Suicide Prevention

It is important for school districts to be aware of student populations that are at elevated risk for suicidal behavior based on various factors. 

Youth Living with Mental and/or Substance Use Disorders 

Mental health conditions — in particular depression/dysthymia, attention-deficit hyperactivity disorder, eating disorders, intermittent explosive disorder and conduct disorder — are important risk factors for suicidal behavior among young people. An estimated one in four to five children have a diagnosable mental condition that will cause severe impairment with the average onset of depression and dysthymia occurring between ages 11 and 14. Therefore, school staff may play a pivotal role in recognizing and referring the student to treatment that may reduce risk and enhance overall performance and improve long-term outcomes. Though mental health conditions are a risk factor for suicide, the majority of people with mental health concerns do not engage in suicidal behavior. 

Youth Who Engage in Self-Harm or Have Attempted Suicide 

Suicide risk is significantly higher among those who engage in non-suicidal self-harm than among the general population. Whether or not they report suicidal intent, one study found that 70-percent of adolescents admitted into inpatient psychiatric treatment who engage in self-harm report attempting suicide at least once in their lives. Additionally, a previous suicide attempt is a known powerful risk factor for suicide death. One study found that as many as 88-percent of people who attempt suicide for the first time and are seen in the Emergency Department go on to attempt suicide again within two years. Many adolescents who attempt suicide do not receive necessary follow-up care due to many reasons, including limited access to resources, transportation, insurance, copays and parental consent.

Youth in Out-of-Home Settings 

Youth involved in the juvenile justice or child welfare systems have a high prevalence of risk factors for suicide. Up to 60- to 70-percent of young people involved in the juvenile justice system meet criteria for at least one psychiatric disorder, and youth in juvenile justice residential programs are three times more likely to die by suicide than the general youth population. According to a study released in 2018, nearly a quarter of youth in foster care had a diagnosis of major depression in the last year. Additionally, a quarter of foster care youth reported attempting suicide by the time they were 17.5 years old.

Youth Experiencing Homelessness

For youth experiencing homelessness, the rate of self-injury, suicidal ideation and suicide attempts is over two times greater than those of the adolescent population in general. These young people also have higher rates of mood disorders, conduct disorder and post-traumatic stress disorder. One study found that more than half of runaway and homeless youth experience suicidal ideation. 

American Indian/Alaska Native (AI/AN) Youth

In 2017, the rate of suicide among AI/AN youth ages 15-19 was over 1.6 times that of the general youth population. Risk factors that can affect this group include substance use, discrimination, lack of access to mental health care and historical trauma. For more information about historical trauma and how it can affect AI/AN youth, see ihs.gov/suicideprevention. 

LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer or Questioning) Youth 

The CDC finds that LGBTQQ youth are 4.5 times more likely and questioning youth are over twice as likely to consider attempting suicide as their heterosexual peers. One study found that 40-percent of transgender people have attempted suicide sometime in their lifetimes; of those who attempted, 73-percent made their first attempt before the age of 18. Suicidal behavior among LGBTQ youth can be related to experiences of discrimination, family rejection, harassment, bullying, violence and victimization. For those youth with baseline risk for suicide (especially those with a mental health condition), these experiences can place them at increased risk. It is not their sexual orientation or gender identity that place LGBTQ youth at greater risk of suicidal behavior, but rather societal and external factors that influence how they are treated, shunned, abused or neglected, in concert with other individual factors such as mental health history. 

Youth Bereaved by Suicide

Studies show that those who have experienced suicide loss through the death of a friend or loved one are nearly four times as likely to attempt suicide themselves.

Youth Living with Medical Conditions or Disabilities 

A number of physical conditions are associated with an elevated risk for suicidal behavior. Some of these conditions include chronic pain, loss of mobility, disfigurement, cognitive delays that make problem-solving a challenge and other chronic limitations. Adolescents with asthma are more likely to report suicidal ideation and behavior than those without asthma. Additionally, studies show that suicide rates are significantly higher among people with certain types of disabilities, such as those with multiple sclerosis or spinal cord injuries.