Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
권호 표지
DOI QR코드

DOI QR Code

The Impact of Referral to Mental Health Services on Suicide Death Risk in Adolescent Suicide Survivors

  • Received : 2020.07.06
  • Accepted : 2020.08.12
  • Published : 2020.10.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study aims to examine the effect of adolescent suicide survivors' experience on suicide death risk, and the effect of referral to mental health services (hereafter referral) in this regard. Methods: This study used the data of 878 suicide-deceased and suicide-attempted adolescents aged 8-19 years, managed by the Suicide and School Mental Health Institute from 2016 to 2018. Results: Regression analysis for main effects showed that although suicide experience had no direct effect on suicide death, non-referral status was associated with a greater risk of death by suicide. While the "non-suicide survivor with non-referral" and "suicide survivor with non-referral" groups showed 1.87 [adjusted odds ratio=1.87, 95% confidence interval (CI)=1.21-2.89] and 4.59 (adjusted odds ratio=4.59, 95% CI=2.02-10.42) times higher odds of suicide death, respectively, the "suicide survivor with referral" group showed no difference compared to the "non-suicide survivor with referral" group. Conclusion: From these findings, there is a need to strengthen referral to mental health services and apply complicated grief treatment to improve the mental health of adolescent suicide survivors.

Keywords

References

  1. Korea Suicide Prevention Center. 2020 Suicide Prevention White Paper. 1st ed. Seoul: Korea Suicide Prevention Center;2020. p.20.
  2. Cerel J, Maple M, Aldrich R, van de Venne J. Exposure to suicide and identification as survivor. Results from a random-digit dial survey. Crisis 2013;34:413-419. https://doi.org/10.1027/0227-5910/a000220
  3. Song IH, Kwon SW, Kim JE. Association between suicidal ideation and exposure to suicide in social relationships among family, friend, and acquaintance survivors in South Korea. Suicide Life Threat Behav 2015;45:376-390. https://doi.org/10.1111/sltb.12158
  4. Knieper AJ. The suicide survivor's grief and recovery. Suicide Life Threat Behav 1999;29:353-364.
  5. Shneidman EF. Introduction. In: Cain AC, editor. Survivors of suicide. Springfield: Thomas;1972. p.ix-xi.
  6. Cerel J, Brown MM, Maple M, Singleton M, van de Venne J, Moore M, et al. How many people are exposed to suicide? Not six. Suicide Life Threat Behav 2019;49:529-534. https://doi.org/10.1111/sltb.12450
  7. Gould MS, Lake AM. The contagion of suicidal behavior. Contagion of Violence: Workshop Summary; 2013. National Academies Press [cited 2020 June 21]. Available from URL: https://www.ncbi.nlm.nih.gov/books/NBK207262/.
  8. Insel BJ, Gould MS. Impact of modeling on adolescent suicidal behavior. Psychiatr Clin North Am 2008;31:293-316. https://doi.org/10.1016/j.psc.2008.01.007
  9. Cheng Q, Li H, Silenzio V, Caine ED. Suicide contagion: a systematic review of definitions and research utility. PLoS One 2014;9:e108724. https://doi.org/10.1371/journal.pone.0108724
  10. Brent DA, Kerr MM, Goldstein C, Bozigar J, Wartella M, Allan MJ. An outbreak of suicide and suicidal behavior in a high school. J Am Acad Child Adolesc Psychiatry 1989;28:918-924. https://doi.org/10.1097/00004583-198911000-00017
  11. Tal I, Mauro C, Reynolds CF 3rd, Shear MK, Simon N, Lebowitz B, et al. Complicated grief after suicide bereavement and other causes of death. Death Stud 2017;41:267-275. https://doi.org/10.1080/07481187.2016.1265028
  12. Pitman AL, Osborn DP, Rantell K, King MB. Bereavement by suicide as a risk factor for suicide attempt: a cross-sectional national UK-wide study of 3432 young bereaved adults. BMJ Open 2016;6:e009948. https://doi.org/10.1136/bmjopen-2015-009948
  13. Song IH, Kwon SW, Kim JE. Suicide attempts by family members and peers and their impact on suicidal ideation among adolescents: an analysis of the mediating effect of depressive mood. Korean Journal of Social Welfare Research 2016;49:29-47.
  14. Wang YG, Chen S, Xu ZM, Shen ZH, Wang YQ, He XY, et al. Family history of suicide and high motor impulsivity distinguish suicide attempters from suicide ideators among college students. J Psychiatr Res 2017;90:21-25. https://doi.org/10.1016/j.jpsychires.2017.02.006
  15. Jakobsen IS, Christiansen E. Young people's risk of suicide attempts in relation to parental death: a population-based register study. J Child Psychol Psychiatry 2011;52:176-183. https://doi.org/10.1111/j.1469-7610.2010.02298.x
  16. Wilcox HC, Kuramoto SJ, Lichtenstein P, Langstrom N, Brent DA, Runeson B. Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death. J Am Acad Child Adolesc Psychiatry 2010;49:514-523; quiz 530. https://doi.org/10.1016/j.jaac.2010.01.020
  17. Kang NR, Chung US, Kwack YS. Impact of peer's suicide on mental health of adolescents. J Korean Acad Child Adolesc Psychiatry 2015;26:266-272. https://doi.org/10.5765/jkacap.2015.26.4.266
  18. Anderson JK, Ford T, Soneson E, Coon JT, Humphrey A, Rogers M, et al. A systematic review of effectiveness and cost-effectiveness of school-based identification of children and young people at risk of, or currently experiencing mental health difficulties. Psychol Med 2019;49:9-19. https://doi.org/10.1017/S0033291718002490
  19. Gaete J, Martinez V, Fritsch R, Rojas G, Montgomery AA, Araya R. Indicated school-based intervention to improve depressive symptoms among at risk Chilean adolescents: a randomized controlled trial. BMC Psychiatry 2016;16:276. https://doi.org/10.1186/s12888-016-0985-4
  20. Klimes-Dougan B, Klingbeil DA, Meller SJ. The impact of universal suicide-prevention programs on the help-seeking attitudes and behaviors of youths. Crisis 2013;34:82-97. https://doi.org/10.1027/0227-5910/a000178
  21. Baiden P, Fallon B. Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada. Child Abuse Negl 2018;79:115-124. https://doi.org/10.1016/j.chiabu.2018.01.027
  22. Gould MS, Marrocco FA, Hoagwood K, Kleinman M, Amakawa L, Altschuler E. Service use by at-risk youths after school-based suicide screening. J Am Acad Child Adolesc Psychiatry 2009;48:1193-1201. https://doi.org/10.1097/CHI.0b013e3181bef6d5
  23. Kim J, Hong S, Hong H. Exploring demands and directions of field experts on ministry of education's school-based suicide prevention policy. Journal of Education & Culture 2019;25:5-31.
  24. Husky MM, Kaplan A, McGuire L, Flynn L, Chrostowski C, Olfson M. Identifying adolescents at risk through voluntary schoolbased mental health screening. J Adolesc 2011;34:505-511. https://doi.org/10.1016/j.adolescence.2010.05.018
  25. Cha JH, Ahn ME, Kim DW, Lee SK, Lee CH, Kim SM, et al. Clinical characteristics of intentional self-harm inpatient with lethal methods. J Korean Soc Emerg Med 2019;30:419-427.
  26. Stikkelbroek Y, Bodden DH, Reitz E, Vollebergh WA, van Baar AL. Mental health of adolescents before and after the death of a parent or sibling. Eur Child Adolesc Psychiatry 2016;25:49-59. https://doi.org/10.1007/s00787-015-0695-3
  27. Cha JM, Kim JE, Kim MA, Shim B, Cha MJ, Lee JJ, et al. Five months follow-up study of school-based crisis intervention for Korean high school students who experienced a peer suicide. J Korean Med Sci 2018;33:e192. https://doi.org/10.3346/jkms.2018.33.e192
  28. Mash HB, Fullerton CS, Shear MK, Ursano RJ. Complicated grief and depression in young adults: personality and relationship quality. J Nerv Ment Dis 2014;202:539-543. https://doi.org/10.1097/NMD.0000000000000155
  29. O'Connor RC, Nock MK. The psychology of suicidal behaviour. Lancet Psychiatry 2014;1:73-85. https://doi.org/10.1016/S2215-0366(14)70222-6
  30. Dickens N. Prevalence of complicated grief and posttraumatic stress disorder in children and adolescents following sibling death. The Family Journal 2014;22:119-126. https://doi.org/10.1177/1066480713505066
  31. Melhem NM, Moritz G, Walker M, Shear MK, Brent D. Phenomenology and correlates of complicated grief in children and adolescents. J Am Acad Child Adolesc Psychiatry 2007;46:493-499. https://doi.org/10.1097/chi.0b013e31803062a9
  32. Salloum A, Bjoerke A, Johnco C. The associations of complicated grief, depression, posttraumatic growth, and hope among bereaved youth. Omega (Westport) 2019;79:157-173. https://doi.org/10.1177/0030222817719805
  33. Brent DA, Melhem NM, Masten AS, Porta G, Payne MW. Longitudinal effects of parental bereavement on adolescent developmental competence. J Clin Child Adolesc Psychol 2012;41:778-791. https://doi.org/10.1080/15374416.2012.717871
  34. Kilmer RP, Gil-Rivas V, Griese B, Hardy SJ, Hafstad GS, Alisic E. Posttraumatic growth in children and youth: clinical implications of an emerging research literature. Am J Orthopsychiatry 2014;84:506-518. https://doi.org/10.1037/ort0000016

Cited by

  1. A Narrative Review of Suicide: Aiming at a More Encompassing Understanding vol.6, pp.3, 2021, https://doi.org/10.3390/philosophies6030074