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Juvenile Suicide in Confinement: A National Survey.

D.H., 17, hanged himself with a bed sheet tied to the cell door at a juvenile detention facility in a southern state on Jan. 6. M.S., 14, hanged herself with a bed sheet tied to a shower brace at a public juvenile training school in a western state on Dec. 22, 1999. J.S., 16, hanged himself with a bed sheet tied to a sprinkler head on the ceiling of his room at a county juvenile boot camp in an eastern state on Nov. 2,1999. K.T., 13, hanged himself with a bed sheet tied to a ceiling grate at a private juvenile training school in a northwestern state on Oct. 15, 1999.

These deaths represent only a handful of the unknown number of suicides that occur each year in juvenile facilities across the country. Youth suicide in the general population is a major public health problem. According to the Centers for Disease Control, as of 1995, the suicide rate of adolescents (ages 15 to 19) has quadrupled from 2.7 per 100,000 in 1950 to 10.8 per 100,000 in 1992. More teen-agers die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia and influenza, and chronic lung disease combined, according to the U.S. Department of Health and Human Services.

Until now, there has not been any comparable national research conducted regarding the nature and extent of juvenile suicide in confinement. The only national survey of juvenile suicides in custody contained several flaws in the calculation of suicide rates. Re-analysis of suicide rates in that study found that youth suicide in juvenile detention centers was estimated to be more than four times greater than the general population. Despite this statistical analysis, there still is no information available regarding the circumstances surrounding juvenile suicide in confinement.

What Is Known

Research has identified mental disorders and substance abuse as the most important set of risk factors for adolescent suicide in the general population. Other risk factors included impulsive aggression, parental depression and substance abuse, family discord and abuse, and poor family support. Life stressors, specifically interpersonal conflict and loss, as well as legal and disciplinary problems, also were associated with suicidal behavior in adolescents, particularly those who were substance abusers. It can be argued that many of these risk factors are prevalent in youths confined in juvenile facilities.

Although historically, there have not been any comprehensive national data regarding the incidence of youth suicide in custody, there is information suggesting a high prevalence of suicidal behavior in juvenile correctional facilities. According to one recent study, more than 11,000 juveniles are estimated to engage in more than 17,000 incidents of suicidal behavior in juvenile facilities each year. In addition, the limited research on juvenile suicide in custody suggests that confined youths may be more vulnerable to suicidal behavior based on current and/or prior suicidal ideation. For example, one study found that incarcerated youths with either major affective disorders or borderline personality disorders had higher degrees of suicidal ideation and more suicide attempts than adolescents in the general population.

Other studies have found that a high percentage of detained youths reported prior histories of suicide attempts, current and active suicidal behavior, and prior histories of psychiatric hospitalization. Two recent studies of youths confined in juvenile detention facilities found that suicidal behavior in males was associated with depression and decreased social connection, whereas suicidal behavior in females was associated with impulsivity and instability. Finally, other researchers have found high rates of suicidal behavior and psychiatric disorders among American Indian youths confined in juvenile facilities.

The Project

Beginning last August, the National Center on Institutions and Alternatives (NCIA) initiated a project to conduct the first national study of juvenile suicide in confinement. The project is funded by the U.S. Department of Justice's Office of Juvenile Justice and Delinquency Prevention (OJJDP). NCIA is being assisted with this project by two prominent national juvenile justice organizations (the National Juvenile Detention Association and Council of Juvenile Correctional Administrators), as well as a four-member consultant team comprised of prominent juvenile justice practitioners and researchers.

The Juvenile Suicide in Confinement Project will determine the extent and distribution of suicides during a five-year period (1995-1999) in all juvenile facilities (estimated by OJJDP to be approximately 3,400) throughout the country. The study will be restricted to juveniles housed in more traditional types of confinement facilities -- juvenile detention centers/homes, reception/diagnostic centers, training schools/secure facilities, residential treatment centers, ranches, camps and farms -- operated by state and local governments and private organizations.

During the first phase of the project, a one-page survey instrument will be mailed to facility directors with an inquiry about whether the facility experienced any juvenile suicides between 1995 and 1999. In order to more accurately account for the total number of juvenile suicides during the survey years, NCIA will supplement the verification process by contacting various secondary sources, i.e., each state department of juvenile corrections, each attorney general's office and each state and/or county medical examiner throughout the country, and inquire about the number of juvenile suicides in their respective jurisdictions during the survey years. In addition, NCIA also will seek assistance from OJJDP's state advisory groups, state criminal justice councils and state juvenile justice specialists to further ensure accurate identification of all juvenile suicides during this period.

Once facilities experiencing suicides during the five-year study period have been identified, the second phase of the survey process will include dissemination of an in-depth survey instrument to facilities that experienced suicides between 1995 and 1999. The survey instrument will collect data on the demographic characteristics of each victim, characteristics of the incidents and characteristics of the juvenile facility sustaining the suicide.

Demographic characteristics will include, but not be limited to: age, sex, race, family status, current offense, prior offenses, legal status (detained, committed, other), length of confinement, drug/alcohol intoxication at confinement, substance abuse history, medical/psychiatric history, history of discipline within the facility and history of suicidal behavior.

Incident characteristics will include, but not be limited to: date, time and location of suicide, any special housing status (e.g., isolation, room restriction, etc.), method and instrument used, time span between incident and finding victim, and any emergency medical intervention used.

Facility characteristics will include, but not be limited to: facility type, facility location (urban, suburban, rural), construction/renovation dates, history of suicidal incidents and the four assessment criteria used in OJJDP's Conditions of Confinement study -- written suicide prevention plan, intake screening procedures for suicide risk, staff training in suicide prevention and observation levels for suicidal youths.

During the final phase of the project, NCIA will collect, analyze and describe the findings from the national survey in a comprehensive report to OJJDP. At minimum, descriptive statistics will be offered regarding the extent and distribution of juvenile suicide in confinement, as well as descriptive data on demographic characteristics of victims, of the incidents and of the juvenile facilities sustaining the suicides. In addition to the study findings, the report will offer conclusions and policy recommendations, if appropriate. Most important, in order to ensure complete confidentiality, all data provided by juvenile facilities will be coded and held in strict confidence. Results of the study will be presented in summary fashion, therefore, victim and facility names will not appear in any project report.

Conclusion

In addressing the issue of mental health disorders and substance abuse among juvenile offenders, former OJJDP administrator Shay Bilchik recently stated, "With more and more juveniles coming into the justice system, it is crucial that we deal not only with the specific behavior or circum stances that bring them to our attention, but also with their underlying, often long-term mental health and substance abuse problems." Consistent with this philosophy, the Juvenile Suicide in Confinement Project will, for the first time, provide comprehensive data on the nature and extent of juvenile suicide. In addition, findings from this study will be used as a resource tool for juvenile justice practitioners in expanding their knowledge base and juvenile correctional administrators in creating and/or revising policies and training curricula on suicide prevention.

Lindsay M. Hayes is a nationally recognized expert in the area of suicide prevention within adult and juvenile correctional facilities.

REFERENCES

Alessi, N.E., M. McManus, A. Brickman and L. Grapentine. 1984. Suicidal behavior among serious juvenile offenders. American Journal of Psychiatry, 141(2): 286-287.

Bilchik, S. 1998. Mental health disorders and substance abuse problems among juveniles. OJJDP Fact Sheet, No. 82. Washington, D.C.: Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice.

Brent, D.A. 1995. Risk factors for adolescent suicide and suicidal behavior: Mental and substance abuse disorders, family environmental factors and life stress. Suicide and Life-Threatening Behavior, 25 (Supplement): 52-63.

Centers for Disease Control.1995. Suicide in the United States 1980-1992. Atlanta: U.S. Department of Health and Human Services.

Davis, D.L., G.L. Bean, J.E. Schumacher and T.L. Stringer. 1991. Prevalence of emotional disorders in a juvenile justice institutional population. American Journal of Forensic Psychology, 9:1-13.

Dembo, R., L. Williams, E.D. Wish, E. Berry, A.M. Getreu, M. Washburn and J. Schmeidler. 1990. Examination of the relationships among drug use, emotional! psychological problems and crime among youths entering a juvenile detention center. The International Journal of the Addictions, 25:1301-1340.

Duclos, C.W., J. Beals, D.K. Novins, C. Martin, CS. Jewett and S.M, Manson. 1998. Prevalence of common psychiatric disorders among American Indian adolescent detainees. Journal of the American Academy of Child and Adolescent Psychiatry, 37(8):866-873.

Duclos, C.W., W. LeBeau and G. Elias. 1994. American Indian suicidal behavior in detention environments: Cause for continued basic and applied research. Jail Suicide Update, 5(4):49.

Flaherty, M. (1980). An assessment of the national incidence of juvenile suicides in adult jails, lockups and juvenile detention centers. Champaign, Ill.: Community Research Forum.

Hayes, L.M. (1999). Suicide prevention in juvenile correction and detention facilities: A resource guide. South Easton, Mass.: Council of Juvenile Correctional Administrators.

Mace, D., P. Rohde and V. Gnau. 1997. Psychological patterns of depression and suicidal behavior of adolescents in a juvenile detention facility. Journal of Juvenile Justice and Detention Services, 12(1):18-23.

Memory, J. (1989). Juvenile suicides in secure detention facilities: Correction of published rates. Death Studies, 13:455-463.

Parent, D.G., V. Leiter, S. Kennedy, L. Livens, D. Wentworth and S. Wilcox. 1994. Conditions of confinement: Juvenile detention and corrections facilities. Washington, D.C.: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Rohde, P., J.R. Seeley and DE. Mace.1997. Correlates of suicidal behavior in a juvenile detention population. Suicide and Life-Threatening Behavior, 27(2):164-175.

U.S. Department of Health and Human Services. 1999. The surgeon general's call to action to prevent suicide, 1999. Washington, D.C.: U.S. Department of Health and Human Services.

Waite, D. 1992. Unpublished Data. Richmond, Va: Department of Youth and Family Services.
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Author:Hayes, Lindsay M.
Publication:Corrections Today
Geographic Code:1USA
Date:Jul 1, 2000
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