Suicide Attempt Trends in Central Texas Youth

Purpose: It is estimated that two million adolescents in the United States attempt suicide each year. While effective school-based and community-based youth suicide prevention interventions have been identified, research is limited on the months and/or seasons that have an increase of youth suicide attempts. One international study that examined a combined sample of adolescents and adults over a calendar year found the highest frequency of suicide attempts in September for women and August for men. Few studies however, have examined child and adolescent suicide attempt frequencies over a calendar year. This information is essential in order to identify optimal time points for the implementation of youth suicide prevention interventions. The purpose of this study is to retrospectively examine youth suicide attempts over 20 months in an effort to identify time periods of high frequency.

Methods: A retrospective cohort design was conducted to identify patients presenting to two hospitals in Central Texas with a Level 1 Trauma Center due to a suicide attempt. Given the lack of consistent classification of suicide attempts in medical records, a two-step screening process was conducted. First, four data sources were queried to identify encounters of patients 5 and 18 years of age presenting to a hospital due to self-directed violence between 1/1/2011 and 8/31/2012. Next, the 1,903 encounters from step one were screened to assess if they met classification requirements for suicide attempts versus other forms self-directed violence (e.g., suicidal ideations, cutting, etc.).The screening resulted in 252 encounters identified as suicide attempts. Researchers used descriptive statistics to describe the sample and graphs and examine trends in suicide attempt encounters by gender, race/ethnicity over a 20 month period.

Results: Of the 235 patients who attempted suicide, the majority were female (75.74%) and Non-Hispanic White (48.51%). More than a third of patients who attempted suicide were Hispanic (34.47%), followed by patients who were black Non-Hispanic (11.91%) and other Non-Hispanic (5.11%).  The average age of patients was 14.69 years old (SD=2.09). In the full sample (N=252), there was a visually significant increase in suicide attempts that occurred near the spring (February-May) and fall (September-November) seasons. These patterns were visually significant for males and females (March and April, respectively). In addition, all ethnicities showed increases in the number of suicide attempts near the spring and fall. Specifically, in white Non-Hispanic encounters, marked increases were visible in fall (November) and spring (April). Among Hispanics, the greatest increases in encounters occurred in spring (April).  Spring (May) displayed the greatest visual increase in suicide attempts among the other Non-Hispanic population.

Implications: Fall and spring showed the highest frequency of suicide attempts in central Texas youth. Findings from this study provide evidence for the need of social workers and suicide prevention specialists to target suicide prevention efforts at the beginning and end of the school year in order to best reach at-risk youth. Future research is needed to examine reasons for the increase in suicide attempts during these time periods (i.e., transition into and out of the school year, season changes, etc.).