Evidence on youth suicide prevention highlights research gaps

EDITOR—Hawton and James' review on youth suicide and deliberate self harm is a timely reminder of the public health importance of suicide as a cause of death in young people.1

A recent evidence briefing on youth suicide prevention, completed by my coauthors and me with the Health Development Agency and the Institute of Public Health in Ireland, highlighted the gaps in research on this important area.2 The briefing is a review of systematic reviews and meta-analyses and draws on some of Hawton's previous work.3

Many of the reviews found that primary research in this area lacked sufficient programme description to allow the interventions to be replicated in other areas. The briefing highlighted the difficulty in finding answers to youth suicide prevention through randomised controlled trials. Suicide is a rare outcome and requires large trials to develop significant findings. To isolate the impact of the study intervention amid other factors affecting the context of the lives of young people under study is difficult.

Suicide in young people is a complex outcome with many often coexisting risk factors, and future suicide prevention practice needs to be evaluated carefully to build the evidence base. Promising approaches such as providing contact cards for those who have harmed themselves and initiatives focusing on developing young people's problem solving and self esteem should be pursued and studied. In designing programmes for prevention we should engage young people in their development.