Life experiences preceding high lethality suicide attempts in adolescents at a level I regional trauma center

Suicide Life Threat Behav. 2021 Oct;51(5):836-843. doi: 10.1111/sltb.12740. Epub 2021 Mar 5.


Objective: To describe life experiences associated with patterns of medically treated and documented self-directed violence among youth who attempted suicide using highly lethal means to understand precipitating factors among youth using such lethal means.

Method: Using data from a regional, level 1 Trauma center, we identified all youth suicide attempt survivors who received treatment from 2010 to 2018 for a suicide attempt with a firearm, hanging, or jump from height injury (n = 42). We described differences in patient demographics and life experiences associated with patterns of self-directed violence by suicide attempt mechanism. We additionally assessed mechanisms used in any prior suicide attempts to identify potential increasing lethality of mechanism selection.

Results: There were 42 eligible patients included, of whom 40.5% attempted suicide with a firearm, 26.2% with hanging, 33.3% with jumping injury. A greater proportion of patients with firearm injuries endorsed social support and had fewer preparatory acts, history of self-harming behavior, prior suicide behaviors, and fewer prior attempts compared to patients who attempted suicide with other mechanisms.

Conclusions: Given our findings, means safety should remain a key strategy to prevent highly lethal suicidal behavior among adolescents, especially with firearms, given that such attempts may occur prior to formal contact with mental health services.

Keywords: attempted suicide; firearm suicide; high lethality; trauma inpatients; youth suicide.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Firearms*
  • Humans
  • Life Change Events
  • Suicide, Attempted
  • Trauma Centers
  • Wounds, Gunshot*