Exploring Differences in Reasons for Suicidal Thoughts Among Middle and High School Students in a Rural School Mental Health System

Background & Purpose:  

Youth suicide is a national public health priority and of growing concern to schools, families, and communities. Data from the CDC indicate that suicide is the 3^rd and 4^th leading cause of death for 15-24 and 10-14 year olds, respectively. In response, many schools are strengthening their school mental health systems to include suicide prevention strategies. School social workers are critical within these efforts. Because of the oftentimes limited resources available, especially in many rural communities, it is critical to understand what contributes to youths’ suicidal thoughts to help advance prevention and early intervention efforts. Also, understanding potential differences that may exist in relation to broad demographic factors would help to further target these strategies. This study uniquely examines the following research questions in rural middle and high school students, 1) What are the underlying reasons youth attribute to their suicidal thoughts? 2) Are there differences in reasons for suicidal thoughts in relationship to grade-level, gender, and race/ethnicity?

Methods:

A sample of 4,291 6^th-12^th graders from a rural school district completed a suicide prevention program knowledge survey. One survey item, “Have you ever had thoughts of hurting yourself?” was used to identify suicide risk based on responses of in the past year or past few days.  Twelve percent of the sample was identified at-risk and in need of further assessment (n = 513). Over half of youth were in middle school (58%), and 54% were female. In relationship to race/ethnicity, 70% of adolescents were white, 23% black, 6% Hispanic, and 1% Asian.

At-risk adolescents were assessed by a SMH staff member. As part of the assessment, youth identified life events and/or difficulties that contributed to their suicidal thoughts. These reasons were coded into one of twelve categories and served as the secondary data analyzed for this study. Data were grouped by family-related reasons (i.e., relationships with parents, parent separation/divorce, or family problems) and school-related reasons (i.e., feeling bullied, peer problems, and school problems) to examine demographic group differences. Descriptive and chi-square analyses were used to analyze the data.

Results:

Overall, family problems and feeling bullied were the most commonly reported reasons for suicidal thoughts. Developmental differences in youths’ reasons for suicidal thoughts was found (χ²(1,n=338)=4.58, p<.05). Among youth reporting school reasons, 71% were in middle school versus high school. Gender differences existed when comparing the type of school reason (χ²(2,n=76)=6.19, p<.05) with females comprising 80% of youth reporting peer problems, males comprising 85% of those feeling bullied, and females comprising 73% of those reporting school problems. Differences also existed when comparing family-related reasons. Females comprised 72% of youth reporting relationships with parents as the reason for suicidal thoughts (χ²(2,n=262 =5.11, p<.10). There was no support for any race/ethnicity differences.

Conclusions/Implications:

This study highlights the importance of addressing family and school problems through prevention and early intervention strategies. Preliminary support also was found for targeting these strategies in the face of limited resources. This study has important implications for research and policy on suicide prevention in schools.