Suicide and Self-Inflicted Injury: Policy Implications

Among all youth, the vast majority of those who commit suicide have a psychiatric disorder, and most of those youths show symptoms that could be identified by screening (1, 2). Many primary care providers do not routinely screen youth for mental health issues, and teachers often lack the training or the time to identify emotional/mental health issues and refer students for intervention (1, 5). Some youth are particularly at risk. Lesbian, gay, and bisexual adolescents attempt suicide at a rate three to six times that of comparably aged heterosexual youth, and are frequently the target of bullying when they do not conform to traditional gender roles (3, 4). 

According to research and subject experts, policy options that could promote emotional health and prevent suicides and self-inflicted injuries include:

• Ensuring adequate funding and training for a range of school professionals to recognize the signs of depression, self-injury, and suicidal ideation, and to connect students with appropriate services (2, 3, 5, 6), including specific training for meeting the needs of gay, lesbian, bisexual, and transgender youth (3, 4)
• Supporting efforts in schools to offer comprehensive K-12 education for social-emotional development, including interpersonal communication, goal setting, anger management, and advocacy skills, as supported by the National Association of State Boards of Education and the California Education Code (9, 10)
• Encouraging school districts to collaborate with communities and the media to limit publicity and glamorization of youth suicide, to prevent contagion among other vulnerable youth (6)
• Promoting efforts in schools and communities to provide youth with positive experiences and opportunities, such as quality after-school programs, to develop skills that will help them make healthy choices and become caring, responsible adults (8)
• Structuring public health systems and insurance reimbursement policies to require depression screening and encourage regular administration of psychosocial exams to youth (1, 2, 7)
• Eliminating discriminatory public policies that can contribute to mental health issues among gay, lesbian, bisexual, and transgender youth (3)

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 School Safety & Bullying/Harassment at School; School Connectedness; Pupil Support Service Personnel; Alcohol, Tobacco & Other Drugs; and Child Abuse & Foster Care. 

Sources for this narrative:

1. TeenScreen National Center for Mental Health Checkups at Columbia University. (2009). Adolescent mental health checkups: Recommendations to realizations. Accessed online from
   http://www.teenscreen.org/images/stories/PDF/Event%20Report.pdf
2. TeenScreen National Center for Mental Health Checkups at Columbia University. (n.d.). Youth suicide and prevention. Accessed online from
   http://www.teenscreen.org/images/stories/PDF/YouthSuicideandPrevention.pdf
3. Haas, A. P., et al. (2010). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58(1), 10-51. Retrieved October 31, 2011 from
   http://www.tandfonline.com/doi/abs/10.1080/00918369.2011.534038
4. Centers for Disease Control and Prevention (CDC). (2011). Lesbian, gay, bisexual and transgender health: Youth. Accessed online from 
   http://www.cdc.gov/lgbthealth/youth.htm
5. Suicide Prevention Resource Center. (2010). The role of teachers in preventing suicide.
   http://www.sprc.org/featured_resources/customized/teachers.asp#role
6. Mann, J. J., Apter, A., & Bertolote, J., et al. (2005). Suicide prevention strategies: A systemic review. JAMA,294(16), 2064-2074. Accessed online from
   http://dhmh.maryland.gov/suicideprevention/Suicide%20prevention%20strategies-systematic%20review.pdf
7. Goldenring, J. M., & Rosen, D. S. (2004). Getting into adolescent heads: An essential update. Contemporary Pediatrics, 21, 64. Accessed online from 
   http://www.aap.org/pubserv/PSVpreview/pages/Files/HEADSS.pdf
8. Search Institute. (2011). Developmental assets research. Accessed online from 
   http://www.search-institute.org/research/assets
9. California Department of Education. (n.d.). California education code: Section 51890. Accessed online from
   http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=51001-52000&file=51890-51891
10. National Association of State Boards of Education. (2010). National guidelines: Health, mental health and safety guidelines for schools. Accessed online from 
    http://www.nationalguidelines.org/guideline.cfm?guideNum=2-07