Introduction:
Selective prevention initiatives have been identified as a key component of suicide prevention for young people. These activities generally focus on preventing the onset of suicide-related symptoms and behaviours, such as thoughts of suicide, plans or attempts in groups that are considered at increased risk when compared to the rest of the population. This research aimed to use current evidence and national survey data to better understand the characteristics of adolescents who are more likely to experience suicidality and estimate the proportion of those in Australia who would benefit the most from selective prevention strategies.
Methodology:
The study analysed data on adolescents aged 12-17 from the 2013-2014 Young Minds Matter (YMM) survey conducted in Australia. Factors likely to increase risk of suicide and suicidality were identified through a literature review and consultation with an Expert Advisory Group formed as part of the LIFEWAYS project, comprising service providers, researchers and lived experience. For corresponding variables available in the YMM dataset, chi-squared analyses assessed univariate associations with any adolescent-reported suicidal thoughts, plans or attempts in the past 12 months. Variables with significant univariate associations and representing distinct constructs were included in a multivariable logistic regression to test which associations with suicidality remained significant controlling for other factors. A final logistic regression analysis examined likelihood of suicidality depending on the number of significant factors present. The approach was refined with feedback from the Expert Advisory Group.
Results:
Twelve-month suicide-related symptoms and behaviours were reported by 7.9% of YMM survey respondents and over 50 variables with a possible association were identified for testing in the dataset following the literature review and consultation process. Based on the results of the chi-square analyses, 21 variables were then considered for inclusion in the regression analyses, of which only seven ultimately remained significant. These included indicators of recent mental illness, self-harm, disordered eating, bullying (being bullied or bullying others), feelings of loneliness and poor child-parent communication. Approximately 56.0% of the sample had at least one indicator present (13.8% with symptoms of suicidality), 29.0% had more than one indicator (24.0% with symptoms) and 15.7% had three or more indicators (36.1% with symptoms).
Conclusion:
This analysis highlighted factors associated with an increased likelihood of suicide-related symptoms and behaviours in adolescents and quantified their prevalence in a large national sample. The results may help inform the planning of selective suicide prevention services for this age group in Australia going forward.