Background
Suicide is a leading cause of death among children, adolescents, and young adults (AYA), and mental health disorders are a major contributing factor. Yet, suicidal behaviors among children and AYA with mental health concerns remain understudied and age‐specific risk factors are poorly understood. We examined the risk factors for suicide attempt in children and AYA with mental health disorders across three age groups: pre‐adolescent children (aged ≤ 12), adolescents (aged 13–17), and young adults (aged 18–25).
Methods
A cross‐sectional study of children and AYA hospitalized for a mental health disorder (n = 18,018) at a private hospital system with 141 facilities across the United States (year 2014).
Results
Suicide attempts six months prior to hospitalization were reported in 12.1% (n = 177) pre‐adolescent children, 22% (n = 1476) adolescents, and 17.9% (n = 1766) young adults. Evidence of psychological trauma was present in 55.4% of pre‐adolescent children, 51.2% of adolescents, and 44.5% of young adults. Predictors for suicide attempt observed across all three age groups included the following: female sex, depressive disorder, and being a victim of bullying. Risk factors for suicide attempt specific to pre‐adolescent children included being uninsured and having an unsafe home or school environment. Among AYA, suicide attempt was associated with non‐Hispanic white, family history of suicide, emotional traumas, and other traumatic experiences. Alcohol use disorder was also a significant predictor of suicide attempt in young adults.
Conclusions
Suicide attempts among children and AYA admitted to a hospital with mental health concerns are highly prevalent. Socioeconomic stressors appeared to be an important contributing factor of suicidal behavior in pre‐adolescent children but not in older AYA. Effective suicide prevention strategies targeting children and AYA would need to consider age‐specific risk factors.