Authors Louis Appleby, Nav Kapur, Jenny Shaw, Pauline Turnbull, Kirsten Windfuhr, Saied Ibrahim, Cathryn Rodway, Su-Gwan Tham
Published by University of Manchester, May 2016
Suicide is the biggest killer of young people in the UK. An average of 428 under-25s took their own lives each year in England between 2003 and 2013. Of these, 137 were aged under 20, and 60 were under-18s. Researchers at the University of Manchester's Centre for Mental Health and Safety wanted to examine the experiences leading to suicide in children and young people and find out whether specific experiences such as bullying, abuse, and internet and social media use are linked to suicide in the young.
The research team analysed data from sources such as inquest hearings for 130 people under the age of 20 in England who killed themselves between January 2014 and April 2015. Of these, 46 per cent were under 18 and 71 per cent were male.
In total, 23 per cent had used the internet in some way that was related to suicide, such as expressing suicidal thoughts on social media - nine per cent - or searching for information on a suicide method at 12 per cent. Other factors included writing about feelings of hopelessness and online bullying.
The researchers found 28 per cent of the young people who died had been bereaved. They found 19 per cent had a relationship break-up in the three months before killing themselves while an additional 25 per cent had relationship problems. Meanwhile 36 per cent had experienced family problems in the three months prior to death. A history of abuse - physical, emotional or sexual - was recorded in 13 per cent of cases, and neglect in six per cent.
Bullying was an issue for 22 per cent of young people in the sample - 20 per cent were victims of face-to-face bullying and six per cent had been bullied online. Just over half - 53 per cent - were in education when they died with 29 per cent of the sample facing exams or exam results.
The study found 36 per cent had a physical health condition, with the most common being skin problems like acne, severe enough to lead to medical attention, or respiratory disease such as asthma. Overall, 39 per cent had a diagnosis of mental illness, most commonly bipolar affective disorder or depression. Alcohol consumption was reported to be excessive in 26 per cent, while 29 per cent had used illicit drugs - 21 per cent doing so in the three months prior to death. More than half - 54 per cent - had self-harmed and 10 per cent had self-harmed in the week before death. In all, 57 per cent had expressed thoughts about suicide, most often to a family member - 24 per cent - or friend at 15 per cent.
The researchers found 41 per cent had contact with mental health services, 18 per cent with social care and local authority services, and 30 per cent with youth justice or the police. However, 43 per cent had no contact with any agency, such as child and adolescent mental health services (CAMHS) or social services.
IMPLICATIONS FOR PRACTICE
For many young people in this research, longstanding family adversity seems to have been followed by difficulties in other areas of life, and complicated by mental health problems. Agencies that work with young people can contribute to suicide prevention by recognising the pattern of cumulative risks and "final straw" stresses, such as relationship problems or exams, which lead to suicide, say the researchers. They point out many children and young people who die by suicide have not expressed recent suicidal ideas, so not voicing such thoughts cannot be assumed to show lack of risk. While improved services for self-harm and access to CAMHS are crucial to addressing suicide risk, this research shows the vital preventative role of schools, primary care, social services, and youth justice.
- Thematic Review of Deaths of Children and Young People Through Probable Suicide, 2006-12, Dr Ann John and others, Public Health Wales NHS Trust, March 2014. A report exploring contributory factors, opportunities for prevention and ways to reduce the risk of suicide for children and young people in Wales.
- Suicide in Juveniles and Adolescents in the United Kingdom, Kirsten Windfuhr and others, Journal of Child Psychology and Psychiatry, November 2008. An examination of suicide rates and service contact among 10- to 19-year-olds.
- Self-Harm and Suicide in Adolescents, Professor Keith Hawton, Kate Saunders, Professor Rory O'Connor, The Lancet, June 2012. A paper looking at the evidence around adolescent self-harm and suicide, which sets out to identify key areas of uncertainty.