Suicide prevention programs may be either universal (delivered to all children in a given population) or targeted (delivered to those most at risk). Both approaches have a role in preventing youth suicide. Universal programs have the benefits of reaching large numbers of young people without stigmatizing them and without requiring extensive screening efforts.

Of the programs examined by the Children’s Health Policy Centre, Youth Aware of Mental Health (YAM) showed the most promise. Self-reported suicide-related outcomes were assessed three and 12 months after students completed the program. At three-month follow-up, there was no significant difference between youth who received YAM and those in the control group regarding suicide attempts (0.9% vs. 1.1%) or severe suicidal ideation in the prior two weeks (1.5% for both groups). However, statistically significant differences did emerge later. By one-year follow-up, 0.7% of youth who participated in YAM had made a suicide attempt compared with 1.5% of youth in the control group. As well, 0.8% of youth who received YAM had experienced severe suicidal ideation in the two weeks prior to the one-year assessment, compared with 1.4% of youth in the control group. These findings suggest that YAM may be especially helpful in reducing suicidality.

For more information, see Vol. 16, No. 4 of the Children’s Mental Health Research Quarterly.

A significant number of young Canadians struggle with thoughts of suicide. Data from the National Longitudinal Survey of Children and Youth revealed that 13% of 14- and 15-year-olds reported having seriously considered attempting suicide in the past year. Similar findings emerged from the most recent BC Adolescent Health Survey which found 17% of respondents reported seriously considering killing themselves in the past year.

Identifying and responding to youth who have thoughts of suicide is critical since about one-third will make a suicide attempt within a year. Services immediately available to children and youth in BC who are struggling with thoughts of suicide include the following:

• YouthInBC.com provides assistance from a crisis responder 24 hours a day by phone (1-800-784-2433 or 604-872-3311 for youth in Greater Vancouver) and online chatting from noon to 1 a.m. through their website: youthinbc.com.

• Kids Help Phone provides support from a professional counsellor 24 hours a day by phone (1-800-668-6868) or from a crisis responder by text (686868) or via Facebook Messenger through their website: kidshelpphone.ca. Young people can be connected with First Nations, Inuit or Métis crisis responders.

• Youth Space provides support from trained volunteers from 6 p.m. to midnight by chat through their website (youthspace.ca) or by text (778-783-0177).

For more information, see Vol. 16, No. 4 of the Children’s Mental Health Research Quarterly.

The National Longitudinal Survey of Children and Youth provides important information on suicide attempts among Canadian youth. After tracking a representative sample of young people for more than a decade, researchers found most young people (96.0%) had never attempted suicide. But among the 4.0% who did make an attempt, researchers found clear patterns. For half of these young people, attempts occurred only during adolescence, while for the other half, they continued into adulthood. Where attempts were limited to the teen years, risk peaked at ages 14 to 15 and then declined. In contrast, where attempts continued into adulthood, risk increased steadily throughout adolescence.

BC data on youth suicide attempts also exist. Among the 38,000 students in Grades 7 to 12 participating in the McCreary Centre Society’s most recent BC Adolescent Health Survey, 5% acknowledged attempting suicide in the past year  — a figure in keeping with the Canadian data noted above. Overall, suicide attempts warrant serious attention because they are an important risk factor for subsequent attempts, including fatal ones.

For more information, see Vol. 16, No. 4 of the Children’s Mental Health Research Quarterly.

Suicide affects far too many young Canadians and their families. In fact, suicide is the second leading cause of death in this country, behind only unintentional injuries, for 15- to 19-year-olds, and the third leading cause for 10- to 14-year-olds. To help meet the goal of reducing youth suicide, the World Health Organization (WHO) has been a leader in collecting vital information. A recent meta-analysis of WHO data compared suicide rates for 10- to 19-year-olds across 35 countries, including Canada. From 2010 to 2018, the suicide rate for Canadian youth was 5.01 per 100,000 — putting Canada above the average global rate of 3.77 per 100,000. Still, WHO data revealed declining Canadian youth suicide rates in recent years, with the comparable figure for 2000 to 2011 being 5.36 per 100,000.

Suicides by Canadian youth differ based on age, gender and the interaction of the two. Regarding age, suicides are more frequent for 15- to 19-year-olds. Regarding gender, and as typical of other countries, boys account for the most suicides among older teens, at 70%. But among those between 10 and 14 years, girls account for 59% of suicides — making Canada the only country among the 35 included in the meta-analysis of WHO data with higher suicide rates for girls than for boys in this younger age group.

Researchers have also documented differing patterns in Canadian youth suicide rates over time, by gender. Between 2000 and 2018, the suicide rate for boys between 10 and 19 years declined slightly. The comparable suicide rate for girls showed a statistically significant increase of 0.09 deaths per 100,000.

For more information, see Vol. 16, No. 4 of the Children’s Mental Health Research Quarterly.

ADHD Awareness Month is part of a global effort to share information to help people with ADHD thrive. Attention Deficit/Hyperactivity Disorder (ADHD) affects children and adults all around the world, and this month offers an opportunity to fight misconceptions about ADHD and highlight helpful strategies for managing it. The ADHD Awareness Month Coalition provides numerous online resources, including expert Q & As, videos and podcasts, personal stories, and daily tips for life with ADHD.

ADHD is the second most common mental health disorder in children, exceeded only by anxiety. Positive and engaged caregiving can help children develop the self-regulation skills they need, and there is evidence that interventions such as child Cognitive Behavioural Therapy (CBT), behavioural therapy and neurofeedback can also be effective in helping children with ADHD. To learn more, see Vol. 10, No. 4 and Vol. 11, No. 1 of the Children’s Mental Health Research Quarterly.

On October 10 — World Mental Health Day — mental health organizations and advocates will come together to speak out for better mental health supports in the workplace as part of this year’s theme, “Mental Health at Work.” More than 60% of the global population is employed, making workplace metal health a vital issue for governments, employers and employees to address. Ensuring caregivers and parents have adequate mental health support in the workplace is critical, as the mental health of caregivers significantly impacts that of children and youth. Conversely, childhood mental disorders can also have considerable consequences for families, including parents having to miss work to address their child’s mental health needs. To learn more about the high burden associated with childhood mental disorders, see Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.

The National Day for Truth and Reconciliation, held annually on Sept. 30, offers an opportunity to reflect on the harms done to Indigenous peoples by Canada’s colonial and residential school systems. From 1867 through 1996, there were 140 federally run residential schools in operation in Canada. The day honours the Survivors of those schools and the children who never returned home.

The National Day for Truth and Reconciliation coincides with Orange Shirt Day, a grassroots initiative that commemorates the residential school experience and promotes the idea “Every Child Matters.” By wearing an orange shirt on Sept. 30, participants can help promote awareness of the individual, family and community intergenerational impacts of residential schools and make a statement in support of reconciliation.

Orange Shirt Day and the Day for Truth and Reconciliation offer a chance to open a dialogue on anti-racism. As a determinant of health, racism has a profound impact on child well-being. To learn more about the impacts of racism on young people, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

The International Day of Non-Violence occurs a few days later, on October 2. The day commemorates the birth of Mahatma Gandhi, leader of the Indian independence movement. Gandhi used non-violent activism to help end British colonialism in India. Established by the UN in 2007, the goal of the day is to spread the message of non-violence. According to the UN, it reaffirms the desire “to secure a culture of peace, tolerance, understanding and non-violence.”

Violence in the home, including physical punishment, can be a disruptive force in the lives of children and youth. While physical punishment used to be commonplace, fewer and fewer parents are using this form of discipline. To learn more about the trend towards a violence-free childhood, see Vol 9, No. 1 of the Children’s Mental Health Research Quarterly.

Findings from a recent systematic review by the Children’s Health Policy Centre offer hope for children at risk of being hospitalized.  These findings suggest four implications for practice and policy:

• Reduce mental health hospitalizations safely by supporting children in community. An evaluation of a program known as Home Treatment provides evidence that it is possible to shorten inpatient stays when adequate outpatient supports are provided. Young people with these extra supports had stays that were 21 days shorter compared with regular services without any difference in overall functioning eight months later.

• Recognize that extra supports after hospital discharge can have wide-ranging benefits. A study of a program known as Supported Discharge Service demonstrates it’s possible to reduce the number of children frequently engaging in self-harm, while increasing their engagement in school and other productive activities. These findings suggest that supporting children after hospitalization can yield multiple gains across multiple domains.

• Build on the research evidence to better serve children in rural and remote communities. Supported Discharge Service was delivered in two regions, one of which was rural, showing that it is feasible to provide intensive mental health services even in more remote communities. Using technology to deliver interventions virtually may be another way to reach more children in rural and remote communities. Such delivery is increasingly common since the COVID-19 pandemic began, according to a recent US study of mental health care delivery, which found a twelvefold increase in psychologists’ use of telecommunications such as video calls.

• Support children post-hospitalization knowing that doing so will pay off. The Home Treatment and Supported Discharge Service studies both provide evidence of cost-effectiveness. These findings suggest that any costs associated with providing added supports post-hospitalization are likely outweighed by the benefits. For example, even though the costs of Supported Discharge Service were not significantly lower than regular services, the intervention was still cost-effective when considering the benefits it produced, including reducing self-harm and increasing engagement in productive activities.

The CHPC review suggests that after a mental health hospitalization, young people can be supported to return home more quickly and remain there, with less need for rehospitalization. This review also found that intensive community-based services are cost-effective, enabling children and youth to flourish without the impediment of prolonged or repeated hospitalizations. When these interventions are coupled with adequate investments in programs that address social determinants of mental health as well as effective prevention and treatment programs, fewer children will likely need hospital care for mental health issues.

For more information, see Vol. 16, No. 3 of the Children’s Mental Health Research Quarterly.