Self-Inflicted Injury Hospitalizations

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Learn More About Youth Suicide and Self-Inflicted Injury

Measures of Youth Suicide and Self-Inflicted Injury on Kidsdata.org
Kidsdata.org provides indicators of suicidal ideation—the percentage of students who seriously consider attempting suicide—by grade level, gender, level of school connectedness,* parent education level, race/ethnicity, and sexual orientation. The rate of suicide per 100,000 youth ages 15-24, along with the number of youth suicides by age, gender, and race/ethnicity, also are provided.

Data on self-inflicted injury hospitalizations are available as numbers and rates per 100,000 children and youth ages 5-20 overall, and as numbers by age. Non-fatal suicide attempts and self-mutilation both are included among self-inflicted injuries.
*Levels of school connectedness are based on a scale created from responses to five questions about feeling safe, close to people, and a part of school, being happy at school, and about teachers treating students fairly.
Youth Suicide and Self-Inflicted Injury
Bullying and Harassment at School
Children's Emotional Health
Deaths
Pupil Support Services
Hospitalizations
School Climate
Youth Alcohol, Tobacco, and Other Drug Use
Injuries
Why This Topic Is Important
Youth suicide and self-inflicted injury are serious social and public health concerns. Suicide is the second leading cause of death among young people ages 15-24 in the U.S. (1). A nationwide survey in 2015 found that more than 1 in 6 high school students reported seriously considering suicide in the previous year, and more than 1 in 12 reported attempting it (2). In addition, approximately 157,000 youth ages 10-24 are treated for self-inflicted injuries in emergency rooms every year (3). Self-inflicted injuries are not necessarily the result of suicide attempts; in fact, self-harm without the intent to die is more prevalent than self-harm with such intent (4). Across all ages, suicide and self-inflicted injury in the U.S. cost an estimated $45 billion annually in medical expenses and work loss; actual costs may be higher as many suicides and attempted suicides are not reported due to social stigma (5, 6).

Some groups are at a higher risk for suicide than others. Males are more likely than females to commit suicide, but females are more likely to report attempting suicide (2, 3). Among racial/ethnic groups with data, American Indian/Alaska Native youth have the highest suicide rates (3). Research also shows that lesbian, gay, and bisexual youth are more likely to engage in suicidal behavior than their heterosexual peers (7). Several other factors put teens at risk for suicide, including a family history of suicide, past suicide attempts, mental illness, substance abuse, stressful life events, low levels of communication with parents, access to lethal means, exposure to suicidal behavior of others, and incarceration (3, 6).
Find more information and research about youth suicide and self-inflicted injury in kidsdata.org's Research & Links section.

Sources for this narrative:

1.  National Center for Injury Prevention and Control. (2018). Ten leading causes of death and injury. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/injury/wisqars/LeadingCauses.html

2.  Kann, L., et al. (2016). Youth risk behavior surveillance – United States, 2015. Morbidity and Mortality Weekly Report Surveillance Summaries, 65(6), 1-174. Retrieved from: https://www.cdc.gov/mmwr/volumes/65/ss/ss6506a1.htm

3.  Centers for Disease Control and Prevention. (2013). Suicide among youth. Retrieved from:
https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/suicideyouth.html

4.  Swahn, M. H., et al. (2012). Self-harm and suicide attempts among high-risk, urban youth in the U.S.: Shared and unique risk and protective factors. International Journal of Environmental Research and Public Health, 9(1), 178-191. Retrieved from: http://www.mdpi.com/1660-4601/9/1/178

5.  U.S. Surgeon General, & National Action Alliance for Suicide Prevention. (2012). 2012 national strategy for suicide prevention: Goals and objectives for action. Retrieved from: http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention

6.  National Center for Injury Prevention and Control. (2015). Understanding suicide. Centers for Disease Control and Prevention. Retrieved from: http://www.cdc.gov/violenceprevention/pdf/suicide_factsheet-a.pdf

7.  Marshal, M. P., et al. (2013). Trajectories of depressive symptoms and suicidality among heterosexual and sexual minority youth. Journal of Youth and Adolescence, 42(8), 1243-1256. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744095
How Children Are Faring
In 2013-2015, an estimated 19% of 9th graders, 18% of 11th graders, and 26% of non-traditional students in California seriously considered attempting suicide in the previous year. Suicidal ideation was higher among females than among males, and highest for American Indian/Alaska Native, Native Hawaiian/Pacific Islander, and multiracial students, among racial/ethnic groups with data. The proportion of gay, lesbian, and bisexual students who seriously considered attempting suicide was nearly one-half (49%), more than three times the estimate for their straight peers (16%).

In 2014, there were 3,575 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, rates have risen in recent years, from a 22-year low of 34.3 per 100,000 in 2008 to 43.1 per 100,000 in 2014. Most counties with data saw a similar increase during this period. County rates ranged from 24.3 to 71.2 per 100,000 in 2014. Statewide, teens and young adults ages 16-20 account for the majority of youth hospitalizations for self-inflicted injuries: 61% of discharges in 2014 (2164 of 3575).

In 2015, 495 California children and youth ages 5-24 were known to have committed suicide: 23 ages 5-14, 171 ages 15-19, and 301 ages 20-24. Statewide, the rate of suicide among youth ages 15-24 was 7.9 per 100,000 in 2013-2015, down from 9.4 per 100,000 in 1995-1997. Since 1999-2001—the first time period for which national comparison data are available—California's youth suicide rate has been lower than the U.S. rate, which has risen above 10 per 100,000 in recent years. Statewide and nationally, many more male than female youth commit suicide. In 2015, males accounted for more than three-quarters of youth suicides in California (371 of 472).
Policy Implications
Suicide is considered a major, preventable public health problem, and is the second leading cause of death among teens ages 15-19 nationwide (1). Some groups are at higher risk for suicide, such as LGBT youth, American Indian/Alaska Native youth, and those in the juvenile justice and child welfare systems (2). Self-inflicted injury, e.g., cutting and self-hitting, also is a serious public health concern, affecting an estimated 13-23% of adolescents (3). While self-injury is a risk factor for suicide, many young people engage in self-harm without intending to die, and most youth who hurt themselves do not seek treatment (3). In fact, most children who need mental health treatment, in general, do not receive it (4). Screening, early identification, and access to services are critical in preventing and reducing mental health problems (4). However, experts recommend that policy strategies go beyond preventing and treating problems, to promoting positive youth mental health (4, 5).

Policy options that could promote emotional health and prevent youth suicides and self-inflicted injuries include:
  • Setting school policies that foster a positive, caring environment and promote student engagement in school; also, supporting comprehensive K-12 education for social-emotional learning, including problem-solving and coping skills (4, 5, 6, 7)
  • Promoting efforts in communities to ensure youth have connections to caring adults and access to safe, positive activities, such as quality after-school programs and mentoring programs (5, 7, 8)
  • Ensuring adequate funding and training for those who work directly with young people—teachers, school staff, social workers, juvenile justice staff, and others—to recognize signs of suicidal behavior and self-injury and to refer youth to appropriate services; school training also should focus on how to promote a safe and supportive environment for all students, including LGBT youth (4, 5, 6)
  • Promoting mental health training for pediatricians and consistent screening in primary care settings (4, 5, 9)
  • Supporting public education and awareness campaigns to reduce the stigma associated with mental health problems and increase knowledge of warning signs; this could include “mental health first aid” training for wide-ranging audiences, focusing on how to recognize early signs, provide non-professional support, and help youth access community resources (4, 5)
  • Ensuring that all youth with mental health needs have access to high-quality, culturally appropriate services; as part of this, expanding the workforce of qualified mental health professionals (4, 5)
  • Encouraging the media to limit publicity and glamorization of youth suicide, e.g., keeping coverage brief and not explicit or sensational, to prevent contagion among other vulnerable youth (5, 10)
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 Children's Emotional Health, School Connectedness, and Bullying and Harassment at School.

Sources for this narrative:

1.  National Center for Injury Prevention and Control. (2018). Ten leading causes of death and injury. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/injury/wisqars/LeadingCauses.html

2.  Youth.gov. (n.d.). Suicide prevention: Increased risk groups. Interagency Working Group on Youth Programs. Retrieved from: http://youth.gov/youth-topics/youth-suicide-prevention/increased-risk-groups

3.  Swahn, M. H., et al. (2012). Self-harm and suicide attempts among high-risk, urban youth in the U.S.: Shared and unique risk and protective factors. International Journal of Environmental Research and Public Health, 9(1), 178-191. Retrieved from: http://www.mdpi.com/1660-4601/9/1/178

4.  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: http://www.rwjf.org/en/library/research/2014/07/are-the-children-well-.html

5.  U.S. Surgeon General, & National Action Alliance for Suicide Prevention. (2012). 2012 national strategy for suicide prevention: Goals and objectives for action. Retrieved from: http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention

6.  Centers for Disease Control and Prevention. (2017). Lesbian, gay, bisexual and transgender health: LGBT youth. Retrieved from: http://www.cdc.gov/lgbthealth/youth.htm

7.  World Health Organization. (2014). Preventing suicide: A global imperative. Retrieved from: http://www.who.int/mental_health/suicide-prevention/world_report_2014/en

8.  Centers for Disease Control and Prevention. (n.d.). Preventing suicide through connectedness. Retrieved from: http://www.cdc.gov/violenceprevention/pdf/asap_suicide_issue3-a.pdf

9.  Weitzman, C., et al. (2015). Promoting optimal development: Screening for behavioral and emotional problems. Pediatrics, 135(2), 384-395. Retrieved from: http://pediatrics.aappublications.org/content/135/2/384

10.  Recommendations for reporting on suicide. (n.d.). Retrieved from: http://reportingonsuicide.org/recommendations
Websites with Related Information
Key Reports and Research
County/Regional Reports
More Data Sources For Youth Suicide and Self-Inflicted Injury