New insight on suicide prevention

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Youth suicide attempts are inextricably linked to relationships, new research indicates. 

High schools where students are connected with peers and adult staff, and have established strong ties with the same adults, have lower rates of suicide attempts, a study published recently in the Journal of Child Psychology and Psychiatry shows.

This focus on social networks had been relatively unexplored in previous research on suicide, says lead author Peter Wyman, a professor in the department of psychiatry at the University of Rochester School of Medicine and Dentistry. 

“Most suicide prevention is centered on the high-risk individual,” Wyman says. “We wanted this study to provide us with new ways of thinking on how to intervene to strengthen protective relationships on a broader school level, and even on a community level.”

In New York, suicide is the second leading cause of death among those aged 15 to 34, according to the American Foundation for Suicide Prevention. On average, one person dies every five hours in the state.

Wyman’s study, titled “Peer-adult network structure and suicide attempts in 38 high schools: implications for network-informed suicide prevention,” surveyed 10,291 students, including some in New York, to determine social integration through the relationship network structure of each school.

Using a new approach, students were not only asked to name seven close friends, but also were prompted to list seven adults with whom they had trusted personal relationships. Researchers used the friendship and adult nominations submitted to build comprehensive social networks for each school. The data helped determine whether differences in social networks between schools resulted in different rates of suicide attempts and suicidal ideation, or thoughts about taking one’s own life.

Researchers discovered that rates of suicide attempts and ideation were higher in schools where students named fewer friends, friendship nominations were concentrated in fewer students, and students’ friends were less often friends with each other. Schools where students who were isolated from adults or relationships with adults were concentrated among fewer students reported higher rates of suicide attempts.

  • However, schools where students and their close friends shared strong bonds with the same adult, and where a smaller number of adults were nominated by a larger share of students showed lower rates of suicide attempts, Wyman’s study found.

Nationally, suicide attempts and ideation have increased. The number of children and teens who visited emergency rooms for these conditions doubled between 2007 and 2015, according to an April study published by JAMA Pediatrics.

“Despite a great deal of effort, suicide rates continue to rise. This study identifies protective schoolwide network factors, such as cohesion between adolescents’ peer and adult networks,” Wyman says. “This network-informed perspective gives us some new concepts for suicide prevention. Strengthening inter-generational cohesion so that more friendship groups share a trusted adult could make it easier for youth to close the circle through that connection if a friend is at-risk.”

His recent study recommends developing ways to strengthen social networks.

“The time has come for our field to think more broadly about suicide prevention,” says Anthony Pisani, associate professor at the UR’s School of Medicine and Dentistry. “Individual risk factors, like depression, substance use or traumatic history, are important, but we also need to think about the health of the social ties and systems in which we are all interwoven.” 

Engaging peer group leaders has been at the core of Wyman and Pisani’s work in schools. They have used the approach with two intervention programs—Sources of Strength and Above the Influence of Vaping—in 60 high schools and middle schools across the state. 

A suicide prevention program, Sources of Strength uses peer leaders to enhance protective factors associated with reducing suicide in school populations. Above the Influence of Vaping, a substance-abuse prevention effort, uses similar methods combined with science-based peer-to-peer messaging. 

Smriti Jacob is Rochester Beacon managing editor.

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