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Young people at suicide risk may show only mild to moderate mental distress

By Nicole MacKee
Suicidal thoughts or nonsuicidal self-injury in young people should prompt a swift professional response, UK researchers say, after finding that such behaviours reflect common mental distress even in the absence of other symptoms.

In an observational analysis of 3500 young people (aged 14 to 24 years), published in BMJ Open, the researchers found that most participants who experienced suicidal thoughts or nonsuicidal self-injury had close to average common mental distress scores.

They concluded that universal suicide prevention strategies to reduce mental distress rates across the whole population might be more effective than approaches targeting youths with the most severe distress or with psychiatric disorders.

In a media statement, the University of Cambridge researchers said that ‘small increases in stress across the entire population due to the coronavirus lockdown could cause far more young people to be at risk of suicide than can be detected through evidence of psychiatric disorders’.

Associate Professor Jo Robinson, Head, Suicide Prevention Research at Orygen, Melbourne, told Medicine Today it was critical that self-harming behaviours and suicidal ideation were always taken seriously.

‘In Australia, our research has found that young people who present with these problems are often not taken seriously and don’t always get the appropriate service response,’ she said. ‘Unfortunately, when people do express these thoughts, particularly young females, they often get dismissed.

Associate Professor Robinson said this may be one factor behind the significant increase in the rate of suicide among females (aged 10 to 24 years), but not males, in Australia between 2004 and 2014 (BMC Public Health 2019; 19: 1389).

Multidimensional approaches to suicide prevention were most likely to prevent suicide and deliver support to at-risk young people, she said. ‘A multifaceted approach to suicide prevention is generally considered to be best practice.’

Universal, population-based strategies, such as educational programs, could be combined with more targeted approaches for vulnerable and at-risk youths, she added. ‘Young people who are self-harming or who are expressing suicidal ideation can be targeted with clinical treatment, such as cognitive behaviour therapy.’ Associate Professor Robinson said it was also important to listen to young people when formulating suicide prevention strategies.

‘One of the gaps in our policy approach in Australia is that we don’t listen to young people enough; we don’t really ask them what they think the solutions are.’
BMJ Open 2020; 10: e032494; doi:10.1136/bmjopen-2019-032494.