DOVER, Del. - A preliminary study of a series of suicides involving Delaware teenagers earlier this year found that many of those who killed themselves had multiple risk factors, a federal health official said Thursday.
Dr. Alex Crosby, with the Division of Violence Prevention for the U.S. Centers for Disease Control and Prevention, said researchers investigated 11 suicides from January through early May. Those deaths involved people ages 13 to 21 in Kent and Sussex counties.
Researchers also reported an estimated 116 nonfatal suicide attempts in the 12- to-21 age group during the study period.
The study found no "direct contagion" suggesting that the suicide of one person led directly to an increase in suicidal behavior among others. But Crosby, a medical epidemiologist, said many of those who killed themselves had several identifiable risk factors.
Mental health problems such as depression or anxiety were the most commonly detected risk factor, followed by conflict with a parent or parents, legal problems, and substance abuse and problems with a girlfriend or boyfriend.
Researchers found that all of those who killed themselves had at least two risk factors, and that more than half had experienced five or more.
"Suicide is really a complex phenomenon," Crosby said. "Hardly anyone has only one risk factor."
While problems with peers is among the risk factors listed, researchers found that youth in Kent County reported less bullying victimization than the national average in a 2011 behavioral survey, and that Sussex County responses were about the same as the U.S. average.
Researchers found that all of the 11 deaths involved hanging or self-inflicted gunshots. The majority of nonfatal suicide attempts involved overdoses, many with prescription or over-the-counter drugs, and cutting.
Seven of the 11 fatal cases involved males, and eight were in the 16-to-18 age group.
State officials contacted the Atlanta-based CDC in March following the suicides of six young people, including three who attended the same high school.
CDC researchers used data from the medical examiner's office, law enforcement agencies, hospital emergency departments and inpatient psychiatric hospitals in their investigation of the deaths and nonfatal suicidal behaviors. They also interviewed adults who regularly interact with young people, including those affected by the suicides, but did not speak directly with students or other young people.
Crosby said the researchers were extremely careful not to retraumatize any youth, adding they sought out someone who worked with youth to help in the work.
Another study limitation noted by researchers was the inability to thoroughly investigate social media activity, including communication between individual students, that could be related to the suicides.
Recommendations by CDC researchers to prevent future suicide deaths include periodic mental health awareness training for adults who work with youth to identify those who are at risk.
State health and social services secretary Rita Landgraf said she thought the CDC had done a good job in gathering the data and that she looked forward to follow-up work by researchers that will help state officials in suicide intervention and awareness.
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