Racial and Ethnic Differences in Non-Lethal Suicide Behavior and Screening Services of Justice-Involved Youth

Background and purpose. Suicide is the third leading cause of death in adolescence (CDC, 2015).  Previous studies have found justice-involved youth to be more than two times more likely to report a history of suicide attempts and to take their own life while in custody than youth in the general population (Gallagher  & Dobrin, 2006; Nock et al., 2012; Sedlak & McPherson, 2010).  Certain demographic characteristics are associated with greater risk.  Females report much higher levels of ideation and attempts compared to males in national estimates regardless if they are justice-involved or general population. Significant racial/ethnic differences are evident in nationally representative general population studies, (Nock et al, 2012; CDC), but less is known about the racial/ethnic differences and suicide behavior of equivalent studies of justice-involved youth. The objectives of this study were to 1) to demonstrate race/ethnic differences in non-lethal suicide behavior between youth in the general population and justice-involved youth, and 2) examine facility screening practices by youth race/ethnicity to identify disparities in screening services relative to need.  It is hypothesized that racial and ethnic differences will be apparent in both suicide behavior and available screening practices.

Methods. Existing data from two nationally representative samples-the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A) and the Survey of Youth in Residential Placement (SYRP)- were analyzed including only self-reports of youth ages 13-18 in  order to make comparisons of suicide behavior between the two populations.  Using only the SYRP data, information about facility screening practices was analyzed to determine if there were significant differences in the availability of screening services by youth race/ethnicity. 

Results. Comparisons between the samples demonstrated that justice-involved youth had elevated levels of ideations and were six times more likely to attempt suicide compared to the general population.  White youth reported the highest rates of suicide attempts in the justice sample while Hispanic youth reported the highest numbers in the general population. African-American youth had the lowest rates of suicide attempts in both samples.  White and African-American youth (25.4%, 20.4%) were significantly less likely to be in a facility that did not provide any screening or only provided screening to some youth. Conversely, Hispanic and American Indian or Alaska Native/Native Hawaiian or other Pacific Islander (AIAN/NHPI) youth were significantly more likely to be in facilities that did not provide screening or only provided screening to some youth (34.7%, 34.0%).

Conclusions and implications. Justice-involved youth are at much higher risk for attempted and completed suicides compared to the general population; however, 20% - 35% of justice involved youth in this study were housed in facilities that did not screen for suicide risk or only screened a select number of youth.  White youth reported the highest rates of previous suicide attempts and they were more likely to be in facilities that screened all youth compared to Hispanic and AIAN/NHPI populations.