Stanford Medicine Newsletter Updates For the Local Community


CDC on youth suicide

Psychiatrist discusses report on Santa Clara County


Earlier this year, the federal Centers for Disease Control and Prevention released a report on risk factors for suicide among youth in Santa Clara County. The report, which was requested by members of the Palo Alto community in response to youth suicide clusters in 2009 and 2014, reviewed suicidal behaviors in young people in the county, as well as the community response. Steven Adelsheim, MD, clinical professor of psychiatry and behavioral sciences at the School of Medicine and a child and adolescent psychiatrist at Lucile Packard Children’s Hospital Stanford, has been involved in efforts to improve mental health care for local youth.

Q: What did the report say about suicide rates and precipitating circumstances behind youth suicides in Santa Clara County?

Adelsheim: The report found that youth suicide rates for residents of Santa Clara County have remained really stable, with no significant difference over time since 2003. When you look across the board at the county’s 10- to 24-year-olds, the annual suicide rate is 5.4 per 100,000 people, which is very similar to the California rate of 5.3 per 100,000. The national suicide rate among this age group is higher than rates for our county and state, at about 8 per 100,000.

In the county, two-thirds of suicides occurred among young people aged 20 to 24, and three-fourths were male. Their ethnicity distribution was close to that of the county as a whole. The cities of Palo Alto and Morgan Hill did have higher rates than the county as a whole: 14.1 suicide deaths per 100,000 among Palo Alto residents and 12.7 per 100,000 among Morgan Hill residents.

A key finding of the report was that many people who died by suicide had faced a recent crisis or mental health issue. About a third were currently being treated for mental illness, and 48 percent had current mental health problems, including depression, substance abuse and alcohol dependence. Fifty-two percent had had a recent life crisis, such as a breakup with a boyfriend or girlfriend, problems at school or a significant argument.

Q: To what extent do you think the findings support or refute assumptions people may have made about youth suicides in Santa Clara County?

Steven Adelsheim, MD


Adelsheim: Locally, before the report came out, there was a sense that losses of young people in the Palo Alto area were much larger compared with the county as a whole. It’s true that the rate of youth suicides within Palo Alto was found to be higher than for young people elsewhere in the county, and there may be some ongoing stressors among Palo Alto youth, such as academic stress, that the community is working hard to address. But the findings also make clear that no single factor explains suicide-related deaths.

The report reflects well on efforts the Palo Alto community has been making to improve all aspects of mental health among young people. Strong partnerships have been formed between the school district, the city, parents, teens and mental health care providers, including our team at Stanford. All these partners deserve credit because their efforts are making a difference.

Q: One area of focus for the CDC report was the quality of news reporting about Santa Clara County’s youth suicides. What does the media need to improve?

Adelsheim: Responsible news reporting is an important element of reducing suicide contagion among youth, but the CDC report shows that local and national coverage of youth suicides was fairly uneven in quality. The CDC documented problems of sensationalistic terms and headlines, as well as photos or language depicting the means by which people had died. Those should be avoided in news coverage of suicides.

Also, there are several things media stories can include to make coverage more responsible, which the report found were sometimes missing. For instance, it helps to talk about suicide as a public health issue that is multifactorial and can have important mental health aspects. It’s useful to talk about hope and tell stories of people who were struggling but then did better. And it’s very important to say that treatment for mental health problems works, to say there are treatment options, and to provide contact information for crisis services and say, “If you’re concerned that you may harm yourself, here is the place to go.”

Q: How have Stanford Children’s Health and Lucile Packard Children’s Hospital Stanford responded to the need for better mental health services for our community’s youth?

Adelsheim: We’re doing a lot of work with schools in Santa Clara and San Mateo counties, where we’ve been providing direct care, prevention efforts, early intervention, and training and support for school staff around suicide prevention. We’re working with groups like Project Safety Net in Palo Alto and the HEARD Alliance to increase the range of support available for young people, as well as providing community education. In 2015 we established the INSPIRE clinic, a program focused on early detection and intervention for young people with psychosis, because we know that early detection leads to vastly improved outcomes in school, work and life in general.

In addition, we’ve partnered with Mills-Peninsula Medical Center to have a Stanford child and adolescent psychiatrist staff several pediatric inpatient mental health beds. Having hospital beds available for youth in crisis is important, but only one piece of the puzzle. We also want to help young people much earlier. To that end, we’ve been developing a local version of the headspace program, based on a successful Australian program of the same name, for providing outpatient counseling and other early-intervention services to youth.

We want to have capacity that stretches from prevention to early intervention to acute-care services, and we’re really proud to partner with so many community groups to work toward this worthy goal.

Individuals in crisis can receive help from the Santa Clara County Suicide & Crisis Hotline at 1-855-278-4204. Help is also available from anywhere in the United States via Crisis Text Line (text HOME to 741741) or the National Suicide Prevention Lifeline at 1-800-273-8255. All three services are free, confidential and available 24 hours a day, seven days a week.

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