Youth Suicidal Behavior: An Introduction and Overview

By Miller, David N.; Eckert, Tanya L. | School Psychology Review, June 2009 | Go to article overview

Youth Suicidal Behavior: An Introduction and Overview


Miller, David N., Eckert, Tanya L., School Psychology Review


Abstract. Youth suicidal behavior continues to be a significant national problem in need of urgent attention by school personnel. The purpose of this introductory article to the special series is to provide an overview of youth suicidal behavior, including research based information on demographic data; risk factors and warning signs; and where, when, and how youth suicidal behavior typically occurs. Common myths and current controversies about youth suicide are also discussed, as are the implications of youth suicidal behavior for school-based practice. A brief discussion of current research gaps and needs is provided, as well as an introduction to the other articles in the special series on school-based suicide prevention.

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Among the many challenges confronting our nation's schools, few if any are more urgent than youth suicidal behavior. Youth suicide continues to be a significant public health problem at a national level, and clearly is "a crisis in need of attention" (Mazza, 2006, p. 156). Unfortunately, although school psychologists have an ethical and legal responsibility to prevent youth suicide whenever possible (Jacob & Hartshorne, 2007), they report being frequently ill-prepared to effectively respond to this problem (Anderson & Miller, 2009; Debski, Spadafore, Jacob, Poole, & Hixson, 2007; Miller & Jome, 2008, 2009). This issue is a critical one, given that the manner in which school psychologists and other school-based practitioners respond to suicidal youth can literally mean the difference between life and death.

According to the Centers for Disease Control and Prevention, although suicide is the 11th leading cause of death among Americans overall, it is the third-leading cause of death among young people in the United States, trailing only accidents and homicide (Centers for Disease Control and Prevention, 2006). Moreover, although overall suicide rates among youth ages 10-19 years declined from 1990 to 2004, from 2003 to 2004 suicide rates for females ages 10-19 and males ages 15-19 increased significantly (Centers for Disease Control and Prevention, 2007). The number of children ages 10-14 committing suicide has been of particular concern, with suicide rates increasing 51% between 1981 and 2004 among children in this age group (American Association of Suicidology, 2006). Adding to this concern is the possibility that the number of reported youth suicides may be an underestimate of their actual occurrence (Lieberman, Poland, & Cassel, 2008). Furthermore, despite fluctuating rates of youth suicide over the last several decades, including notable decreases during the 1990s, the overall suicide rate for children and adolescents has increased over 300% since the 1950s (Berman, Jobes, & Silverman, 2006) and will likely continue to increase (Gutierrez & Osman, 2008).

Suicide (i.e., a fatal, self-inflicted act with the explicit or inferred intent to die) is only one behavior among a continuum of suicidal behaviors, which also includes suicidal ideation (i.e., serious thoughts of suicide often viewed as a precursor to more serious forms of suicidal behavior), suicidal intent (i.e., the intentions of an individual at the time of his or her suicide attempt in regard to that person's wish to die), and suicide attempts (i.e., self-injurious behaviors conducted for the intent of causing death; Mazza, 2006). As such, suicidal behavior includes and incorporates a much larger set of behaviors than suicide alone. The behaviors along this continuum vary and are not mutually exclusive, nor do all suicidal youth advance sequentially through them. Moreover, although the frequency of each behavior decreases as individuals move along this continuum, the level of lethality and probability of death increases (Mazza & Reynolds, 2008), The profile of individuals who engage in different forms of suicidal behavior also varies. For example, the typical youth who attempts suicide is an adolescent female who ingests drugs at home in front of others (e. …

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