said they believe by the time some kids get help, it's too late. They believe the conversation has to start in schools.

Little funding, few requirements hinder efforts
When Laurie Graf asks a morning health class at Tower High School in Warren Woods to describe people with mental illness, the Michigan School of Professional Psychology student nods as the teens throw out "crazy," "nuts" and "psycho."

The 30-year-old asks if she looks crazy, and two dozen heads shake no.

Then Graf reveals she's struggled with depression and suicide. The mood in the class shifts. The ninth- and tenth-graders start asking questions.

Juvenile Suicides, 1981–1998

2004 National:

Introduction

Between 1981 and 1998, 20,775 juveniles ages 7–17 committed suicide in the United States—nearly as many as were homicide or cancer victims. Males were the victims in 78% of these juvenile suicides. Over the same period, the suicide rate for American Indian juveniles was far higher than for any other race.

Statistics on juvenile suicides, and juvenile deaths in general, come from the National Vital Statistics System (NVSS), compiled by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC). NVSS summarizes information from death certificates filed in state vital statistics offices and includes cause-of-death information reported by attending physicians, medical examiners, or coroners. Analyses of these data for the period 1981–98 uncovered the following:

The number of youth ages 13–14 who committed suicide in the U.S. equaled the number who were murdered.

Of the juveniles who committed suicide, 66% of the males and 62% of the females were 17 years old.

Sixty-two percent of juvenile suicides were committed with a firearm, 24% resulted from suffocation (primarily hanging), and 10% were caused by poisoning.

Indicators of School Crime and Safety, 2012

June 2013: NCJ 241446

Presents data on crime and safety at school from the perspectives of students, teachers, and principals. This annual report, a joint effort by the Bureau of Justice Statistics and the National Center for Education Statistics (NCES), provides detailed statistical information on the nature of crime in schools. This report contains 21 indicators of crime at school from a number of sources, including the National Crime Victimization Survey (NCVS), the School Crime Supplement to the NCVS, the Youth Risk Behavior Survey, the School Survey on Crime and Safety, and the School and Staffing Survey. Topics covered include victimization at school, teacher injury, bullying and cyber-bullying, school conditions, fights, weapons, availability and student use of drugs and alcohol, and student perceptions of personal safety at school.
Highlights:

• Of the 31 student, staff, and nonstudent school associated violent deaths occurring between July 1, 2010, and June 30, 2011, 25 were homicides and 6 were suicides. From July 1, 2010, through June 30, 2011, there were 11 homicides and 3 suicides of school-age youth (ages 5–18) at school.
• In 2011, students ages 12–18 were victims of about 1,246,000 nonfatal victimizations at school, including 648,600 thefts and 597,500 violent victimizations. This was more than the number of nonfatal victimizations that occurred at school in 2010.
• During the 2009–10 school year, 85% of public schools recorded that one or more crime incidents had taken place at school, amounting to an estimated 1.9 million crimes. This translates to a rate of 40 crimes per 1,000 public school students enrolled in 2009–10.
• During the same year, 60% of public schools reported a crime incident that occurred at school to the police, amounting to 689,000 crimes—or 15 crimes per 1,000 public school students enrolled.
• During the 2009–10 school year, 39% of public schools (about 32,300 schools) took at least one serious disciplinary action against a student for specific offenses. Of the 433,800 serious disciplinary actions taken during the 2009–10 school year, 74% were suspensions for 5 days or more, 20% were transfers to specialized schools, and 6% were removals with no services for the remainder of the school year.

..Source.. by Thomas Snyder, NCES, Jennifer Truman, Ph.D., BJS

Suicidal Behavior in Children and Adolescents

2-9-2012 Global:

Age at first suicide attempt

Mazza and colleagues1 examined the age at onset of suicide attempts in youths. This longitudinal study included 883 youths who were assessed annually starting at approximately ages 6 to 18 years. Data were collected retrospectively regarding suicide attempts. When the youths were 18 to 19 years old, they were asked whether they had ever attempted suicide, the number of suicide attempts, the age of first suicide attempt, and whether they received medical treatment for their suicide attempt. Seventy-eight youths reported making a suicide attempt: 36% made their first suicide attempt during elementary or middle school. The youngest age of a suicide attempt was at 9 years.

Youths with multiple suicide attempts were more likely to have made their first attempt during elementary school or middle school compared with single attempters who had a later onset of suicide attempts. For those youths who attempted suicide, depressive symptoms were higher during the year that they made their first suicide attempt. The researchers stress the importance of including suicide prevention programs in elementary and middle schools, in addition to high school.

Suicide methods

Are the methods of suicide used by children and adolescents different from those of adults? Hepp and colleagues2 examined Swiss suicides from 1998-2007. During this 10-year period, there were 12,226 suicides: 333 of the suicides were in the child and adolescent age-group. Of these, 226 (68%) were in boys and 107 (32%) were in girls. For boys, the most common methods of suicide were use of firearms (26.1%), hanging (25.2%), railway suicide (20.8%), and jumping from heights (19.5%). Compared with suicides by adults, railway suicides and jump-ing from heights were significantly higher in the child and adolescent age-group.

Suicide by intoxication was significantly higher in the male adult group than the male child and adolescent group. Suicides by gas, by drowning, and by firearms were also more common in the adult male group than in the child and adolescent male group.

For girls, the most common methods of suicide were railway suicide (31.8%), jumping from heights (23.4%), hanging (18.7%), and intoxication (16.8%). Railway suicides were significantly more common in the female child and adolescent group than in the female adult group, whereas drowning was significantly higher in the female adult group than the female child and adolescent group.

The researchers concluded that availability is an important factor in the methods chosen by children and adolescents who commit suicide. In Switzerland, railways are readily accessible, as are bridges. Such “hot­spots” should be adequately monitored to prevent youth suicides.

Suicide risk factors

Risk factors for suicide in children and adolescents have been a strong research focus. Mood disorders are a significant risk factor for suicidal behavior in youths. Three multicenter treatment studies of adolescents with depression, the Treatment for Adolescents with Depression Study (TADS), the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study, and the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT), provide clinically useful information about predictors of suicidal events in youths.

In the TADS study, predictors of suicidal events included higher levels of self-reported suicidal ideation and depression at baseline, persistent depression, minimal improvement in depression, and acute interpersonal conflict (eg, conflict with parents or peers).3 In the TORDIA study, predictors of suicidal events were high baseline suicidal ideation, family conflict, and drug or alcohol(Drug information on alcohol) use.4 In the ADAPT trial, nonsuicidal self-injury, high suicidality, and family dysfunction were factors predictive of future suicide attempts. A history of nonsuicidal self-injury was a stronger predictor of suicide attempts than a prior history of a suicide attempt.5

Séguin and colleagues6 examined the effects of adversity on youths and young adults who committed suicide. The sample group included 67 persons who committed suicide; 36% were younger than 19 years. The control group consisted of 56 living individuals matched for age and sex.

Serious adversity was found to occur at a young age in the suicidal group compared with the nonsuicidal group. Half of the children in the suicidal group were exposed to abuse, physical violence, and/or sexual violence between birth and age 4 years. In the 5- to 9-year-old group, 60% were exposed to abuse or violence. By age 10 to 14 years, 77% of the group were exposed to these adversities. In contrast, the rates of abuse and violence in the nonsuicidal group were 14%, 18%, and 34%, respectively. The researchers note that the cumulative burden of adversity is greater for individuals with an earlier exposure to abuse and violence.

In a compelling editorial, Brent7 comments that identification of risk factors has been insufficient in preventing youth suicides. He argues that protective factors should be a research focus and that interventions should be directed toward family and personal resiliency. He suggests that consideration be given to an intervention that both treats the current disorder and fosters long-term resilience. He also recommends that health risk behaviors, such as substance use and risky sexual behavior, be included in interventions with suicidal youth. ..Source.. by Psychiatric Times.com

Justice Department Sat on Youth Suicide Study

2-12-2009 National:

Earlier this month, with little fanfare, the U.S. Department of Justice released a new study on suicides in juvenile lock-ups -- institutions ranging from county detention centers to state correctional facilities to privately run boot camps and ranches.

Or, more accurately: DOJ released a 5-year-old study "Characteristics of Juvenile Suicide in Confinement" based on data dating back to the 1990s.

The author of the study, which was commissioned by the DOJ's Office of Juvenile Justice and Delinquency Prevention, says federal officials allowed his work to gather dust for approximately a half decade before finally publishing it this month.

"This was the first national study on juvenile suicide in confinement and it was important to get the data out," said the author, Lindsay Hayes, a Massachusetts researcher and consultant who crafted the report as a contractor for DOJ.

Controversy over the report's delay was first reported by Youth Today, a newspaper geared towards social workers and youth advocates.

After scrutinizing 79 suicides that occurred between 1995 and 1999, Hayes came to several fairly startling conclusions, finding that 43 percent of the deaths happened in facilities "that did not provide any type of suicide prevention training" to frontline staffers, and that isolating teens in their rooms dramatically increased the risk of suicide.

Hayes' research also highlighted embarrassing gaps in government regulation. Oversight agencies in several states didn't even know about suicides that had transpired in county detention centers and private facilities and were not tracking deaths in such institutions.

Hayes, who is angry that the study languished, says he delivered his 15-page report in February 2004. While government reports often go through a heavy editing and revising process, Hayes claims the final draft of "Characteristics of Juvenile Suicide in Confinement" is identical to the version he wrote up five years earlier, aside from some minor copyediting.

"It's exactly the same document. None of the data has been changed," Hayes told us.

At Justice, a spokesperson said the department was investigating the delay but stressed that official reports are often years in the making. "We're doing some investigation about why it took so long," the spokesperson said. "That's all I can say right now."

Dan Macallair, executive director of the Center on Juvenile and Criminal Justice [5], a San Francisco nonprofit, said the report would have made headlines had it been released in a timely fashion.

"It would have been huge," Macallair said. "It would have led to legislative hearings, newspaper articles...It would have sparked an outcry."

Over the years, Hayes said, the Justice Department vacillated on the status of the document, saying first that it was fast-tracked for publication and later that it had been rejected and "unapproved." Last fall, Hayes complained about the delay to J. Robert Flores, then-chief of DOJ's juvenile justice office. "I wrote kind of a nasty letter to Mr. Flores saying I was extremely frustrated that this report didn't come out -- that there are youth dying," recalled Hayes.

The Obama administration recently replaced Flores with Jeff Slowikowski, a veteran staffer who is serving as the office's acting administrator.

This isn't the first time controversy has found Flores, who has been the subject of congressional hearings. In June he was questioned by the House Oversight and Government Reform Committee about millions of dollars in grant spending, with then-Chair Henry Waxman (D-CA) describing Flores' grant-making process as "neither fair nor transparent."

That same month, the Washington Post reported that Flores was the subject of a criminal probe into his "alleged use of government funds for personal travel expenses and his hiring of a politically well-connected contractor who allegedly performed little work in a high-paying job."

Flores could not be reached for comment. ..Source.. by A.C. Thompson, ProPublica