Reducing Suicidal Behaviors among Adolescents

Adolescent girls who view themselves as too fat may display more suicidal behaviors than those who are actually overweight, according to a study by Inas Rashad, an assistant professor of economics at Georgia State University.

Although studies have shown a link between obesity, depressive disorders and suicidal behaviors, Rashad and Dhaval Dave of Bentley University, analyze these indicators in conjunction with an individual’s perception of their weight. The study was accepted for publication last month and is forthcoming in Social Science and Medicine.

“Both obesity and suicide have been highlighted by the Surgeon General as areas of focus for adolescents and areas of great concern,” Rashad said. “We find that the role perception has independently of actual overweight status is an important one, which has implications in terms of any solutions to the obesity epidemic that are put forth.”

The researchers utilized data from 1999 to 2007 from the Youth Risk Behavioral Surveillance System, which indicated that 17 percent of high school students have seriously considered committing suicide. The data were used to not only investigate whether overweight status or perception are causal factors affecting suicidal thoughts and attempts among high school students, but also to estimate the potential economic costs.

“If being overweight not only imposes the usual health care and labor market costs, but also increases the risk of suicide, we need to take these costs into account when offering solutions,” Rashad said.

The study revealed that body dissatisfaction had a strong impact on all suicidal behaviors for girls and was generally insignificant for males. For instance, any perception of being overweight by girls raised the probability of suicidal thoughts by 5.6 percent, the probability of a suicide attempts by 3.2 percent, and the probability of an injury causing suicide attempts by 0.6 percent. The researchers also state that the risk of suicide by adolescent females could potentially add about $280 to $350 million to the costs of adolescent obesity, which includes the direct cost of illnesses and associated health care and indirect costs such as productivity losses, reduced income and premature mortality.

Rashad hopes more research will be done on the topic, but she recommends efforts aimed at preventing youth suicides focus on educating youths and fostering healthy attitudes with regard to weight.

“The prevalence of body dissatisfaction, among special populations of youths such as non-black girls, is significantly higher than the general youth population, even when the underlying weight is in a healthy range,” Rashad said. “Interventions that identify and assist these youths and educate them regarding a healthy body image will succeed in lowering suicide attempts.”

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U.S. Suicide Rate Increases

The rate of suicide in the United States is increased for the first time in a decade, according to a new report from the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. The increase in the overall suicide rate between 1999 and 2005 was due primarily to an increase in suicides among whites aged 40-64, with white middle-aged women experiencing the largest annual increase.

Whereas the overall suicide rate rose 0.7 percent during this time period, the rate among middle-aged white men rose 2.7 percent annually and 3.9 percent among middle-aged women. By contrast, suicide in blacks decreased significantly over the study’s time period, and remained stable among Asian and Native Americans. The results are published online at the website of the American Journal of Preventive Medicine and will be published in the December print edition of the journal.

The researchers also conducted a detailed analysis of suicide methods across specific population groups. While firearms remain the predominant method, the rate of firearm suicides decreased during the study period. Suicide by hanging or suffocation increased markedly with a 6.3 percent annual increase among men, and a 2.3 percent annual increase among women.

Hanging/suffocation accounted for 22 percent of all suicides by 2005, surpassing poisoning at 18 percent.

“The results underscore a change in the epidemiology of suicide, with middle-aged whites emerging as a new high-risk group,” said study co-author Susan P. Baker, MPH, a professor with the Bloomberg School’s Center for Injury Research and Policy. “Historically, suicide prevention programs have focused on groups considered to be at highest risk—teens and young adults of both genders as well as elderly white men. This research tells us we need to refocus our resources to develop prevention programs for men and women in their middle years.”

Baker along with colleagues Guoqing Hu, PhD, Holly Wilcox, PhD, Lawrence Wissow, MD, MPH, analyzed data from the Web-based Injury Statistics Query and Reporting System (WISQARS) mortality reports, which provides data on deaths according to cause and intent of injury by age, race, gender and state. WISQARS mortality data are based on annual data files of the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC).

The reasons for the increase in the suicide rate are not fully understood. “While it would be straightforward to attribute the results to a rise in so-called mid-life crises, recent studies find that middle age is mostly a time of relative security and emotional wellbeing,” said Baker. “Further research is warranted to explore societal changes that may be disproportionably affecting the middle-aged in this country.”

The research was funded by the Center for Injury Research and Policy.

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Young African-American Males Face Mental Health Crisis; Experts Call For New Treatment Strategies and Better Access to Care

PRNewswire-USNewswire/ -- A significant increase in mental illness and behavioral problems among adolescent African-American males demonstrates the need for new approaches to treatment and better understanding of the complex challenges facing these youths, according to a policy paper issued by Community Voices: Healthcare for the Underserved, an advocacy group based at Morehouse School of Medicine.

The paper, titled "The Secret Epidemic: Exploring the Mental Health Crisis Affecting Adolescent African-American Males," outlines data indicating that mental health problems are rising among members of this at-risk group, their access to treatment facilities is relatively low and treatment strategies must be revamped to address the socioeconomic issues that confront them.

"Our research found that many young black males are treatable, but they are going undiagnosed because of failures in America's health-care system," said Dr. Henrie M. Treadwell, Director of Community Voices, a nonprofit seeking to improve health services and access to health care. "Our entire society feels the impact of this failure. Suicides and homicides have increased for this group, and the residual effect is impacting communities across the country. This problem must be addressed."

Dr. Claire Xanthos, a health services research specialist, wrote the paper, which cites studies showing that black males ages 15-19 die from homicide at 46 times the rate of their white counterparts and that from 1980 to 1995, the suicide rate for black adolescents rose from 5.6 to 13 per 100,000 of the population.

Xanthos writes that "these figures should not be surprising since adolescent African-American males in contemporary American society face major challenges to their psychological development and well-being. In addition to dealing with the physical, mental and emotional issues typically experienced during adolescence, adolescent African-American males are confronted with unique social and environmental stressors. They must frequently cope with racism and its associated stressors, including family stressors, educational stressors, and urban stressors."

Moreover, the paper notes that:

-- Racism can affect mental health by reducing socioeconomic status, diminishing access to desirable resources and contributing to poor living conditions.

-- When positive adult male role models are absent, many black youths turn to their peers for help in forming a male identity, an adaptation that often means absorbing negative influences.

-- Urban stress is an important factor in the psychological development of young black males because many live in deprived and dangerous neighborhoods where they are exposed to violence.

-- Significant problems are also encountered by black males who grow up in predominantly white, middle-class communities where they feel distanced from the white youths and also from blacks from poorer communities.

Citing these problems, the paper makes a plea for better access to mental health treatment for young black males, noting that they currently often confront a "confusing maze" when trying to get help.

The paper notes that when young black youths do find treatment, depression is often overlooked because their symptoms often differ from white youths'. For cultural and social reasons, black youths often express suicidal feelings through somatic complaints rather than sadness or depression.

Moreover, the paper calls for more "bicultural" training for young black males. Such training would better prepare them to follow proper behavior in school and the workplace, while also working with young black males to get them ready to deal with the discrimination they are likely to face. Also cited is the need for a significant increase in the number of black therapists available to work with African-American youths.

Dr. Treadwell said it is essential that new policies be implemented to address the social and environmental factors that create poor mental health outcomes for young black males.

"We must increase the capacity of America's mental health system to help resolve the problems faced by young black males," she said. "There must be more research in this area, and more people of color must be trained and hired to help this at-risk group."

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