Youth suicide and self-inflicted injury are complex issues that are not caused by any single factor. Addressing these prevalent, preventable public health problems requires comprehensive, cross-sector commitments focused on risk and protective factors at the individual, family, community, and system levels (1, 2). Additionally, experts recommend that policy strategies go beyond preventing and treating problems to promoting positive mental health (1, 3).
Screening, early identification, access to services, and receipt of services are critical in preventing and reducing mental health problems associated with suicidal behavior (2). Youth who hurt themselves without suicidal intent are at risk for suicide and do not often seek treatment (4). In fact, most youth who need mental health services, in general, do not receive them (3, 5).
California law requires public school districts and charter schools serving Grades 7-12 to establish suicide prevention policies that address high-risk groups, including LGBTQ youth, those who are homeless or in out-of-home settings, youth bereaved by suicide, and youth with mental health problems, disabilities, or substance use disorders (1).
Policy and practice options to prevent suicide and self-injury and promote youth mental health include:
- Continuing to support K-12 schools in creating positive school climates and implementing a whole-child approach to education that includes evidence-based systems to address students’ physical, emotional, behavioral, and other needs; related to this, promoting efforts to integrate social-emotional learning—such as problem-solving, help-seeking, and coping skills—into PreK-12 education (1, 2, 6, 7)
- In accordance with California law, ensuring effective implementation of suicide prevention policies in public and charter schools serving Grades 7-12; also, encouraging K-6 and private schools to establish similar policies, and urging all schools to develop clear protocols for addressing non-suicidal self-injury (1, 6)
- Assuring adequate training for those who work directly with youth—teachers, school staff, coaches, clergy, juvenile justice staff, and others—to recognize signs of suicidal behavior and self-injury and to respond effectively, including helping youth find and receive services (1, 2, 6)
- Promoting health care systems change to support mental health and prevent suicide and self-injury, including enhanced workforce training, systematic screening and risk assessment, and improved coordination and continuity of care (2)
- Ensuring that all youth with mental health needs have access to high-quality, culturally appropriate services with consistent coverage through insurance plans; as part of this, expanding the workforce of qualified mental health professionals, especially in underserved communities (2)
- Ensuring that families have access to affordable, high-quality parenting and relationship skills programs, which help improve family interactions and children's emotional health (2)
- Promoting community efforts to provide youth with connections to caring adults and access to safe, positive activities, such as quality mentoring, after-school, and social norming programs, particularly in communities with limited resources (1, 2)
- Promoting local strategies to reduce access to lethal means (e.g., bridges and railway tracks) and improve safe storage of medications, firearms, and other lethal items (2)
- Supporting public education to reduce the stigma associated with mental illness, increase help-seeking, and improve knowledge of warning signs and appropriate responses (2, 6)
- Encouraging media to avoid sensationalizing youth suicide (e.g., by keeping coverage brief and not explicit), which can help prevent contagion, and to balance suicide coverage with prevention messages, stories of hope, and resources for help (2)
For more policy ideas and information on this topic, see kidsdata.org’s Research & Links section or visit the Suicide Prevention Resource Center, Centers for Disease Control and Prevention, and Self-Injury Outreach and Support. Also see Policy Implications for related topics in kidsdata.org’s Emotional and Behavioral Health category.
Sources for this narrative:
1. Joshi, S. V., et al. (2017).
K-12 toolkit for mental health promotion and suicide prevention. HEARD Alliance. Retrieved from:
https://www.heardalliance.org/help-toolkit
2. Stone, D. M., et al. (2017).
Preventing suicide: A technical package of policy, programs, and practices. National Center for Injury Prevention and Control. Retrieved from:
https://www.cdc.gov/violenceprevention/pdf/suicidetechnicalpackage.pdf
3. Murphey, D., et al. (2014).
Are the children well? A model and recommendations for promoting the mental wellness of the nation's young people. Child Trends & Robert Wood Johnson Foundation. Retrieved from:
https://www.childtrends.org/publications/are-the-children-well-a-model-and-recommendations-for-promoting-the-mental-wellness-of-the-nations-young-people
4. Lewis, S. P., et al. (2019). Addressing self-injury on college campuses: Institutional recommendations.
Journal of College Counseling, 22(1), 70-82. Retrieved from:
https://onlinelibrary.wiley.com/doi/full/10.1002/jocc.12115
5. As cited on kidsdata.org,
Youth needing help for emotional or mental health problems, by receipt of counseling (California and L.A. County only). (2020). California Health Interview Survey.
6. Whitlock, J., & Hasking, P. (2017). Hurting from the inside out: Understanding self-injury.
Educational Leadership, 7(4), 24-30. Retrieved from:
http://www.ascd.org/publications/educational_leadership/dec17/vol75/num04/Hurting_From_the_Inside_Out@_Understanding_Self-Injury.aspx
7. Alliance for Continuous Improvement. (n.d.).
California education GPS. Californians Dedicated to Education Foundation. Retrieved from:
https://www.caledgps.org