Risk of Suicide and Self-harm in Kids: The Development of an Algorithm to Identify High-Risk Individuals Within the Chil
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ORIGINAL ARTICLE
Risk of Suicide and Self‑harm in Kids: The Development of an Algorithm to Identify High‑Risk Individuals Within the Children’s Mental Health System Shannon L. Stewart1 · Angela Celebre1 · John P. Hirdes2 · Jeffrey W. Poss2
© The Author(s) 2020
Abstract Suicide is the second leading cause of death in adolescents within Canada. While several risk factors have been found to be associated with increased risk, appropriate decision-support tools are needed to identify children who are at highest risk for suicide and self-harm. The aim of the present study was to develop and validate a methodology for identifying children at heightened risk for self-harm and suicide. Ontario data based on the interRAI Child and Youth Mental Health Screener (ChYMH-S) were analyzed to develop a decision-support algorithm to identify young persons at risk for suicide or self-harm. The algorithm was validated with additional data from 59 agencies and found to be a strong predictor of suicidal ideation and self-harm. The RiSsK algorithm provides a psychometrically sound decision-support tool that may be used to identify children and youth who exhibit signs and symptoms noted to increase the likelihood of suicide and self-harm. Keywords Children’s mental health · Suicidal ideation · Self-harm · Suicide risk · interRAI
Introduction Suicide is a major public health concern that has devastating long-term effects on both families and communities. It has been estimated that suicide and self-harm costs Canadian society approximately $3.3 billion annually in both direct and indirect costs [1]. Notably, suicide is the second leading cause of death among adolescents in Canada [2]. Previous research suggests that effective prevention strategies for child and adolescent suicide should primarily be targeted at reducing suicide risk factors [3]. Furthermore, the risk factors and features of suicidality in youth are different than those found in adults, hence the urgent need to determine potential risk factors as well as develop decision-support tools to identify these young people at greater risk [4].
Self‑harm: Nonsuicidal Self‑injury and Suicidal Self‑injury Self-harm is defined as any deliberate and direct act that causes harm to one’s body, encompassing both nonsuicidal self-injury (NSSI) and suicidal self-injury (SSI). NSSI is defined as intentional destruction of one’s body tissue without lethal intent and has a prevalence rate in adolescents of approximately 30–40% in clinical samples and 13–29% in non-clinical samples [5–7]; SSI is deliberate self-directed harm to one’s body with the intent to end one’s life and has a lower prevalence by comparison of 24–33% in clinical samples and 4–8% in non-clinical samples [5, 7, 8]. Adolescence represents a period of heightened risk for the initiation and engagement in self-injurious behaviours, given that the average age of onset is 12–13 years [9].
Potential Risk Factors for Self‑harm, NSSI, and SSI * Angela Celebre [email protected] 1
Faculty of Education, Western University, Londo
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