Review Of: Mortier P, J Am Acad Child Adolesc Psychiatry 2018;57(4):263–27

Adolescence is a time of high risk for suicidal thoughts and behaviors (STB), and rates are rising. In those ages 15–29, suicide is the second leading cause of death globally (http://www.who.int/mental_health/prevention/suicide/suicideprevent/en). A recent article published some interesting survey data, giving us a clearer picture of how common STB is and what some of the causes are. Full-time, freshman college students at 19 colleges in 8 countries were surveyed.

The response rate was 45.5%, and the final sample included 13,984 responses (54% female; mean age 19). Approximately one-third of all respondents reported STB at some point during their lifetime. The median age of onset of STB was 14, with 75% of cases starting before age 16. More than half of those with ideation at some point in their life transitioned to a suicide plan, and a quarter of planners attempted suicide.

The strongest correlate for STB and transition from ideation to attempts was non-heterosexual orientation, yet it was notable that students who identified as heterosexual but with same-sex attraction also had a significantly elevated risk of transitioning from suicidal ideation to development of a plan.

CCPR’S Take
Suicidal ideation and behavior are distressingly common among first-year college students worldwide. Those with non-heterosexual orientation may be at particularly high risk. This study tells us to double down on screening our own patients and pressing for more screening efforts. In addition, prevention initiatives and gatekeeper training are effective in decreasing suicidality and increasing help-seeking. Where resources are limited, campus outreach could specifically target high-risk first-year students.

Editor’s note: For resources on screening and intervention for suicide, see: https://suicidepreventionlifeline.org or http://www.sprc.org.