Did you know that among youth, suicide is the second leading cause of death in the United States, and that rates in children and teens between 5 to 21 years of age have increased by 50% over the past decade? Are you also aware that children in the child welfare system carry a three and a half times higher risk of suicide than other children? How can we reduce this risk? To begin to answer that question, we need to better understand if the factors associated with suicidality and the child welfare system (CWS). This is what Ruch et al (10.1542/peds.2020-011585) investigate in a study being early released this month in our journal.
The authors share with us an analysis of a retrospective matched case-control study involving 120 individuals who died by suicide aged 5 to 21 years who were being followed in the Ohio CWS and 1,200 matched controls. Youth who died by suicide were more likely to experience out-of-home placements and be diagnosed with mental and chronic physical health conditions when compared to controls. In fact, those who died by suicide sought mental health care twice as frequently both six months and one month prior to death, and also sought conventional medical care for their physical health six months before death when compared to controls. Emergency room visits for those who died were also approximately two and a half times as likely six months and one month prior to their death.
How do we use this information to prevent suicides in the CWS from occurring? The authors offer some suggestions, but to provide even more insight into the importance of this study, we invited Lisa Horowitz, PhD, MPH, Geoffrey Kahn, MPH, and Holly Wilcox, PhD from the National Institute of Mental Health to share their thoughts in an accompanying commentary (10.1542/peds.2020-043471). They note the importance of the findings in this study and suggest some very practical strategies to consider when youth from CWS present with medical and/or mental health concerns in inpatient, outpatient, and emergency settings. This study and commentary will raise your awareness and help you become better equipped to initiate even better prevention strategies in your office and in the child welfare community. Link to these articles and learn more.