Objective To review critically the past 10 years of research on youth suicide. Method Research literature on youth suicide was reviewed following a systematic search of PsycINFO and Medline. The search for school-based suicide prevention programs was expanded using two education databases: ERIC and Education Full Text. Finally, manual reviews of articles' reference lists identified additional studies. The review focuses on epidemiology, risk factors, prevention strategies, and treatment protocols. Results There has been a dramatic decrease in the youth suicide rate during the past decade. Although a number of factors have been posited for the decline, one of the more plausible ones appears to be the increase in antidepressants being prescribed for adolescents during this period. Youth psychiatric disorder, a family history of suicide and psychopathology, stressful life events, and access to firearms are key risk factors for youth suicide. Exciting new findings have emerged on the biology of suicide in adults, but, while encouraging, these are yet to be replicated in youths. Promising prevention strategies, including school-based skills training for students, screening for at-risk youths, education of primary care physicians, media education, and lethal-means restriction, need continuing evaluation studies. Dialectical behavior therapy, cognitive-behavioral therapy, and treatment with antidepressants have been identified as promising treatments but have not yet been tested in a randomized clinical trial of youth suicide. Conclusions While tremendous strides have been made in our understanding of who is at risk for suicide, it is incumbent upon future research efforts to focus on the development and evaluation of empirically based suicide prevention and treatment protocols.

Youth suicide risk and preventive interventions: A review of the past 10 years.

ContextHousehold firearms are associated with an elevated risk of firearm death
to occupants in the home. Many organizations and health authorities advocate
locking firearms and ammunition to prevent access to guns by children and
adolescents. The association of these firearm storage practices with the reduction
of firearm injury risk is unclear.ObjectiveTo measure the association of specific household firearm storage practices
(locking guns, locking ammunition, keeping guns unloaded) and the risk of
unintentional and self-inflicted firearm injuries.Design and SettingCase-control study of firearms in events identified by medical examiner
and coroner offices from 37 counties in Washington, Oregon, and Missouri,
and 5 trauma centers in Seattle, Spokane, and Tacoma, Wash, and Kansas City,
Mo.Cases and ControlsCase firearms were identified by involvement in an incident in which
a child or adolescent younger than 20 years gained access to a firearm and
shot himself/herself intentionally or unintentionally or shot another individual
unintentionally. Firearm assaults and homicides were excluded. We used records
from hospitals and medical examiners to ascertain these incidents. Using random-digit
dial telephone sampling, control firearms were identified by identification
of eligible households with at least 1 firearm and children living or visiting
in the home. Controls were frequency matched by age group and county.Main Exposure MeasuresThe key exposures of interest in this study were: (1) whether the subject
firearm was stored in a locked location or with an extrinsic lock; (2) whether
the firearm was stored unloaded; (3) whether the firearm was stored both unloaded
in a locked location; (4) whether the ammunition for the firearm was stored
separately; and (5) whether the ammunition was stored in a locked location.
Data regarding the storage status of case and control guns were collected
by interview with respondents from the households of case and control firearms.ResultsWe interviewed 106 respondents with case firearms and 480 with control
firearms. Of the shootings associated with the case firearms, 81 were suicide
attempts (95% fatal) and 25 were unintentional injuries (52% fatal). After
adjustment for potentially confounding variables, guns from case households
were less likely to be stored unloaded than control guns (odds ratio [OR],
0.30; 95% confidence interval [CI], 0.16-0.56). Similarly, case guns were
less likely to be stored locked (OR, 0.27; 95% CI, 0.17-0.45), stored separately
from ammunition (OR, 0.45; 95% CI, 0.34-0.93), or to have ammunition that
was locked (OR, 0.39; 95% CI, 0.23-0.66) than were control guns. These findings
were consistent for both handguns and long guns and were also similar for
both suicide attempts and unintentional injuries.ConclusionsThe 4 practices of keeping a gun locked, unloaded, storing ammunition
locked, and in a separate location are each associated with a protective effect
and suggest a feasible strategy to reduce these types of injuries in homes
with children and teenagers where guns are stored.

https://jamanetwork.com/journals/jama/articlepdf/200330/joc32162.pdf

Gun storage practices and risk of youth suicide and unintentional firearm injuries.

Debate surrounds whether access to firearms in the home increases the risk for violent death. This systematic review identified and evaluated studies that compared suicide and homicide victimizatio...

The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis

These guidelines review what is known about the epidemiology, causes, management, and prevention of suicide and attempted suicide in young people. Detailed guidelines are provided concerning the assessment and emergency management of the children and adolescents who present with suicidal behavior. The guidelines also present suggestions on how the clinician may interface with the community. Crisis hotlines, method restriction, educational programs, and screening/ case-finding suicide prevention strategies are examined, and the clinician is advised on media counseling. Intervention in the community after a suicide, minimization of suicide contagion or imitation, and the training of primary care physicians and other gatekeepers to recognize and refer the potentially suicidal child and adolescent are discussed.

/pdf/practice-parameter-for-the-assessment-and-treatment-of-2zhbwxgx3a.pdf

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Suicidal Behavior

Youth suicide, the third leading cause of death among teenagers and young adults, accounts for more deaths in the United States than all natural causes combined among 15- to 24-year-olds according to the National Center for Health Statistics (2000a). The public health significance of the problem of youth suicide becomes even more apparent when the high rates of nonlethal suicidal behavior are taken into account. This paper reviews the extensive research literature on youth suicide that has emerged during the past two decades. While great advances in knowledge have led to increased understanding of the risk factors for child and adolescent suicides, the application of this knowledge for designing prevention strategies remains inchoate.

Youth suicide prevention.

OBJECTIVES: The purpose of this study was to determine whether purchase of a handgun from a licensed dealer is associated with the risk of homicide or suicide and whether any association varies in relation to time since purchase. METHODS: A case-control study was done among the members of a large health maintenance organization. Case subjects were the 353 suicide victims and 117 homicide victims among the members from 1980 through 1992. Five control subjects were matched to each case subject on age, sex, and zip code of residence. Handgun purchase information was obtained from the Department of Licensing. RESULTS: The adjusted relative risk of suicide was 1.9 (95% confidence interval [CI] = 1.4, 2.5) for persons with a history of family handgun purchase from a registered dealer. The adjusted relative risk for homicide, given a history of family handgun purchase, was 2.2 (95% CI = 1.3, 3.7). For both suicide and homicide, the elevated relative risks persisted for more than 5 years after the purchase. CONCL...

The association between the purchase of a handgun and homicide or suicide.

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The association between the purchase of a handgun and homicide or suicide.