Suicide

The issue of suicide and suicidal behavior in children and adolescents is a significant mental health issue. Using the most current data from 2001, suicide is currently the third leading cause of death in the United States for youths between the ages of 10 and 19 (after automobile accidents and homicide); and in some states suicide is ranked second with homicide ranked third as the leading cause of death in 15- to 19-year-old adolescents.

Suicide, however, is only one behavior among a spectrum of behaviors that represent the suicidal behavior continuum (Reynolds & Mazza, 1994). The suicidal behavior continuum consists of suicidal [Page 548]ideation, suicidal intent, suicide attempt(s), and death caused by suicide, with suicidal ideation at the beginning of the continuum and suicide itself at the other end. Unfortunately, much of the attention regarding child and adolescent suicide focuses only on suicide itself, which is the rarest, missing the other more prevalent, but less lethal behaviors (Anderson, 2002). In fact, according to the Youth Risk Behavior Survey (YRBS) conducted by the Centers for Disease Control and Prevention (CDC) (2004) during the year 2003, 16.9% of high school students stated they had thought seriously of attempting suicide, 16.5% made a plan to attempt suicide, 8.5% actually attempted suicide, and 2.9% made a serious attempt that required medical attention. The analogy of an iceberg works well to represent the suicidal behavior continuum, with suicide being the tip of the iceberg and above the water, while the other behaviors are below the water but represent a greater proportion of the suicidal spectrum (Figure 1).

Figure 1 Suicide Behavior Continuum