Connectedness and Suicide Prevention in Adolescents: Pathways and Implications

Adolescent suicide is a major public health concern. Stressing the need for public health–based solutions, the Centers for Disease Control and Prevention identified “connectedness” as one means of pursuing this agenda. To advance this effort in suicide prevention with adolescents, (1) consistencies and variation in the literature overtly linking connectedness to suicide thoughts and behaviors (STB) are reviewed, (2) three more specific mechanistic pathways are proposed whereby connectedness may influence STB, and (3) several implications related to use of connectedness as a public health framework for adolescent suicide prevention and intervention are outlined.     

Factors from Durkheim's Family Integration Related to Suicidal Ideation among Men with Histories of Child Sexual Abuse

Men who were sexually abused during childhood represent a highly stigmatized, marginalized population at risk for a variety of long‐term mental health problems. Using the family integration dimension of Durkheim's theory of suicide, factors associated with suicidal ideation among a purposive sample of 487 men with histories of child sexual abuse were examined. Four variables—length of cohabitation, maternal support after disclosure, parental divorce, and older age—were negatively related to suicidal ideation. The analysis provides partial support for Durkheim's model. Implications for education, clinical practice, and future research are presented.     

Measuring Associations of the Department of Veterans Affairs' Suicide Prevention Campaign on the Use of Crisis Support Services

Campaigns have become popular in public health approaches to suicide prevention; however, limited empirical investigation of their impact on behavior has been conducted. To address this gap, utilization patterns of crisis support services associated with the Department of Veterans Affairs' Veterans Crisis Line (VCL) suicide prevention campaign were examined. Daily call data for the National Suicide Prevention Lifeline, VCL, and 1‐800‐SUICIDE were modeled using a novel semi‐varying coefficient method. Analyses reveal significant increases in call volume to both targeted and broad resources during the campaign. Findings underscore the need for further research to refine measurement of the effects of these suicide prevention efforts.     

Identifying and Referring Youths at Risk for Suicide Following Participation in School‐Based Gatekeeper Training

Gatekeeper training is a core strategy of the Garrett Lee Smith Memorial Suicide Prevention Act of 2004. Using data gathered from school‐based gatekeeper trainings implemented by GLS grantees, this analysis examines training and gatekeeper factors associated with (1) identification and referral patterns and (2) services at‐risk youths receive. Time spent interacting with youths was positively correlated with the number of gatekeeper identifications and knowledge about service receipt. Gatekeepers who participated in longer trainings identified proportionately more at‐risk youths than participants in shorter trainings. Most gatekeeper trainees referred the identified youths to services regardless of training type.     

Awareness Effects of a Youth Suicide Prevention Media Campaign in Louisiana

Research on the efficacy of mediated suicide awareness campaigns is limited. The impacts of a state‐wide media campaign on call volumes to a national hotline were analyzed to determine if the advertisements have raised awareness of the hotline. We use a quasi‐experimental design to compare call volumes from ZIP codes where and when the campaign is active with those where and when the campaign is not active. Multilevel model estimates suggest that the campaign appears to have significantly and substantially increased calls to the hotline. Results from this study add evidence to the growing public health literature that suggests that mediated campaigns can be an effective tool for raising audience awareness.     

Suicide Attempt Risk in Youths: Utility of the Harkavy–Asnis Suicide Scale for Monitoring Risk Levels

The Harkavy–Asnis Suicide Scale (HASS), one of the few self‐report scales assessing suicidal behavior was evaluated and ideation, was evaluated and predictors of suicide attempts (SAs) were identified with the goal of developing a model that clinicians can use for monitoring SA risk. Participants were 131 pediatric emergency department (ED) patients with suicidal behavior. The HASS and Diagnostic Interview Schedule for Children (DISC‐IV) were administered approximately 2 months after ED presentation. When compared with DISC‐IV ratings, sensitivity of the HASS SA items was excellent (100%), and overall classification accuracy was 72%. SA planning was the strongest predictor of SAs.     

Trajectories of Depressive Symptoms and Externalizing Behaviors across Adolescence: Associations with Histories of Suicide Attempt and Ideation in Early Adulthood

We examined associations between adolescent problem trajectories and suicide risk outcomes in 361 community participants. Depressive symptoms (self‐report) and externalizing behaviors (parent report) were assessed six times from grades 5 to 10. Parallel process linear growth curves indicated that lifetime suicide attempt history assessed to age 25 was associated with higher intercept (grade 5) and slope (increases from grades 5 to 10) of depressive symptoms and higher slope of externalizing behaviors. Both problem intercepts predicted suicidal ideation at ages 18 to 25 years. Adolescent depressive and externalizing symptom trajectories showed independent associations with suicide risk. Preventive intervention that occurs prior to the developmental period in which suicidal thoughts and behaviors show peak prevalence is expected to prevent suicide.