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Danielsen S, Strandberg-Larsen K, Hawton K, Nordentoft M, Erlangsen A, Madsen T. The iceberg model of suicidal ideation and behaviour in Danish adolescents: integration of national registry and self-reported data within a national birth cohort. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02503-w. [PMID: 38916768 DOI: 10.1007/s00787-024-02503-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
Hospital records are used to identify suicide attempts in many countries but not all individuals present to hospital after a suicide attempt i.e., suggesting a 'hidden number'. Our aim was to present the prevalence of suicide ideation, plans, attempts, and suicides among Danish adolescents, including attempts not resulting in hospital contact. The study population consisted of participants in the Danish National Birth Cohort participating in an 18-year follow-up, with individual-level linkage to national register data. Prevalence was estimated with a variable with mutually exclusive categories ranging from no suicidality to self-reported suicide ideation, -plans, -attempt and hospital-recorded suicide attempt and stratified on sex and parental income. The 'hidden number' was estimated as the ratio between suicide attempts with and without hospital contact. Among 47 858 participants, all aged 18-years, 36% girls and 28% boys reported suicide ideation at least once in their life. In addition, 6% girls and 3% boys had either reported or been recorded with a suicide attempt. For every attempt recorded in the hospital setting, two girls (ratio, 1:2) and six boys (ratio, 1:6) reported having attempted suicide without hospital contact. The prevalence of any suicide attempt was 8% and 3% in the lowest and highest income group, respectively. Before age 18, 0·011% girls and 0·016% boys had died by suicide. In conclusion, suicidal ideation and behaviour are common in adolescents and there is a substantial 'hidden number' of adolescents with suicide attempt. These results emphasize the need for early age suicide preventive interventions in community-settings e.g., school environments.
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Affiliation(s)
- Stine Danielsen
- Danish Research Institute for Suicide Prevention - DRISP, Mental Health Center Copenhagen, University of Copenhagen, Gentofte Hospitalsvej 15, Opg. 15, 4. floor, Hellerup, DK - 2900, Denmark.
| | - Katrine Strandberg-Larsen
- Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, bd. 24, PO Box 2099, Copenhagen, DK - 1014, Denmark
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of OxfordWarneford Hospital, Oxford, OX3 7JX, England
| | - Merete Nordentoft
- Danish Research Institute for Suicide Prevention - DRISP, Mental Health Center Copenhagen, University of Copenhagen, Gentofte Hospitalsvej 15, Opg. 15, 4. floor, Hellerup, DK - 2900, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention - DRISP, Mental Health Center Copenhagen, University of Copenhagen, Gentofte Hospitalsvej 15, Opg. 15, 4. floor, Hellerup, DK - 2900, Denmark
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Trine Madsen
- Danish Research Institute for Suicide Prevention - DRISP, Mental Health Center Copenhagen, University of Copenhagen, Gentofte Hospitalsvej 15, Opg. 15, 4. floor, Hellerup, DK - 2900, Denmark
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Ayer L, Boudreaux B, Paige JW, Holmes P, Blagg TL, Mendon-Plasek SJ. Artificial Intelligence-Based Student Activity Monitoring for Suicide Risk: Considerations for K-12 Schools, Caregivers, Government, and Technology Developers. RAND HEALTH QUARTERLY 2024; 11:2. [PMID: 38601718 PMCID: PMC10911757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
In response to the widespread youth mental health crisis, some kindergarten-through-12th-grade (K-12) schools have begun employing artificial intelligence (AI)-based tools to help identify students at risk for suicide and self-harm. The adoption of AI and other types of educational technology to partially address student mental health needs has been a natural forward step for many schools during the transition to remote education. However, there is limited understanding about how such programs work, how they are implemented by schools, and how they may benefit or harm students and their families. To assist policymakers, school districts, school leaders, and others in making decisions regarding the use of these tools, the authors address these knowledge gaps by providing a preliminary examination of how AI-based suicide risk monitoring programs are implemented in K-12 schools, how stakeholders perceive the effects that the programs are having on students, and the potential benefits and risks of such tools. Using this analysis, the authors also offer recommendations for school and district leaders; state, federal, and local policymakers; and technology developers to consider as they move forward in maximizing the intended benefits and mitigating the possible risks of AI-based suicide risk monitoring programs.
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Prichett LM, Yolken RH, Severance EG, Young AS, Carmichael D, Zeng Y, Kumra T. Racial and Gender Disparities in Suicide and Mental Health Care Utilization in a Pediatric Primary Care Setting. J Adolesc Health 2024; 74:277-282. [PMID: 37815762 PMCID: PMC10842072 DOI: 10.1016/j.jadohealth.2023.08.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/12/2023] [Accepted: 08/24/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE We examined racial and gender disparities in the underrecognition of mental health disorders in adolescents and young adults as defined by a suicide-related diagnosis without a previous mental or behavioral health diagnosis. METHODS We employed a series of adjusted mixed multilevel logistic regression models to determine the odds of specific mental health diagnoses (anxiety, depression, and suicide-related) in a large, U.S. pediatric ambulatory care group (ages 8-20 years) using Electronic Medical Record Data. RESULTS Using the reference group of White males, White females had 17% increased odds of having a suicide-related diagnosis (odds ratio (OR) 1.17, 95% confidence intervals (CI) 1.03, 1.34) and Black females had 48% increased odds of suicide-related diagnosis (OR 1.48, 95% CI 1.28, 1.71). Conversely, White females had 75% increased odds of recorded anxiety (OR 1.75, 95% CI 1.62, 1.89), Black males had 62% decreased odds of anxiety (OR 0.38, 95% CI 0.33, 0.42), and Black females had 33% decreased odds of anxiety (OR 0.67, 95% CI 0.60, 0.74). White females had 81% increased odds of having recorded depression (OR 1.81, 95% CI 1.62, 2.04) and Black females had 80% increased odds of underrecognized need for mental or behavioral health diagnosis services (OR 1.80, 95% CI 1.53, 2.13) as defined by a suicide-related diagnosis without a previous mental health diagnosis. DISCUSSION Black adolescents and young adult patients are either not accessing or identified as needing mental health services at the same rates as their White peers, and Black females are experiencing the most underrecognition of need for mental health services.
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Affiliation(s)
- Laura M Prichett
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Emily G Severance
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Andrea S Young
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Destini Carmichael
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Yong Zeng
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Tina Kumra
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
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Rao WW, Lin X, Liu H, Yang C, Wang S. Suicidal ideation and self-harm behaviours in children aged 12 years or younger. Lancet Psychiatry 2022; 9:855. [PMID: 36244355 DOI: 10.1016/s2215-0366(22)00319-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 08/28/2022] [Accepted: 08/31/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Wen-Wang Rao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Xiaoxiao Lin
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Huanzhong Liu
- Chaohu Hospital, Anhui Medical University, Chaohu, China
| | - Chao Yang
- Department of Psychiatry, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Shuai Wang
- Department of Translation Medicine Centre, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 31000, China
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