Effects of Geography on Risk for Future Suicidal Ideation and Attempts Among Children and Youth
Year: 2023
Type: article
Study design: Observational Study
Abstract: Objective: Geography may influence the relationships of predictors for suicidal ideation (SI) and suicide attempts (SA) in children and youth. Method: This is a nationwide retrospective cohort study of 124,424 individuals less than 25 years of age using commercial claims data (2011-2015) from the Health Care Cost Institute. Outcomes were time to SI or SA within 3 months after the indexed mental health or substance use disorder (MH/SUD) outpatient visit. Predictors included sociodemographic and clinical characteristics up to 3 years before the index event. Results: < .001), and the Mountain Division consistently had the highest rates for both SI and SA (5.44%-10.26% for SI; 0.70%-2.82% for SA). Having MH emergency department (ED) visits in the past year increased the risk of SI by 28% to 65% for individuals residing in the New England, Mid-Atlantic, East North Central, West North Central, and East South Central Divisions. The main effects of geographic divisions were significant for SA (p<0.001). Risk of SA was lower in New England, Mid-Atlantic, South Atlantic, and Pacific (hazard ratios = 0.57, 0.51, 0.67, and 0.79, respectively) and higher in the Mountain Division (hazard ratio = 1.46). Conclusion: To understand the underlying mechanisms driving the high prevalence of SI and SA in the Mountain Division and the elevated risk of SI after having MH ED visits, future research examining regional differences in risks for SI and SA should include indicators of access to MH ED care and other social determinants of health.
Source: JAACAP Open
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,600
Funders: American Foundation for Suicide Prevention, American Academy of Child and Adolescent Psychiatry, National Institutes of Health, Weill Cornell Medical College, Irving Medical Center, Columbia University, National Institute of Mental Health, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
Awards: G3540322187, G5128213490, G5705794464, G6279170706, Linking VA and non-VA data to study the risk of suicide in chronic pain patients., Predicting Self-Harm, Suicide Attempt, and Suicidal Death using Longitudinal EHR, Claims and Mortality Data, G9000033140, G9000301939, Risk and protective factors for Black youth suicide and suicidal ideation and behaviors
OpenAlex ID: W4385296327