Jun 25 2012
In the first Series paper, Self-harm and suicide in adolescents, Professor Keith Hawton, Dr Kate Saunders of the University of Oxford’s Centre for Suicide Research, and Professor Rory O’Connor of University of Stirling’s Suicidal Behaviour Research Laboratory, UK, examine existing research to look at the connections between self-harm and suicide in young people.
Globally, suicide is the most common cause of death in female adolescents, and the third most common cause of death in male adolescents (after road traffic accidents and violence). Official estimates suggest that there are 164,000 self-inflicted deaths per year globally, but Professor Hawton and colleagues point out that this is likely to be a gross underestimate, since official classifications may often hide deaths from suicide in order to protect families, especially in regions where suicide is still a criminal act.
According to Professor Hawton, “Although suicide is uncommon in adolescents compared with non-fatal self-harm, it is always a tragic outcome. Despite the fact that around 10% of adolescents report having self-harmed, the reasons why they do it and why some –but not others – go on to take their own life are still very poorly understood. Further research in this area is urgently required if we are to make any headway in reducing the number of young people who either cause themselves significant harm or take their own lives.”
Professor O’Connor added, “To prevent adolescent suicide and self-harm, it is also important that we better understand why some young people who have thoughts of suicide do not act on these thoughts – whereas others sadly do and in too many cases die by suicide.”
Of particular concern is the role that new media play, with studies reporting that social networking sites can encourage young people experiencing suicidal tendencies. However, these media don’t necessarily have to play a negative role; Professor Hawton and his colleagues state that: “The challenge is in ensuring that new media provide support for vulnerable young people rather than helping or encouraging self-destructive behaviours”.
While the reasons for adolescent self-harming and suicide are highly complex, further research is needed if clinicians are to gain a better understanding of these worrying phenomena. In particular, effective interventions urgently need to be developed. The role of drug treatments – such as those used to treat depression in adults – is ambiguous at best, with some studies reporting an increase in adolescent suicides where antidepressants are used.
Trials of alternative interventions have been inconclusive and action in this area is desperately needed, with Professor Hawton and colleagues concluding that “The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs”.