Youth Suicide

Youth Suicide

·        Epidemiology:

o  Second only to MVA as cause of death – but still uncommon.

o  3 fold rise in last 30 years.

o  Females attempt, males succeed

o  Second highest rate for 15-24, Finland higher

·        Postulated factors contributing to increase: 

o  ­Depression and substance abuse

o  Unemployment 

o  ­Isolation and alienation

·        Key issue: identifying those at risk

·        Risk factors:

o  Male gender 

o  Psychiatric illness: depression (most common association), alcohol or substance abuse, personality disorder, psychosis

o  Previous suicide attempts

o  Available means: firearms, toxic medications 

o  Social adversity: recent interpersonal loss, homelessness, school failure or drop-out, family or relationship problems, unemployment

o  Recent exposure to suicide

·        Most common presentations are over-dose, self-poisoning and lacerations

·        Management:

o  Treat underlying psychiatric disorder (not TCAs – too lethal in overdose.  Use SSRIs)

o  Reduce ongoing stress: counselling to reduce interpersonal conflict

o  Promote social supports

o  Liase with specialist health services