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- Definition: Number of hospitalizations for non-fatal self-inflicted injuries among children/youth ages 5-20 (e.g., in 2014, 3,575 California children/youth were hospitalized due to non-fatal self-inflicted injuries).Number of hospitalizations for non-fatal self-inflicted injuries per 100,000 children/youth ages 5-20 (e.g., in 2014, there were 43.1 hospitalizations due to non-fatal self-inflicted injuries per 100,000 California children/youth).
- Data Source: California Dept. of Public Health, Office of Statewide Health Planning and Development, Patient Discharge Data; California Dept. of Finance, Race/Ethnic Population with Age and Sex Detail, 1990-1999, 2000-2010, 2010-2060; CDC, WISQARS (Apr. 2016).
- Footnote: These data are measured by the number of discharges from acute care hospital facilities for injuries among children and youth. County-level data reflect the patient's county of residence, not the county in which the hospitalization occurred. The most common types of self-inflicted injury are related to poisoning and cutting/piercing. LNE (Low Number Event) refers to rates that have been suppressed because there were fewer than 20 cases. N/A means that data are not available. Use caution when comparing rates presented on kidsdata.org, which are based on Dec. 2014 population estimates, with those reported by the California Dept. of Public Health, which are based on Nov. 2012 estimates.
Learn More About Youth Suicide and Self-Inflicted Injury
- Measures of Youth Suicide and Self-Inflicted Injury on Kidsdata.org
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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
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- Bullying/Harassment, by Grade Level
- Bias-Related Bullying/Harassment, by Grade Level
- Disability as Reason for Bullying/Harassment, by Grade Level
- Gender as Reason for Bullying/Harassment, by Grade Level
- Race/Ethnicity or National Origin as Reason for Bullying/Harassment, by Grade Level
- Religion as Reason for Bullying/Harassment, by Grade Level
- Sexual Orientation as Reason for Bullying/Harassment, by Grade Level
- Cyberbullying, by Grade Level
- Student Bullying/Harassment Is a Problem at School (Staff Reported)
- Children's Emotional Health
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- Hospitalizations for Mental Health Issues, by Age Group
- Depression-Related Feelings, by Grade Level
- Youth Who Reported Needing Help for Emotional or Mental Health Problems
- Receipt of Mental Health Services Among Children Who Need Treatment or Counseling (Regions of 70,000 Residents or More)
- Students Who Are Well-Behaved (Staff Reported)
- Student Depression or Mental Health Is a Problem at School (Staff Reported)
- School Emphasizes Helping Students with Emotional and Behavioral Problems (Staff Reported)
- Deaths
- Pupil Support Services
- Hospitalizations
- Youth Alcohol, Tobacco, and Other Drug Use
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- Alcohol/Drug Use in Past Month, by Grade Level
- Alcohol/Drug Use on School Property in Past Month, by Grade Level
- Alcohol Use in Past Month, by Grade Level
- Alcohol Use in Lifetime, by Grade Level
- Binge Drinking in Past Month, by Grade Level
- Drinking and Driving or Riding with a Driver Who Has Been Drinking, by Grade Level
- Cigarette Use in Past Month, by Grade Level
- Cigarette Use in Lifetime, by Grade Level
- E-Cigarette Use in Past Month, by Grade Level
- E-Cigarette Use in Lifetime, by Grade Level
- Marijuana Use in Past Month, by Grade Level
- Marijuana Use in Lifetime, by Grade Level
- Student Alcohol and Drug Use Is a Problem at School (Staff Reported)
- Substance Abuse Prevention Is an Important Goal at School (Staff Reported)
- Substance Use Prevention Education Is Provided at School (Staff Reported)
- School Climate
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- School Connectedness (Student Reported), by Grade Level
- School Supports (Student Reported), by Grade Level
- Caring Relationships with Adults at School (Student Reported), by Grade Level
- Meaningful Participation at School (Student Reported), by Grade Level
- Students Who Are Motivated to Learn (Staff Reported)
- School Motivates Students to Learn (Staff Reported)
- Adults at School Care About Students (Staff Reported)
- Adults at School Believe in Student Success (Staff Reported)
- School Gives Students Opportunities to Make a Difference (Staff Reported)
- School Fosters Youth Resilience or Asset Promotion (Staff Reported)
- Injuries
- Why This Topic Is Important
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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
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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
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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 - Research & Links
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- Websites with Related Information
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- American Foundation for Suicide Prevention
- California Dept. of Education: Youth Suicide Prevention
- Centers for Disease Control and Prevention: Children's Mental Health
- Child Mind Institute
- Children and Adolescents with Emotional, Behavioral, and Mental Health Challenges: Professional Resource Guide, Maternal and Child Health Digital Library
- Cornell Research Program on Self-Injury and Recovery
- HEARD Alliance (Health Care Alliance for Response to Adolescent Depression)
- MentalHealth.gov, U.S. Dept. of Health and Human Services
- National Action Alliance for Suicide Prevention, Education Development Center
- National Center for Injury Prevention and Control: Suicide Prevention
- Recommendations for Reporting on Suicide, ReportingOnSuicide.org
- Self-Injury Outreach and Support, University of Guelph & McGill University
- Stanford Center for Youth Mental Health and Wellbeing, Stanford Medicine
- Suicide Prevention Resource Center, Education Development Center
- Tribal Training and Technical Assistance Center: Suicide Prevention Resources, Substance Abuse and Mental Health Services Administration
- VetoViolence, Centers for Disease Control and Prevention
- Youth.gov, Interagency Working Group on Youth Programs
- Key Reports and Research
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- Addressing Self-Injury on College Campuses: Institutional Recommendations, 2019, Journal of College Counseling, Lewis, S. P., et al.
- California Reducing Disparities Project: Strategic Plan to Reduce Mental Health Disparities, 2018, California Pan-Ethnic Health Network
- Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda, 2019, National Academies Press, National Academies of Sciences, Engineering, and Medicine
- Hospitalization for Suicide Ideation or Attempt: 2008-2015, Pediatrics, Plemmons, G., et al.
- Hurting from the Inside Out: Understanding Self-Injury, 2017, Educational Leadership, Whitlock, J., & Hasking, P.
- K-12 Toolkit for Mental Health Promotion and Suicide Prevention, HEARD Alliance, Joshi, S. V., et al.
- National Estimate of LGBTQ Youth Seriously Considering Suicide, 2019, Trevor Project, Green, A. E., et al.
- National Strategy for Suicide Prevention: Implementation Assessment Report, 2017, Substance Abuse and Mental Health Services Administration
- Overview of Homicide and Suicide Deaths in California, 2019, California Dept. of Public Health
- Portrait of Promise: The California Statewide Plan to Promote Health and Mental Health Equity, 2015, California Dept. of Public Health, Office of Health Equity
- Preventing Suicide: A Technical Package of Policy, Programs, and Practices, 2017, National Center for Injury Prevention and Control, Stone, D. M., et al.
- Self-Injury: A General Information Guide, Self-Injury Outreach and Support
- Suicide After Deliberate Self-Harm in Adolescents and Young Adults, 2018, Pediatrics, Olfson, M., et al.
- The Epidemiology of Unintentional and Violence-Related Injury Morbidity and Mortality Among Children and Adolescents in the United States, 2018, International Journal of Environmental Research and Public Health, Ballesteros, M. F., et al.
- Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016, JAMA Network Open, Ruch, D. A., et al.
- County/Regional Reports
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- Annual Report on the Conditions of Children in Orange County, Orange County Children's Partnership
- Community Health Assessment and Community Health Improvement Plan, Los Angeles County Dept. of Public Health
- Live Well San Diego Report Card on Children, Families, and Community, 2017, The Children's Initiative & Live Well San Diego
- Los Angeles County Youth Suicide Prevention Project, Los Angeles County Dept. of Mental Health & Los Angeles County Office of Education
- San Mateo County All Together Better, San Mateo County Health
- Undetermined Risk Factors for Suicide Among Youth, Ages 10-24 – Santa Clara County, CA, 2016, Santa Clara County Public Health Dept.
- More Data Sources For Youth Suicide and Self-Inflicted Injury
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- California School Climate, Health, and Learning Surveys Public Dashboards, WestEd & California Dept. of Education
- Child Trends Databank: Teen Suicide
- FastStats: Injuries, National Center for Health Statistics
- Health, United States, 2018 – Data Finder, National Center for Health Statistics
- Mental Health Data and Publications, Centers for Disease Control and Prevention
- Substance Abuse and Mental Health Services Administration (SAMHSA): Data, U.S. Dept. of Health and Human Services
- Youth Risk Behavior Surveillance System (YRBSS), Centers for Disease Control and Prevention
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