Suicide remains the second leading cause of death among incarcerated youth aged 10- to 24-years in the United States. A new study published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) by Elsevier concluded that there is little disagreement that youth in custody are at an increased risk for suicidal behavior.
Suicide rates were reported to be 2-to-3 times higher for youth in custody than those in the general population; calls for improving current intervention methods in correctional facilities and identifying the signs earlier are highlighted in the study.
‘Suicide risk assessments and implementation of targeted suicide prevention programs is the need of the hour for incarcerated youth.’
Based on a US Department of Justice survey conducted from 2000 to 2014, researchers from Nationwide Children's Hospital, Columbus, OH, USA, looked at circumstances preceding suicide to understand better why this disparity in suicide rate exists, and identified that key risk factors for suicide - history of suicide attempts; history of mental health conditions; and alcohol/drug use - were not significantly different between the two groups.
"Youth who were incarcerated and died by suicide were no more likely to have mental health conditions than those who died by suicide in the community," said Donna Ruch, PhD, post-doctoral scientist at the Center for Suicide Prevention and Research in The Research Institute at Nationwide Children's. "That surprised us and led us to question whether there may be something about the environment that contributed to the increase in suicides."
The study used a nationally representative sample to examine characteristics and circumstances leading to suicide deaths among incarcerated youth. By mining the National Violent Death Reporting System data from 2003 to 2012, researchers compared data from youth aged 10-to-24 who died by suicide during incarceration to those who died by suicide in the general population.
A key difference between the groups is that incarcerated youth were less likely to disclose suicide intent (19.2 compared to 30.5 percent) or leave a suicide note (23.5 compared to 31.0 percent).
"The immediate shock of confinement and disruption to a youth's regular life can be traumatic and increase the risk for suicidal behavior," explained Dr. Ruch. "This might be especially true for incarcerated youth with existing risk factors."
According to the study, the prominence of strangulation or suffocation as a means of suicide for incarcerated youth highlights the potential impact of greater attention to restricting access to ligatures and ligature points in correctional facilities.
Practical recommendations from the study include timely and ongoing suicide risk assessments and implementation of targeted suicide prevention programs for incarcerated youth. According to the study, 93 percent of juvenile correctional facilities screen for suicide risk at intake only, with re-screening performed only when "deemed necessary." Adequately addressing the mental health needs of juveniles detained in adult facilities is even more challenging, Dr. Ruch highlighted. The authors note that their study was not designed to address this issue.