Public Health Surveillance of Youth Suicide Attempts: Challenges and Opportunities

Profile of the attention provided to suicide attempts by adolescents in emergency rooms and associated factors

OBJECTIVE

to identify the profile of emergency department visits for suicide attempts by adolescents and their associated factors.

METHOD

a cross-sectional, documentary, and retrospective study was conducted with 140 medical records of adolescents treated for suicide attempts in an emergency department linked to a teaching hospital in the municipality of São Paulo, Brazil, between January 2015 and May 2023. Data was collected between August and November 2023. Descriptive and inferential analysis (Pearson's chi-square test) was performed, considering a p-value≤0.05 as statistically significant. National ethical guidelines were respected.

RESULTS

drug intoxications were the most common, associated with females (p<0.001) and continuous use of psychotropic medications (p=0.01). Poisonings were associated with the absence of continuous psychotropic medication use (p=0.02) and treatment in the emergency room (p=0.01). Males were associated with intoxications from alcohol and drugs (p<0.001), wounds from sharp objects (p<0.05), and precipitation (p=0.03).

CONCLUSION

this study found a prevalence of emergency department visits for suicide attempts through intoxications associated with sex, medication use, and treatment in the emergency room. We hope that his profile can help professionals structure action plans to improve clinical care, mental health care, prevention, and post-attempt strategies.

[Public Health Policies for Youth - Bibliometric Study and Research Agenda based on the Web of Science]

The scope of this research outlines the field of study on public health policies for youth supported by bibliometric maps, from the perspective of identifying research gaps. VOSviewer software was used based on the exploratory-descriptive profile, with data located in October 2021, using the key words "public", "youth", "health" with the connecting "and", which resulted in 172 articles. The following groupings were located: co-authorship by country; co-authorship by key words; co-quote by article; co-quote by reference cited; bibliographic coupling; co-quote of authors. The results reveal an interdisciplinary field, represented by studies in the areas of education, social work, law, and social sciences, with a significant recurrence of the themes of mental health, violence, and obesity, as well as discussions on substance use and abuse, such as cigarette smoking for example. Debates about the social configuration, defined by the idea of community, as well as its prevalence and prevention are present in the scope of these studies. Finally, eight research agenda topics are derived from the discussion about the growing movement towards health promotion as a public policy, while socio-economic and cultural aspects are presented with greater emphasis, in the quest to understand the impacts of this scenario for youth.

Leveraging general risk surveillance to reduce suicide in early adolescents: Associations between suicidality, disordered eating, and other developmental risk factors

OBJECTIVE

Suicide is a leading cause of death in early adolescents (i.e., children ages 11-14), underscoring the need for a more complex understanding of suicidality in youth. Syndemics framework posits that the overlap of multiple maladaptive behaviors (or risk factors) produces worse health outcomes compared to each behavior alone. The use of this framework in preventing suicide necessitates that identification of developmental risk factors that occur in tandem to suicide (e.g., disordered eating behaviors and substance use) may be important for intervening on those at greatest risk of suicide.

METHOD

The present study uses latent class analysis (LCA) to evaluate the relationship between suicidality and disordered eating behaviors in early adolescence, and associations with other developmental risk factors in an epidemiological sample of middle school students (N = 3,811).

RESULTS

Lifetime prevalence ranged from 6.8% to 18.2% for suicidality, and 5.3%-48.7% for disordered eating behavior. Our final model identified six independent classes, and each class had differential associations with several additional developmental risk factors.

CONCLUSION

By pinpointing specific classes of individuals who may be at risk for multiple developmental risk factors, our results have important implications for public health intervention and prevention efforts for a wide range of adolescent risk behaviors, including suicidality.

Comparison of Past Year Substance Use Estimates by Age, Sex, and Race/Ethnicity Between Two Representative Samples of the U.S. Adult Population

Comparative evaluations of national survey data can improve future survey design and sampling strategies thereby enhancing our ability to detect important population level trends. This paper presents differences in past year estimates of alcohol, cigarette, marijuana, and non-medical painkiller use prevalence by age, sex, and race/ethnicity between the 2012 National Survey on Drug Use and Health (NSDUH) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) administered in 2012-2013. In general, estimates were higher for the NSDUH survey, but patterns of substance use prevalence were similar across race/ethnicity, age, and sex. Results show most significant differences in estimates, across substances, age groups, and sex were greatest among Hispanics, followed by non-Hispanic Whites, and non-Hispanic Blacks. Members of other racial/ethnic groups (e.g., Asian-American, Native American/Alaskan Native) were underrepresented in the NSDUH survey. In many cases, estimates for these subpopulations could not be calculated using the NSDUH data limiting our ability to draw comparisons with the NESARC estimates. Methodological differences in data collection for the NSDUH and NESARC surveys may have contributed to these findings. To promote effective population health surveillance methods, more work is needed to derive reliable and valid estimates from demographic subpopulations to better improve policymaking and intervention programming for at-risk populations.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11113-021-09645-8.