Suicide prevention among young people: Exploring different Angles for Effective Policy and Practice

In chapter 2 we determined by means of a modified Delphi design, which suicide-related indicators are prioritized by healthcare professionals, peer specialists, and parents for monitoring the quality of care for young people with suicidal behavior (self-harm, suicidal ideation and suicide attempts) in youth mental health care. We found that participants of the Delphi rounds achieved consensus on the salience of nine suicide-related indicators: “Discussing suicidality with young person”, “Involving parents/relatives/significant others about suicidality”, “Presence of a safety plan”, “Appropriate care for each young person”, “Multidisciplinary assessment of suicidal behavior”, “Suicide prevention training of staff”, “Sudden change in behavior/symptoms”, “Risk assessment with accompanying action plan”, and “Proximity of care provider”. Chapter 3 presents the results of logistic regression analyses which were performed to describe time trends, risk factors, and risk groups associated with suicidal ideation and suicide attempts among over 100.000 students in vocational education over the past 10 years. We found that both suicidal ideation and suicide attempts have increased among students in vocational education over the past decade, with anxiety and depression being significant contributing factors. Although the results showed that females reported a higher prevalence of anxiety and depression, male students in vocational education tend to experience suicidal ideation and suicide attempts more rapidly as a result of these conditions. In chapter 4 a summary of the available scientific literature about the self-perceived needs of adolescents with suicidal behavior (self-harm, suicidal ideation and suicide attempts) is presented in the form of a scoping review. Starting our database with over 12.000 articles we finally included 29 studies from 14 predominantly Anglo countries. The identified needs of adolescents with suicidal behavior could be grouped into needs related to the following areas: the importance of connecting with other people; self-help strategies and personal growth; mental health care; school or study programs; and needs related to society in relation to the taboo on suicidal behavior. Chapter 5 describes a study in which 19 young adults with recent suicidal ideation were interviewed regarding their needs and perspectives concerning recovery and suicide prevention. The findings suggested a growing necessity for greater public awareness and understanding of suicide, providing mental health education from early stages of development, alleviating obstacles in mental health services like extended waiting periods, and strengthening informal support networks by fostering both online and offline peer interactions. Additionally, respondents underscored broader societal challenges such as the decline of social welfare, the increase of academic stress, and the influence of social media as pressing needs in the present era. In chapter 6 the additional value of young peer informants in a psychological autopsy study was assessed. Our findings revealed that peers, having personally witnessed certain events or incidents perceived as stressful for youth, were generally able to provide additional clarifications on the perspectives of parents. Additionally, siblings specifically contributed to greater detail than other peers (friends/relatives) regarding topics as family relationships and the home environment.