Improving Suicide Prevention by Examining Characteristics and Precipitating Circumstances Among Children Aged 5 to 11 Years

Donna Ruch, PhD

Donna Ruch, PhD, is a research scientist in the Center for Suicide Prevention and Research in the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

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Suicide is the eighth leading cause of death among youth aged 5 to 11 in the United States, and suicide rates in this age group increased nearly 15% annually between 2012 and 2017, according to the Centers for Disease Control and Prevention. However, research on suicide deaths among this age range has been limited.

To address this gap, a team of researchers led by Donna Ruch, PhD, a research scientist in the Center for Suicide Prevention and Research at Nationwide Children’s Hospital, and Jeff Bridge, PhD, director of the center, examined common characteristics and precipitating circumstances of youth suicide deaths using the National Violent Death Reporting System (NVDRS). Their study is published in JAMA Network Open.

Results showed that suicide in children is most often associated with mental health concerns, prior suicidal behavior, trauma — including abuse or neglect, exposure to domestic violence, suicide or the death of a family member — or peer, school or family-related problems. Suicide deaths were commonly preceded by a negative or “triggering” event on the day of death such as an argument between the child and a family member or a disciplinary action.

Researchers found children in the study were disciplined on the day of suicide in 32% of cases. Disciplinary actions often followed a school-related issue or an argument between children and their parent or guardian and involved sending children to their bedrooms in half of cases or taking away a technological device in 29% of cases.

Donna Ruch, PhD

“We found these major themes were often co-occurring...children with mental health concerns or a history of suicidal behavior often had traumatic histories related to adverse family situations.”

Donna Ruch, PhD

“We found these major themes were often co-occurring,” says Dr. Ruch. “Children with mental health concerns or a history of suicidal behavior often had traumatic histories related to adverse family situations. School problems frequently resulted in parent-child conflicts and were more likely to occur in children with mental health concerns.”

The study also found common patterns in how the suicide deaths occurred. While most suicides in this age group occurred by hanging/suffocation in the child’s bedroom, 19% occurred by firearm. In all cases where detailed information on these deaths was available, children had obtained unsecured guns from within their homes, where they were stored loaded, unlocked, with ammunition or otherwise unsafely.

“These findings underscore the importance of early suicide prevention efforts that include improvements in suicide risk assessment, family relations and lethal means safety, particularly safe firearm storage,” says Dr. Bridge.

Ruch DA, Heck KM, Sheftall AH, Fontanella CA, Stevens J, Zhu M, Horowitz LM, Campo JV, Bridge JA. Characteristics and precipitating circumstances of suicide among children aged 5-11 years in the United States: 2013–2017. JAMA Network Open. 2021 Jul 1;4(7):e2115683.