Not all suicide is the same and youth suicide often has different drivers to suicide at later ages. Further while much is spoken and argued about its prevention, it remains a complex and contentious area with much advocacy for unproven interventions.
In particular this paper makes the point that youth suicide is more than simply a mental health issue and that, with what we know at present, the focus must also include an emphasis on primary prevention starting from very early in life. This means promoting resilience to the inevitable exposure to emotional stresses and building self-control skills in early childhood and primary school years, by using approaches that we already know about. It means promoting mental health awareness and ensuring that there are competent and adequate adult and peer support systems in secondary schools. This must be backed up by a capacity to find and rapidly support those children and young adults who are in mental distress and ensuring that the needed interventions and therapy are early and effective
Summary and conclusions
Youth suicide remains a complex, multifaceted challenge. A focus on adolescent mental health, although important, is not sufficient. Rather, we conclude that the high-priority need is to introduce and reinforce programmes focused on primary prevention starting early in life and developing secondary prevention strategies involving well-trained and engaged mentors including peer mentors. Understanding and co-design with our communities and particularly with Māori perspectives will be crucial at each stage as we develop, test and take to scale approaches shown to make a difference.
The primary prevention approach involves strategies to improve impulse control and executive function from early childhood and this has broad spillover benefits. It involves combining these critical interventions in early childhood and primary education with secondary prevention approaches in adolescents and it requires a social investment approach particularly focusing on those communities with low resilience and self-esteem.