(Good Medical Health) – An American study suggests that adolescents and young men in correctional facilities are at increased risk of suicide. However, they are very similar to young people without committing suicide.

One of the few differences identified by researchers is that a representative sample of all suicides among boys and men aged 10 to 24 at the national level is that jailed youths are most likely to die during the first seven days of incarceration.

This suggests that screening these youth for suicide risk factors at the time of admission and tracking signs of suicidal intent could reduce the number of deaths, the authors conclude in the Journal of the American Academy. psychiatry of the child and the adolescent.

"Suicide prevention efforts among incarcerated youth should focus on timely and ongoing suicide risk assessment and safety planning," said Donna Ruch, lead author of the Prevention Center study. and suicide research at Nationwide Children's Hospital in Columbus, Ohio.

From 2000 to 2014, suicide rates were two to three times higher among youth in custody than in the general population, and more youth in custody died by suicide than any other reported cause of death, notes the team. Ruch.

According to the Centers for Disease Control and Prevention, suicides are generally the second leading cause of death among 10- to 24-year-olds.

"The National Action Alliance for Suicide Prevention has also identified young people incarcerated as suicidal people at risk and has set itself the strategic goal of reducing suicidal behavior in this population," he said. Ruch told Good Medical Health by email.

Researchers analyzed the characteristics and circumstances of approximately 10,000 suicides among young men between the ages of 10 and 24 between 2003 and 2012, of whom 213 were detained in a short-term juvenile detention center, a correctional facility. long-term penitentiary for adults. The study team used the National Reporting System for Violent Deaths, which captures and links data on violent deaths from multiple reports of coroners, forensic pathologists, and law enforcement officers.

Overall, the majority of suicides in detention and incarceration were white men aged 20 to 24 years. But suicides among black youth were significantly more likely to occur in custody.

In addition, inmates were more likely to die by hanging, strangulation or suffocation and less likely to die by firearms than those who were not incarcerated. Youth in custody were also more likely than non-incarcerated peers to reveal the reason for their suicide, to leave a note or to show depressive symptoms leading to suicide.

The study also found that about 37% of young people who died by suicide had a documented mental health problem. In general, suicide risk factors, such as history of suicide attempts, history of mental health problems and drug or alcohol use, were not significantly different between those who were in detention and those who were not there.

This could mean that unique aspects of the incarceration environment could be associated with a higher suicide risk, note the authors of the study.

Based on a few case studies, they also found that one-third of these suicides in custody occurred within 24 hours of incarceration and 76% within seven days of incarceration.

"This may be due to many factors, including the shock of incarceration, exacerbating the already fragile state of youth," said Madhav Bhatta of Kent State University in Ohio, who said: did not participate in the study.

"Correctional facilities need better methods to track the risk of potential suicide among young inmates, particularly during admission and early incarceration," Bhatta said in an email.

The Ruch team is currently planning a follow-up study to identify the best screening tools to detect suicide risk in the criminal justice system and the most effective way to administer these assessments.

Correctional institutions may also consider adaptive computer testing for suicide assessments, which alters the questions based on the respondent's previous responses and can adapt over time if repeatedly questioned, said Karen Abram of the Feinberg School of Medicine at Northwestern University in Chicago. involved in the study.

"Youth suicide is a preventable public health problem," she said in an e-mail. "Staff training in suicide prevention is essential, especially to recognize the warning signs of suicide."

SOURCE: bit.ly/2TpXvr9 Journal of the American Academy of Child and Adolescent Psychiatry, posted online 23 January 2019.