Suicide Risk after Intentional Self-Harm in Adolescents and Young Adults

Adolescents and young adults treated for nonfatal self-harm are at increased risk for suicide death. In this high-risk group, American Indians and Alaska Natives and those who use violent self-harm methods are among those at highest risk for suicide. 

Using Medicaid records of adolescents and young adults treated for self-harm, researchers analyzed whether demographic and clinical characteristics could predict increased odds of repeat self-harm or suicide death up to one year later. They found that adolescents and young adults with a past-year history of self-harm were 26.7 times more likely to die by suicide than a demographically matched population. Among adolescents and young adults treated for self-harm, the odds of future suicide were five times higher for American Indians and Alaska Natives than for non-Hispanic whites. Adolescents and young adults whose initial self-harm episode involved violent methods, like firearms or hanging, were at increased risk of suicide death compared to those who used less violent methods, like poisoning or cutting.

These findings underscore the importance of targeting suicide prevention efforts at adolescents and young adults with a past-year history of self-harm. Close follow-up care may help ensure the safety of adolescents and young adults at highest risk, including American Indians and Alaska Natives and those with a history of self-harm using violent methods.

Olfson, M., Wall, M., Wang, S., Crystal, S., Bridge, J. A., Liu, S.-M., & Blanco, C. (2018). Suicide after deliberate self-harm in adolescents and young adults. Pediatrics, 141(4). Advance online publication. doi:10.1542/peds.2017-3517