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How a new tool could reduce suicide among teens

Researchers from BYU, Johns Hopkins and Harvard have created a computer algorithm they say predicts with 91% accuracy which youths have suicidal thoughts and behaviors

Illustration by Alex Cochran, Deseret News

Suicides across the nation dropped very slightly during the pandemic, after nearly 20 years of increases, according to federal data. Still, an astounding 46,000 Americans across age groups took their own lives during 2020 — a number far higher than the entire student body of any of Utah’s colleges or universities in a given year.

But a new tool has been created that could help parents, teachers, school counselors and others identify youths who might be most at risk for suicide with an eye toward targeting interventions. Researchers from Brigham Young University, Johns Hopkins and Harvard have created a computer algorithm they say predicts with 91% accuracy which youths have suicidal thoughts and behaviors. The study’s “machine-learning approach” was explored this week in the journal PLOS ONE,

Suicide is the second-leading cause of death for adolescents in the United States, behind unintentional injuries.

The algorithm was made by taking data from 179,384 junior and high school students in Utah who took the biennial Student Health and Risk Prevention survey between 2011 and 2017. Among roughly 300 total questions, it asked whether, in the past year, a student had thought about suicide, planned suicide or tried to take their own life. The researchers fed the entire 1.2 billion data points into a supercomputer to see if it could find correlation between other factors impacting the youths’ lives and their positive responses to the suicide-related questions.

Being bullied and harassed online or at school are the top predictors of suicidal thoughts and behaviors, according to the researchers. But negative family dynamics — including serious arguments, arguing repeatedly about the same things and name-calling and insults — also create risk that youths will at least contemplate suicide.

Lower, but still on the top 10 list of factors, were whether the adolescent felt safe at school, the age when the student first had more than a sip of alcohol and how each felt about marijuana use. The researchers noted females and older students (risk rises around ninth or 10th grade) were at higher risk of suicidal thoughts and planning compared to males and younger students, though more males die by suicide. How students felt about their grades also predicts suicide attempts.

“Research from the 2015 Youth Risk Behavior Study has shown that students who feel successful at school are less likely to consider, plan or attempt suicide,” the study says. “School health professionals, state officials and other stakeholders should target suicide prevention activities or provide grade remediation to assist students at risk.”

Carl Hanson, a BYU public health professor, said if those with particular risk factors can be identified, it might be possible to curb the rate of suicide.

“I think suicide is certainly a public health concern. And it’s something that we all should be thinking about. I think we all have a responsibility to a rising generation,” he said.

Just knowing that bullying or a volatile home life creates risk provides an opportunity to provide youths with support that can help them, he said, noting that knowledge can empower communities to strengthen families and address issues that impact youths.

“The results are most usable by school teachers and administrators who may consider how they monitor signs of bullying. They might also build a positive school climate through leadership and developmentally wise services among staff in the classroom, office, playfields and school bus settings,” said Michael Barnes, study co-author and associate dean in BYU’s College of Life Sciences.

Changing trajectories

Quinn Snell, a computer science professor at BYU, said he’d like to see school counselors and public health officials take the study findings “and be able to say there are some important questions that we should be asking our students and looking at to help them,” paying particular attention to preventing bullying.

Identifying children who are at risk and then trying to be proactive, rather than having to react after something serious happens, is vital, he said. Knowing that bullying and cyberbullying are key contributors could prompt schools and parents to ramp up efforts to address those issues, as well.

“Let’s make sure we’re having programs and are talking to kids about online behavior and bullying and helping them recognize the signs of that,” Snell said.

Families also need to know how what happens at school and at home impacts their children so they can create a supportive environment, he added.

Barnes agrees. He said the study makes clear that schools cannot tackle suicide effectively alone.

“Families matter a great deal. For example, StopBullying.gov recommends that community services and resources help families recognize the warning signs of bullying, cyberbullying and learn how to foster open lines of communication between parents and children,” he said.

All ages struggling

While the computer model identifies factors that impact youths, the concern stretches across ages.

The Vital Statistics Rapid Release from the Centers for Disease Control and Prevention that came out this week showed the number of suicides in 2020 (45,855) was 3% lower than in 2019, as was the rate (13.5 per 100,000 compared to 13.9 the previous year.) The rate dropped 2% in 2020 for males and 8% for females.

Most of the decline in the suicide rate during the pandemic was due to a decrease among whites, who account for a disproportionate share of suicides overall.

CDC experts point out that even with modest declines, the numbers are near historic highs, as they’ve been climbing for nearly 20 years. The center said between 2000 and 2018, suicides increased by about 35%.

A decline was not seen across all demographic groups. The rates for young people ages 10-14, 15-24 and 25-34 all increased slightly compared to the previous year, though only the 5% jump among the latter group was statistically significant.

By gender, too, there were increases. Age adjusted suicide rates among young males ages 10 to 14 increased by 13%, while that rate for females ages 15 to 24 was 4% higher. Neither, though, reached the level of statistical significance. But they certainly didn’t go down.

Suicides increased among Black people ages 15-34 and Hispanics 25-34. NPR pointed out that a study published in the Journal of the American Academy of Child and Adolescent Psychiatry this fall found the rise in suicide rates among Black girls outpaced other groups.

“When we look at suicide in the research, it’s very much white youth and white older men. And unfortunately, that doesn’t help us in terms of creating prevention programming for Black youth and for Hispanic youth,” said Arielle Sheftall, principal investigator at the Center for Suicide Prevention and Research and lead author on that study, who spoke to NPR’s Here & Now when the research was published in September.

“Suicide is less predictable than other causes of death,” Sally Curtin, a statistician at the CDC and lead author on the report, told NPR. “You can have an increase in risk factors for suicidal behavior, such as mental health issues, depression, anxiety, substance abuse and financial stress ... but it does not necessarily translate into an increase in deaths.”

Other members of the algorithm study team are Orion Weller of Johns Hopkins, Luke Sagers of Harvard and E. Shannon Tass of BYU.

If you or someone you know is in crisis, you can call the National Suicide Prevention Hotline 24 hours a day: 1-800-273-8255.