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The article examines trends in suicide rates among Black females aged 15–84 in the U.S. from 1999 to 2020, revealing a notable increase from 2.1 to 3.4 per 100,000 during this period. Topics include a concentration of rising suicide rates among the youngest cohorts, with particular emphasis on the need for mental health care access and addressing structural racism, while also highlighting geographical variations that call for region-specific prevention efforts.

Despite evidence of an intersection between suicide risk and intimate partner violence (IPV), crisis hotlines tend to focus on callers at-risk for suicide or callers involved in IPV, but not both. In an effort to begin to address this gap, we developed and conducted an initial pilot test of a suicide prevention curriculum for hotline workers at the National Domestic Violence Hotline (NDVH), highlighting the intersection of these two public health issues. A mixed methods approach was used as a first step to assess the impact of the 3-h suicide prevention training for 42 domestic violence hotline workers. Results showed significant increase in knowledge regarding suicide risk from pre to post-training and a high degree of satisfaction among attendees. Focus groups conducted with hotline workers 3 months after training indicated a greater willingness to engage callers in suicide screening and prevention efforts. A 6-month follow-up focus group with NDVH managers revealed that suicide prevention had become more integrated in the agency culture, a finding that was consistent with an environmental scan of the workplace that showed an increase in displays of suicide prevention information. In sum, suicide prevention training can be feasibly incorporated into domestic violence hotline workers' roles. Limitations and suggestions for future studies are discussed., Author(s): Wendi F. Cross [sup.1] , Hugh F. Crean [sup.1] , Madelyn S. Gould [sup.2] , Jacquelyn Campbell [sup.3] , Norma Amezcua [sup.4] , Katie Ray Jones [sup.4] , Jennifer [...]

Linking at-risk callers to ongoing mental health care is a key goal of crisis hotline interventions that has not often been addressed in evaluations of hotlines' effectiveness. We conducted telephone interviews with 376 suicidal and 278 nonsuicidal crisis callers to the National Suicide Prevention Lifeline (Lifeline) to assess rates of mental health care utilization following Lifeline calls and to assess attitudinal and structural barriers to service utilization. Postcall utilization rates were approximately 50% for suicidal and crisis callers who received mental health care referrals. Lack of health insurance and callers' perceptions about mental health problems emerged as significant barriers to accessing continued help. (Contains 4 tables.)

Objective: We sought to examine follow-up service use by students identified at risk for suicidal behavior in a school-based screening program and assess barriers to seeking services as perceived by youths and parents. Method: We conducted a longitudinal study of 317 at-risk youths identified by a school-based suicide screening in six high schools in New York State. The at-risk teenagers and their parents were interviewed approximately 2 years after the initial screen to assess service use during the intervening period and identify barriers that may have interfered with seeking treatment. Results: At the time of the screening, 72% of the at-risk students were not receiving any type of mental health service. Of these students, 51% were deemed in need of services and subsequently referred by us to a mental health professional. Nearly 70% followed through with the screening's referral recommendations. The youths and their parents reported perceptions about mental health problems, specifically relating to the need for treatment, as the primary reasons for not seeking service. Conclusions: Screening seems to be effective in enhancing the likelihood that students at risk for suicidal behavior will get into treatment. Well-developed and systematic planning is needed to ensure that screening and referral services are coordinated so as to facilitate access for youths into timely treatment. (Contains 4 tables.)

The examination of the data from a sample of 5,302 Finnish children who were born in 1981 finds that bullying at age eight years and later is associated with later suicide attempts and completed suicide for boys but not after controlling for conduct and depression symptoms. For girls, the association is still seen even after controlling for conduct and depression symptoms.

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted. (Contains 5 tables.) [For part 2, see EJ785871.]

In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' suicide state from the beginning to the end of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March 2003 and July 2004, 1,085 suicide callers were assessed during their calls and 380 (35.0%) participated in the follow-up assessment. Several key findings emerged. Seriously suicidal individuals reached out to telephone crisis services. Significant decreases in suicidality were found during the course of the telephone session, with continuing decreases in hopelessness and psychological pain in the following weeks. A caller's intent to die at the end of the call was the most potent predictor of subsequent suicidality. The need to heighten outreach strategies and improve referrals is highlighted. (Contains 4 tables.) [For part 1, see EJ785868.]

Objective: To assess the association between bullying behavior and depression, suicidal ideation, and suicide attempts among adolescents. Method: A self-report survey was completed by 9th-through 12th-grade students (n = 2342) in six New York State high schools from 2002 through 2004. Regression analyses were conducted to examine the association between being victimized and bullying others with depression, ideation, and attempts. Results: Approximately 9% of the sample reported being victimized frequently, and 13% reported bullying others frequently. Frequent exposure to victimization or bullying others was related to high risks of depression, ideation, and suicide attempts compared with adolescents not involved in bullying behavior. Infrequent involvement in bullying behavior also was related to increased risk of depression and suicidality, particularly among girls. The findings indicate that both victims and bullies are at high risk and that the most troubled adolescents are those who are both victims and bullies. Psychopathology was associated with bullying behavior both in and away from school. Conclusions: Victimization and bullying are potential risk factors for adolescent depression and suicidality. In evaluations of students involved in bullying behavior, it is important to assess depression and suicidality. (Contains 4 tables.)

The purpose of this study was to examine the attitudes toward the use of telephone crisis services (hotlines) among 519 adolescents in 9th through 12th grade mandatory health courses in six high schools in New York State. Few adolescents (2.1%) used hotlines and negative attitudes were stronger toward hotlines than they were toward other formal sources of help. The most common reasons for hotline non-use related to feelings of self-reliance and shame. Objections to hotlines were strongest among students most in need of help by virtue of impaired functioning or feelings of hopelessness. The results underscore needed outreach efforts to youth.

Following a comprehensive review of the research literature on youth suicide, the authors discuss the rates and patterns of completed suicides and suicide attempts. The state of research on potential risk and protective factors is also reviewed, covering personal characteristics, family characteristics, adverse life circumstances, and socioenvironmental and contextual factors. (Contains 2 tables.)

Objective: To identify youths' attitudes about coping and help-seeking strategies for suicidal ideation/behavior and examine their demographic and clinical correlates. Method: A self-report survey was completed by high school students (N = 2,419) in six New York State schools from 1998 through 2001. The relationship between suicide attitudes and gender, depression, substance problems, serious suicidal ideation/behavior, and first-hand experience with a suicidal peer was examined. Results: Two factors that approximate avoidance and approach coping responses, maladaptive coping strategies and help-seeking strategies, respectively, were identified. Boys scored higher than girls (t = 7.96, df = 2341, p less than .001), and depressed youths (t = 15.56, df = 2323, p less than .001), students with substance problems (t = 11.07, df = 2340, p less than .001), and suicidal youths (t = 15.14, df = 2341, p less than .001) scored significantly higher than their healthy counterparts on the maladaptive coping strategies factor. Students with first-hand experience with a suicidal peer scored significantly higher on the maladaptive coping strategies factor than those without this experience (t = 7.95, df = 2321, p less than .001). Lower risk groups scored significantly higher on an adaptive help-seeking strategies factor. Conclusions: High-risk adolescents' attitudes are characterized by core beliefs that support the use of maladaptive coping strategies in response to depression and suicidal thoughts and behaviors. Targeting such attitudes is a recommended component of youth suicide prevention efforts.

The impact of the September 11th terrorist attacks on adolescents' mental health is reported. Two successive cohorts of students in 6 New York state high schools, identified from health courses, completed an in-school self-report baseline assessment of hopelessness, impairment, and help-seeking behavior. One year later, these students completed a follow-up telephone interview consisting of a comprehensive psychiatric assessment and a readministration of the baseline survey. The first cohort completed the baseline in 1999 and the follow up in 2000; the second cohort completed the baseline in 2000 and the follow up in 2001. Because the September 11th attacks occurred approximately 1 month before the scheduled commencement of the second cohort's follow up, this "September 11th cohort" also completed questions about the teenagers' experiences of the September 11th terrorist attacks in the follow-up interview. Taking advantage of the data gathered in the first cohort prior to the September 11th attacks, this article presents results comparing the mental health of teenagers in the September 11th cohort (N = 362) to those in the first cohort (N = 429), serving as a control group. Although the majority of youths exhibited no untoward psychological consequences post attacks, a minority of youths, reporting initial responses of numbing after the attacks, exhibited clinically significant psychological morbidity. Youths sought more help from informal than formal sources in the attacks' immediate aftermath. The findings have direct relevance for developing optimal practices to assist vulnerable youths in the aftermath of a terrorist attack. (Contains 5 tables.)

During the past decade there has been increased interest in help-seeking behavior among adolescents. This reflects the recognition that while many psychiatric problems increase markedly during adolescence, the majority of disturbed teenagers do not receive mental health services. Nearly half of all adolescents have reported using the Internet to access information about health issues. The purpose of this study was to provide information on the prevalence of Internet use by teenagers in their attempt to seek help for emotional problems. Over 500 students, ages 13-19, took a self-report questionnaire, which assessed demographic characteristics, hopelessness, functional impairments, and use and perception of various treatment services. The type of support sought on the Internet (e.g. chat rooms, Web sites), satisfaction with this information, and the use of the Internet with other sources of help were examined. (Contains 2 tables.)