Child and Adolescent Suicide Deaths in New Mexico, 1990-1994

Abstract

The suicide death rate in New Mexico is consistently higher than the national rate. Among adolescents, suicide is the third leading cause of death nationally, but in New Mexico it is the second leading cause of death. This study describes the pattern of adolescent suicide deaths in New Mexico. We conducted a retrospective review of all medical examiner autopsies for adolescent suicides (ages 20 years and younger) in New Mexico from 1990-1994. Records were reviewed for demographics and possible contributing factors such as depression, previous attempts, and alcohol and drug use. We identified 184 suicide deaths among children and adolescents ages 9-20 years for an overall rate of 12.9 per 100,000. Our rates for ages 5-9 years (0.2), 10-14 years (3.8), and 15-19 years (22.3) are over twice the U. S. rates. Suicide deaths resulted primarily from firearms (67%), hanging (16%), poisoning (6%), inhalation (4%), and other methods (7%). Method varied by ethnicity (p = .01) and gender (p = .03); males and non-Hispanic Whites were overrepresented among firearm deaths. Firearm ownership was known in 60 (48%) of the firearm deaths. Of these, 53% of the firearms belonged to a family member, 25% to the decedent, and 22% to a friend. Over one-third of decedents (41%) experienced mental disorders, primarily depressed mood and clinical depression. Previous suicide attempts were noted for 15% of the decedents. Some 50% of the decedents had alcohol or drugs present at the time of death; among American Indians/Alaska Natives, 74% had drugs or alcohol present (p = .003). Targeted interventions are needed to reduce adolescent suicide in New Mexico. We suggest raising awareness about acute and chronic contributing factors to suicide; training physicians to look for behavioral manifestations of depression; and involving physicians, teachers, and youth activity leaders in efforts to limit firearm accessibility, such as advising parents to remove firearms from their households.

Planned complex suicide

“…A combination of these two methods in planned complex suicide seems to be very rare, and has not been described until very recently [8,9]. The first method employed, namely the use of firearms, is frequently used in cases of suicide [10,11]. The use of firearms has earlier been described as one of the most preferred methods employed in planned complex suicide, and is, in most cases, employed by men [2,4,7,12].…”

Research Synthesis: Adolescent Suicide and Substance Abuse in the United States, 1990–2002

“…Alcohol and other drugs were reported in 74% of Native American adolescent suicides, yet only 55% of Hispanic and 37% of non-Hispanic Caucasian suicides during the same period (Werenko et al, 2000).…”

Preventing youth suicide: Issues for law enforcement personnel

“…Werenko et al (2000) found that 18% of the 184 youth they studied had a history of substance abuse, and that 50% had drugs or alcohol present at the time of death by suicide. Additional evidence comes from a study by Renaud, Brent, Birmaher, Chiappetta, & Bridge (1999), in which 1/3 of those who died by suicide had a positive toxicology screen for substances.…”

“…Werenko et al (2000) found evidence of family dysfunction among 33% of the 186 young people who died by suicide in New Mexico between 1990 and 1994. King et al (2001) found a significant association between suicide ideation or attempts and stressful life events, poor family environment, and low parental monitoring, among other factors, in a community sample of 1285 individuals ages 9–17 years.…”

“…Young people who have difficulty in school (Fergusson, Beautrais, & Horwood, 2003; Thompson, Moody, & Eggert, 1994), have access to firearms (Cavanagh, Carson, Sharpe, & Lawrie, 2003; Werenko et al, 2000), display antisocial or conduct disordered behaviors (Haavisto et al, 2004; James, Lai, & Dahl, 2005), or have a history of disciplinary or legal problems (Beautrais, 2001; Brent et al, 1993a; Fergusson et al, 2003; Gray et al, 2002) are among those at increased risk for suicide or suicidal behavior. Recent tragedies in United States high schools highlight the fact that the convergence of some or all of these factors can result not only in suicide but also in death and/or serious injury to others.…”