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Children in out-of-home care at higher risk of suicide

Children and young people in out-of-home care are at a higher risk of suicide than young people not involved with child protection systems, an ACU review from the Institute of Child Protection Studies has found.

The review, published in the American Journal of Orthopsychiatry,  found a lack of effective suicide prevention interventions for this vulnerable population.

Child protection researchers Professor Daryl Higgins, director of the Institute of Child Protection Studies, Douglas Russell and Sebastian Trew looked at suicide prevention interventions for children and young people as well as staff and carers in out-of-home care and child protection systems.

Lead author Douglas Russell said large numbers of children enter care with a high risk of suicide. Suicide was 4.9 times more likely for young people in care compared to those without a history of child abuse and neglect.

The researchers reviewed the types of suicide prevention interventions used and evaluated in out-of-home care and child protection systems.

Mr Russell said that only five studies globally met the inclusion criteria for their review, two were shown to reduce suicide related behaviours in young people, while the other three focused on supporting the capabilities of staff or carers in working with young people who might have suicidal thoughts.

“Trauma of children and young people in out-of-home care is directly related to risk factors for suicidal behaviour,” Mr Russell said.

“This review identifies, firstly, how there is a lack of evaluated interventions to reduce suicidal thoughts and deaths in this population.

“Additionally, it identifies interventions that focus on trauma and emotions that are most likely to be successful in reducing suicide due to the considerable conceptual overlap between suicide risk and the trauma profile of children in out-of-home care.”

Recommendations include:

• Adapting, implementing, and evaluating existing clinical interventions that target suicidal behaviours in the general population for young people in out-of-home care
• Developing trauma support models to meet the cultural needs of Aboriginal and Torres Strait Islander people who are overrepresented in out-of-home care
• Adopting high-quality research evaluations for suicide prevention and intervention strategies for children and young people in care.

Professor Higgins, a leading child protection expert, said it was critical to address the known risk factors for suicide through adapting and testing effective interventions for the out-of-home care context.

"We know that child maltreatment and other forms of childhood trauma are significant risk factors for suicide,” he said.

“The clearest risk factors for suicidal behaviour among children and young people are major psychiatric problems, depression, substance abuse disorder and sexual abuse in childhood.  Physical and emotional abuse have shown to indirectly predict suicidal ideation via links with anxiety.”

Professor Higgins said developing effective suicide prevention and interventions for this group, as well as those in the general population, has and continues to be difficult to achieve.

The review was commissioned through the Suicide Prevention Research Fund, managed by Suicide Prevention Australia.