Kidsdata.org provides both the rate of suicides per 100,000 youth ages 15-24, and the rate of hospitalizations for self-inflicted (but non-fatal) injuries per 100,000 children ages 5-20. Suicide attempts and self-mutilation both are included in the rate of hospitalizations for self-inflicted injuries. The number of hospitalizations due to self-inflicted injuries is available overall and by age. In addition, the number of youth suicides is provided by age, race/ethnicity, and gender. 

Suicide is the third leading cause of death for youth ages 10-24 nationwide. Though it is likely underreported due to social stigma, reported suicides account for approximately 4,400 deaths a year among youth in the U.S. (1). Youth suicide rates have decreased somewhat in the past 15 years (2); however, youth suicide continues to be a salient public health problem. On a 2011 survey, 1 in 13 U.S. 9th-12th graders reported having attempted suicide one or more times in the past year, and more than 1 in 7 reported seriously considering attempting suicide (3).

Some groups are at a higher risk for suicide than others. Males are more likely to commit suicide than females, but females are more likely to report attempting suicide (1). Among racial/ethnic groups nationwide, American Indian/Alaska Native and Hispanic/Latino youth have the highest suicide rates (1). In addition, research has shown that lesbian, gay, bisexual, and transgender youth report suicide attempts at significantly higher rates than their heterosexual counterparts (4). Several other factors put teens at risk for suicide, including a family history of suicide or past suicide attempts, mental or physical illness, substance abuse, stressful life events, easy access to lethal methods, exposure to suicidal behavior of others, and incarceration (1).

Approximately 149,000 young people ages 10-24 are treated for self-inflicted injuries at U.S. emergency departments every year (1). According to data collected by the National Center for Injury Prevention and Control, poisoning is the most common form of intentional, self-inflicted, non-fatal injury resulting in hospitalizations for 10- to 24-year-olds (5). Compared to adults, adolescents are at heightened risk for self-injurious behavior (e.g. cutting, scratching, etc.), but these behaviors typically are not suicide attempts. The reasons for adolescent self-injurious behavior are not fully understood, though research suggests it can occur for a variety of reasons, such as coping with intense psychological distress (6).

Find more information and research about suicide and self-inflicted injuries in kidsdata.org's Research & Links section.

Sources for this narrative:

1. Centers for Disease Control and Prevention. (2009). Suicide prevention. Retrieved from: http://www.cdc.gov/ViolencePrevention/pub/youth_suicide.html
2. Child Trends. (2011). Teen homicide, suicide, and firearm deaths. Retrieved from: http://www.childtrendsdatabank.org/?q=node/319
3. U.S. Surgeon General and the National Action Alliance for Suicide Prevention. (2012). 2012 national strategy for suicide prevention. Retrieved from: http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/full_report-rev.pdf 
4. Haas, A. P., et al. (2010). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58(1), 10-51. Retrieved from: http://www.tandfonline.com/doi/abs/10.1080/00918369.2011.534038
5. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. (2010). WISQARS leading causes of nonfatal injury reports. Retrieved from: http://webappa.cdc.gov/sasweb/ncipc/nfilead2001.html
6. Nock, M. K., & Prinstein, M. J. (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology, 114(1), 140-146. Retrieved from: http://www.wjh.harvard.edu/~nock/nocklab/Nock_Prinstein_JAbP2005.pdf

Among all youth, the vast majority of those who commit suicide have a psychiatric disorder, and most of those youths show symptoms that could be identified by screening (1, 2). Many primary care providers do not routinely screen youth for mental health issues, and teachers often lack the training or the time to identify emotional/mental health issues and refer students for intervention (1, 5). Some youth are particularly at risk. Lesbian, gay, and bisexual adolescents attempt suicide at a rate three to six times that of comparably aged heterosexual youth, and are frequently the target of bullying when they do not conform to traditional gender roles (3, 4).

According to research and subject experts, policy options that could promote emotional health and prevent suicides and self-inflicted injuries include:

• Ensuring adequate funding and training for a range of school professionals to recognize the signs of depression, self-injury, and suicidal ideation, and to connect students with appropriate services (2, 3, 5, 6), including specific training for meeting the needs of gay, lesbian, bisexual, and transgender youth (3, 4)
• Supporting efforts in schools to offer comprehensive K-12 education for social-emotional development, including interpersonal communication, goal setting, anger management, and advocacy skills, as supported by the National Association of State Boards of Education and the California Education Code (9, 10)
• Encouraging school districts to collaborate with communities and the media to limit publicity and glamorization of youth suicide, to prevent contagion among other vulnerable youth (6)
• Promoting efforts in schools and communities to provide youth with positive experiences and opportunities, such as quality after-school programs, to develop supportive connections with others and skills that will help them make healthy choices and become caring, responsible adults (8)
• Structuring public health systems and insurance reimbursement policies to require depression screening and encourage regular administration of psychosocial exams to youth (1, 2, 7)
• Eliminating discriminatory public policies that can contribute to mental health issues among gay, lesbian, bisexual, and transgender youth (3)
• Ensuring adequate access to and quality of mental health services for children and youth

For more policy ideas and information on this topic, see kidsdata.org’s Research & Links section, or visit the Suicide Prevention Resource Center, or the Centers for Disease Control and Prevention. Also see Policy Implications on kidsdata.org under School Safety & Bullying/Harassment at School; School Connectedness; Pupil Support Service Personnel; Alcohol, Tobacco & Other Drugs; and Child Abuse & Foster Care.

Sources for this narrative:

1. TeenScreen National Center for Mental Health Checkups at Columbia University. (2009). Adolescent mental health checkups: Recommendations to realizations. Retrieved from: http://www.teenscreen.org/images/stories/PDF/Event%20Report.pdf
2. TeenScreen National Center for Mental Health Checkups at Columbia University. (n.d.). Youth suicide and prevention. Retrieved from: http://www.teenscreen.org/images/stories/PDF/YouthSuicideandPrevention.pdf
3. Haas, A. P., et al. (2010). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58(1), 10-51. Retrieved from: http://www.tandfonline.com/doi/abs/10.1080/00918369.2011.534038
4. Centers for Disease Control and Prevention. (2011). Lesbian, gay, bisexual and transgender health: Youth. Retrieved from: http://www.cdc.gov/lgbthealth/youth.htm
5. Suicide Prevention Resource Center. (2010). The role of teachers in preventing suicide. Retrieved from: http://www.sprc.org/featured_resources/customized/teachers.asp#role
6. Mann, J. J., Apter, A., & Bertolote, J., et al. (2005). Suicide prevention strategies: A systematic review. JAMA, 294(16), 2064-2074. Retrieved from: http://jama.ama-assn.org/content/294/16/2064.full
7. Goldenring, J. M., & Rosen, D. S. (2004). Getting into adolescent heads: An essential update. Contemporary Pediatrics, 21, 64. Retrieved from: http://www.aap.org/pubserv/PSVpreview/pages/Files/HEADSS.pdf
8. Search Institute. (2011). Developmental assets research. Retrieved from http://www.search-institute.org/research/assets
9. California Department of Education. (n.d.). California education code: Section 51890. Retrieved from: http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51890-51891
10. National Association of State Boards of Education. (2010). National guidelines: Health, mental health and safety guidelines for schools. Retrieved from: http://www.nationalguidelines.org/guideline.cfm?guideNum=2-07

In 2010, 457 California children/youth ages 5-24 were known to have committed suicide: 28 children ages 5-14, 150 ages 15-19, and 279 ages 20-24. The state’s youth suicide rate in 2008-10 was 7.2 per 100,000 youth ages 15-24, slightly higher than the rate in 2007-09 (7.0), but substantially lower than the rate in 1995-97 (9.4). National comparison data are available between 1999-2009; during that decade, California's youth suicide rate remained below the U.S. rate of about 10 per 100,000. Statewide and nationally, many more male youth than female youth commit suicide. In 2010, males accounted for almost 80% of youth suicides in California (341 of 429 among ages 15-24).

In 2010, there were 3,135 hospitalizations for non-fatal self-inflicted injuries among children and youth ages 5-20 in California. While the statewide rate of self-inflicted injury hospitalizations has fluctuated over the last two decades, the 2010 rate (36.9 per 100,000) was among the lowest since 1993 (45.8 per 100,000). Most of the state’s counties with available data also saw declines during this period. County rates ranged from 18.2 to 60.4 per 100,000 in 2010. Statewide, the majority of hospitalizations for self-inflicted injuries involve youth ages 16-20; 2,314 (or 74%) of all hospitalizations for self-inflicted injuries in 2010.

• Archives of Pediatrics and Adolescent Medicine
• Emotional, Behavioral and Mental Health Challenges in Children and Adolescents Knowledge Path, Maternal and Child Health Library at Georgetown University
• Injury Prevention and Control: Youth Suicide, Centers for Disease Control and Prevention
• National Action Alliance for Suicide Prevention
• Pediatrics Journal
• Suicide Prevention Resources and Publications, Substance Abuse and Mental Health Services Administration (SAMHSA)

• Characteristics of Juvenile Suicide in Confinement, 02/2009, Office of Juvenile Justice and Delinquency Prevention, Hayes
• Children’s Mental Health: What Every Policymaker Should Know, 04/2010, National Center for Children in Poverty, Stagman & Cooper
• Contextual Features and Behavioral Functions of Self-Mutilation Among Adolescents, 2005, Journal of Abnormal Psychology, Nock & Prinstein
• Epidemiology of Youth Suicide and Suicidal Behavior, 10/2009, Current Opinions in Pediatrics, Cash & Bridge
• National Strategy for Suicide Prevention: Goals and Objectives for Action, 2012, U.S. Surgeon General and the National Action Alliance for Suicide Prevention
• Preventing Suicide: A Toolkit for High Schools, 06/2012, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
• Suicide Prevention Strategies: A Systematic Review, 2005, The Journal of the American Medical Association, Mann et al.
• Suicide Risk and Prevention for Lesbian, Gay, Bisexual, and Transgender Youth, 2008, Suicide Prevention Resource Center
• Suicide Trends Among Youths Aged 10-19 Years in the United States, 1996-2005, 2008, Journal of the American Medical Association, Bridge et al.
• The Mental Health of Adolescents: A National Profile, 2008, National Adolescent Health Information Center, Knopf, Park & Mulye
• What Works to Prevent or Reduce Internalizing Problems or Socio-Emotional Difficulties in Adolescents, 12/2011, Child Trends, Terzian et al.

• San Diego County Report Card on Children & Families, 2011, The Children's Initiative and Johnson Group Consulting, Inc.
• The Developmental Assets Survey: Young People Talk About Growing Up in Silicon Valley, 2011, Project Cornerstone

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