Outcome: Socially and Emotionally Healthy and Safe
Teen Suicide Rate
After a spike in 2007, the teen suicide rate in Travis County decreased in 2008 and 2009, but is rising again, matching the statewide suicide rate. The rate for Travis County of 10.2 suicides per 100,000 represents 17 deaths.
Significance of Indicator: Suicide is one of the leading causes of death for teens. Furthermore, suicide attempts are one of the leading causes of serious teen injuries. In 2010, the Travis County’s suicide rate for youth ages 15-24 was 10.2 per 100,000 slightly lower than the Texas suicide rate of 10.8. Nationwide in 2009, 6.3% of high school students had attempted suicide one or more times - Texas rates are higher, with a range between 6.9% and 7.8%.
How we are doing on this Indicator: The teen suicide rate in Travis County has fluctuated in the past ten years around an average of 9.6 per 100,000 youth. After a spike in 2007, the teen suicide rate in Travis County has decreased to 8.4 (representing 12 deaths) in 2009, but is rising again as 2010 data demonstrate.
What the data tell us
Definition: The number per 100,000 of completed youth suicides ages 15-24.
Data Source: Data Considerations: A postvention study by the Austin ISD and the Travis County Suicide Prevention Coalition notes that Travis County has had two youth suicide clusters in the past 10 years. The majority of the teen suicide deaths in clusters were in Northwest, West or Southwest Austin areas.
A Closer Look at the Data
Click any of the section titles below to view related graph and information.
Youth suicide rates show stark differences by race. Consistent with data from the U.S. and Texas overall, Caucasians have the highest death rate in Travis County for this age group.
In 2010, out of the total 17 youth suicides in Travis County, 8 suicides were by Whites, 1 by Blacks, 5 by Hispanics and 3 identified as Other.
Similar to U.S. and Texas trends, male teens in Travis County had a considerable higher rate of suicides than females. In 2010, 16 males in Travis County committed suicide compared with 1 female. From 1999 through 2009, the average suicide rate for males in Travis County was 15.4 as compared to 3.3 for females.
Definition: The number per 100,000 of completed youth suicides ages 15-24 in 2007-2010
Data Considerations: Suicide numbers for Females in Travis County were too low to calculate a rate. However, there were 1 female suicide in 2007, 3 in 2008, 4 in 2009, and 1 in 2010.
The Story Behind the Indicator
Prevalence of Youth Suicide
The CDC report that suicide is the third leading cause of death, behind accidents and homicide, of people aged 15 to 24, and the fourth leading cause of death for children ages 10-14.
- There are a number of bio-psycho-social risk factors that may lead a teenager to take his or her life, but the most common is depression.
- Feelings of hopelessness and anxiety, along with feelings of being trapped, are contributors to teen suicide. The majority of youth who complete suicide have mental or substance-related disorders or experience abuse in family, peer and dating relationships If not identified and given access to mental health services, these young people are at greater risk of feeling unable to cope with the stressors in their life. In some cases, teenagers believe that suicide is the only solution. In clusters, suicide has become normalized as an "option" by exposure to other attempts and deaths.
- Although there is no official data for suicide deaths or attempts by Lesbian, Gay, Bisexual, Transgender, Questioning youth, national research indicates that this group is at a higher risk, as well as youth who have been bullied and youth who do not appear to conform to mainstream gender roles and popular culture expectations.
- Suicide attempt official data is not collected statewide, but there is some indication of risk from the Youth Risk Behavioral Survey conducted by the Centers for Disease Control and Prevention (CDC). According to National YRBS data for 2011, 7.8% of high school students attempted suicide one or more times during the 12 months before the survey and 15.8% seriously considered attempting suicide. This national survey indicates that the highest reports of suicidal thoughts and attempts is by Hispanic females and that Texas reports higher attempts for this group than the U.S. overall.
- Preventing teen suicide means identifying and treating teen depression. Since more than 75 percent of the people who die by suicide are depressed (according to national studies), it is a good start to begin by treating the symptoms of teen depression, making access to care easier for those at risk and supporting help seeking behavior.
Suicidal Ideations and Suicide Attempts
- Systematic and universal screening is not being implemented in Austin area schools. In 2012-13, AISD piloted a survey of elementary, middle and high school counselors to gather data on students with mental health needs who come to the attention of school staff. Although reporting from middle and high school campuses was inconsistent, the reported mental health needs of students were alarming. The following data include students from all grade levels: There were 521 reports of self-injurious behaviors, 188 reports of eating disorders, 498 reports of substance use, 658 reports of suicidal thoughts, 448 psychiatric crises, 236 students needing transition assistance following a psychiatric crisis, 60 suicide attempts, and 2 completed student suicides, and one teacher suicide.
- From September 2013 to January 2014 alone, Communities in Schools report 236 students disclosing suicidal ideations in elementary, middle and high schools served by the organization. Within that same time frame, AISD school counselors across all schools report 643 students disclosing suicidal ideations. While there may be duplication in these counts by CIS and AISD counselors, they nevertheless point to the magnitude of the problem.
- From September 2013 to January 2014, AISD counselors reported 30 suicide attempts by high school students, 15 suicide attempts by middle school students and 12 suicide attempts by elementary school students. These numbers only include suicide attempts that came to the attention of counselors. Suicide attempts may have occurred off or on campus.
Local Efforts to Improve this Indicator
- The Austin /Travis County Suicide Prevention Coalition identified access to care as an issue for youth – there are not enough adolescent psychiatrists and there is a waiting period to see them. Services are provided through School Nurses (Seton/DCMC), Counselors and Social Service Specialists, Communities in Schools, Austin Travis County Integral Care, Out Youth Services for LGBTQ youth, private providers and Seton Family of Hospitals
- During the 2011-2012 school year, Austin ISD rolled out a web-based, integrated case management system, At the core of the Electronic Child Study Team (eCST) is a student dashboard that provides a user-friendly summary of key student data, a series of tabs that allow the user to drill down into specific data areas (e.g., attendance, assessments, enrollment history, discipline, etc.), templates for responding to the data, and a report generator that allows staff to create lists of students based on customizable sets of descriptive and risk-based search criteria. The tool is designed to house campus-created academic, behavior, attendance, and speech/language interventions; track how the district services students and their families; and progress monitor outcomes at student, campus, and district levels. The tool assists with advanced case management of individual and roster-based intervention plans (Austin ISD Connecting the Dots Initiative Update, 2013).
- The Shared Psychiatric Services (a collaboration between Communities in Schools, SafePlace and Lifeworks funded by the St. David’s Foundation) have served 366 children and teens in 2011-12 with quality psychiatric services and provided coordination with school-based staff to develop more effective accommodations for students with significant mental health needs in the school environment. AISD’s Alternative Learning Center (ALC) and the Elementary Disciplinary Alternative Education Program (EDAEP) are able to refer to LifeWorks’ Shared Psychiatric Services.
- AISD PD has identified a district mental health officer to consult with SROs and campus staff on mental and behavioral health needs of students with critical needs.
- Campus Based Counseling Referral Centers are a district initiative in AISD, which began with a pilot at Crockett High School in Spring 2012. In collaboration with AISD Comprehensive Health Services, Seton Healthcare, and Lone Star Circle of Care, CBCRCs currently operate on eight campuses: Akins HS, Austin HS, Bedichek MS (currently ATCIC, will transition to LSCC 2014), Burnet MS, Crockett HS, Dobie MS, Reagan HS, and Travis HS. In 2014 – ’15 – CBCRCs will are expected to expand to 14 additional campuses with plans to be on every middle and high school campus by 2016 (per principal agreement).
- Note: Other school districts in Travis County are also developing school-based health and mental health centers.
- AISD students receive integrated health messaging through school health lessons. The focus of the AISD’s health education course is to educate students about health concepts through a comprehensive focus. The health course includes the topics: physical/social/mental health, environmental health, consumer health, disease prevention, human sexuality, parenting and paternity awareness, nutrition, alcohol, tobacco, drugs, healthy lifestyles, interpersonal skills, goal setting, decision-making, and CPR/first-aid/AED. Students receive information in health class, through CATCH, through physical education and other core subject areas such as science, math, social studies and language arts.
- Mental Health First Aid Certification training offered by Austin Travis County Integral Care. One of the secondary level Children’s/AISD Student Health Services RNs is completing this certification.
- ASK about Suicide to Save a Life training-of-trainers provided to AISD Social Service Specialists through Texas Suicide Prevention Council. Children’s/AISD Student Health Services RNs have also been trained in the ASK protocol.
- At-risk Online Interactive Training simulations are available free to Texas public middle and high schools and endorsed by the AISD Superintendent for all high school staff. Free online training for college educators is available as well (see www.TexasSuicidePrevention.org for information and access to trainings).
Guidelines and Policy
- Austin ISD has included suicide prevention and postvention in their crisis plans. AISD developed a Campus Reference Guide for Critical Incidence and provided Campus Administrator Training for Responding to students who report suicidal ideation or attempts. The Child and Youth Mental Health Planning Partnership (CYMHPP) is working with the Austin ISD Student Support Services to better track the numbers of students who come to the attention of the counselor with feelings of depression and hopelessness. CYMHPP has also partnered with the AISD School Health Advisory Council to write recommendations for improved behavioral health training, services and service coordination.
- Information on mental health or suicide prevention is available online at www.TexasSuicidePrevention.org, www.MHATexas.org, www.integralcare.org, http://cmhc.utexas.edu/, http://outyouth.org/, and others. Austin Travis County Suicide Prevention Coalition provides educational programming and postvention support. The Central Texas Chapter of American Foundation for Suicide Prevention conducts an annual Out of the Darkness Walk. The African American Family Conference has included information on suicide prevention. Mental Health America of Texas conducts a suicide prevention symposium and distributes publications. The “Save A Number to Save a Life” campaign has urged teens to save both the local and the national suicide prevention crisis lines numbers in their cell phones. Suicide prevention guidelines for news coverage of deaths by suicide were shared with local media.
Services to Youth
- Promote screening for depression among middle and high school students.
- Encourage depression and suicide screening in primary care medical offices since the majority of those who die by suicide have seen their primary care provider within six months prior to their deaths.
- Explore reasons for the youth suicide clusters in West Austin, such as possible resistance to help seeking behavior because of stigma.
- Promote youth suicide prevention training in schools and the community
- Provide training in suicide prevention and postvention for all those who come in contact with youth
Guidelines and Policy
- Explore ways to gather timely attempt data, including collaborating with area hospitals, ATCIC, and Child Fatality Review Team
- Encourage all public and private schools to have both suicide prevention and a suicide postvention plan. (Postvention is what you do AFTER a death by suicide to help prevent more deaths.)
- Identify ways to reach coaches, teachers, youth, youth ministers, middle and high school parents, universities, medical and mental health communities
- Promote help-seeking behavior among youth
- Limit access to means such as gun locks and turning-in old prescriptions
- Promote access to care, such as providing a resource list of mental health professionals in the area who treat mental health and substance abuse disorders
Contributors for this indicator
The Child and Youth Mental Health Planning Partnership, especially the subcommittee for developing indicators: Barbara Ball, SafePlace, and Kris Downing, Communities in Schools of Central Texas.