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Center at the National Institutes of Health in
Bethesda, MD.
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OUR SPEAKER TODAY IS DR. ARIELLE
SHEFTALL, SOCIAL PROFESSOR IN
PSYCHIATRY AT UNIVERSITY OF
ROCHESTER MEDICAL CENTER,
ROCHESTER, NEW YORK, AS WELL AS
DIRECTOR OF ACADEMIC AFFAIRS FOR
DIVERSITY, INCLUSION, CULTURE
AND EQUITY BOARD FOR THE
DEPARTMENT OF PSYCHIATRY.
DR. SHEFTALL EARNED HER
BACHELOR'S DEGREE AT
PENNSYLVANIA STATE UNIVERSITY AS
WELL AS A MASTER'S IN HUMAN
DEVELOPMENT IN FAMILY SCIENCE
AND A PH.D. IN HUMAN DEVELOPMENT
AND FAMILY SCIENCE FROM THE OHIO
STATE UNIVERSITY.
IN 2013, SHE COMPLETED A
POSTDOCTORAL RESEARCH FELLOWSHIP
AT THE DEPARTMENT OF PSYCHIATRY
IN THE NEUROAND BEHAVIORAL
RESEARCH LABORATORY AND CLINIC
AT THE UNIVERSITY OF TEXAS
HEALTH SCIENCE CENTER FOLLOWED
BY A POSTDOCTORAL FELLOWSHIP AT
THE RESEARCH INSTITUTE AT
NATIONWIDE CHILDREN'S HOSPITAL
IN COLUMBUS, OHIO.
AND FURTHER TRAINING AT THE
NATIONAL INSTITUTE OF MENTAL
HEALTH WORKSHOP FOR EARLY STAGE
RESEARCH INVESTIGATORS, AT NIH'S
SUMMER INSTITUTE IN COGNITIVE
NEURAL SCIENCE AT THE UNIVERSITY
OF CALIFORNIA SANTA BARBARA AND
DAVIS.
DR. SHEFTALL'S RESEARCH FOCUSES
ON DEVELOPMENTAL MECHANISMS OF
EARLY TO MIDDLE CHILDHOOD THAT
CONFER VULNERABILITY TO FUTURE
SUICIDAL BEHAVIOR.
HER GOAL IS TO FRAME TARGETS FOR
EARLY INTERVENTION TO DECREASE
INCIDENCES OF FIRST SUICIDE
ATTEMPTS IN AT-RISK YOUTH AND
UNDERSTAND RACIAL DISPARITIES
PRESENT AMONG YOUTH WHO DISPLAY
SUICIDAL BEHAVIOR.
DR. SHEFTALL IS A NATIONALLY AND
INTERNATIONALLY INVITED SPEAKER
FOR HER EXPERTISE IN THE TOPIC
OF YOUTH SUICIDE AND SUICIDAL
BEHAVIOR, SUPPORTING NUMEROUS
TASK FORCES TO INCLUDE
CONGRESSIONAL BLACK CAUCUS
EMERGENCY TASK FORCE, THE BLACK
MENTAL HEALTH BRAIN TRUST, THE
AMERICAN FOUNDATION FOR SUICIDE
PREVENTION, THE HEALTH AND HUMAN
SERVICES OFFICE OF MINORITY
HEALTH, AND AS A MEMBER OF THE
NATIONAL ACADEMY OF SUICIDE
RESEARCH.
SHE HAS SHARED THE RESULTS OF
HER INVESTIGATION I AND AWARDED
AMERICAN FOUNDATION FOR SUICIDE
PREVENTION YOUNG INVESTIGATOR
TRAVEL AWARD AS INTERNATIONAL
SUMMIT FOR SUICIDE RESEARCH IN
2021.
PLEASE WELCOME OUR SPEAKER,
DR. ARIELLE SHEFTALL, WHOSE TALK
IS ENTITLED "THE CHANGING
LANDSCAPE OF YOUTH SUICIDE:
WHAT WE KNOW, WHAT WE DON'T
KNOW, AND WHERE WE GO FROM
HERE."
DR. SHEFTALL.
>>THANK YOU SO MUCH FOR THAT
INTRODUCTION.
I HOPE THAT THIS IS GOING
TO BE A VERY INFORMATIVE
CONVERSATION AS WELL AS
PRESENTATION.
FIRST AND FOREMOST, I JUST WANT
TO LET YOU ALL KNOW THAT I DO
RECEIVE FUNDING FROM THE
NATIONAL INSTITUTE OF MENTAL
HEALTH, AS WELL AS THE AMERICAN
FOUNDATION FOR SUICIDE
PREVENTION.
AND I HAVE NO OTHER
RELATIONSHIPS TO DISCLOSE.
IN TERMS OF THE OBJECTIVES FOR
TODAY, I'M GOING TO GIVE YOU
SOME INSIDE ON WHO I AM
PERSONALLY, BUT ALSO GIVE YOU
SOME INFORMATION ON WHY THIS
TOPIC IS SO IMPORTANT TO ME
PERSONALLY AS WELL.
I'M GOING TO TALK A BIT ABOUT
THE EPIDEMIOLOGY OF YOUTH SIGH
SIDE AS WELL AS FOCUS SOME TIME
ON BLACK SUICIDE AS WELL AS TALK
ABOUT OPPORTUNITIES FOR SUICIDE
PREVENTION.
SO FIRST AND FOREMOST, I WAS
BORN AND RAISED IN SPRINGFIELD,
MASSACHUSETTS.
THIS IS THE LAND OF NONE OTHER
THAN DR. SEUSS.
HE WAS BORN AND RAISED THERE AND
WROTE A LOT OF HIS BOOKS THERE
AND THERE REALLY IS A MULBERRY
STREET THAT EXISTS.
ALSO, SPRINGFIELD IS KNOWN FOR
BASKETBALL.
SO BASKETBALL WAS INVENTED AT
SPRINGFIELD COLLEGE, AND WE HAVE
THE BASKETBALL HALL OF FAME IN
SPRINGFIELD, AND NOT ONLY THAT,
IT WAS THE HOME OF THE FIRST
GAS-POWERED CAR.
SOMETHING I LEARNED WHILE I WAS
LOOKING UP THE CITY TO BE 100%
HONEST.
BUT IT WAS -- IT'S A GOOD CITY,
IT'S THE FOURTH POPULOUS CITY IN
NEW ENGLAND.
SO IF YOU HAVE TIME AND ENERGY,
PLEASE FEEL FREE TO CHECK IT
OUT.
I WOULD DEFINITELY SAY THAT MY
LIFE HAS TAKEN MANY PATHS, AND
IT STARTED OUT PRETTY YOUNG AND
STILL CONTINUES TO PROGRESS
MULTIPLE PATHS, TO BE 100%
HONEST.
WHEN I WAS YOUNG, THIS IS ME
WHEN I WAS 8 YEARS OLD,
CELEBRATING MY 8TH BIRTHDAY.
MY COUSIN IS TO THE RIGHT OF ME,
OR MY LEFT, I GUESS.
LAUREN, WHO IS THE YOUNGEST OF
THE COUSINS, THEN MY MOM IS ON
THE OTHER SIDE OF ME.
AND MY LIFE WAS NOT TYPICAL, I
WOULD SAY.
BUT NOT DIFFERENT FROM OTHERS.
I WAS RAISED BY A SINGLE MOTHER.
I HAVE A YOUNGER BROTHER WHO'S
15 MONTHS YOUNGER THAN ME.
I ALWAYS TELL HIM THAT JUST
BECAUSE IT'S NOT A LOT OF
DIFFERENCE BUT I LIKE TO BE THE
ELDEST.
SO I KNOW BETTER.
BUT I WOULD DEFINITELY SAY EVER
SINCE I CAN REMEMBER, MY MOTHER
WAS SICK.
SO WHEN I WAS REALLY YOUNG, MY
MOTHER WAS DIAGNOSED WITH BREAST
CANCER.
AND UNFORTUNATELY, THAT BREAST
CANCER METASTASIZED TO THE BONE,
AND AT THIS TIME, DURING THIS
TIME, SHE WAS GOING THROUGH
CHEMOTHERAPY AND RADIATION, AND
MY MOM FOUGHT THAT DISEASE WITH
ALL THAT SHE HAD, ALL THAT SHE
HAD, BUT UNFORTUNATELY, WHEN I
WAS 14 YEARS OF AGE, MY MOM LOST
HER LIFE.
TO THE DISEASE.
AND AS YOU CAN IMAGINE,
14-YEAR-OLD, STARTING HIGH
SCHOOL, TRYING TO FIGURE OUT WHO
I WAS, WHAT I WAS AND LOSING MY
BEST FRIEND, MY LIFE REALLY
TURNED DOWN TO A DEEP AND DARK
TUNNEL.
AND AT THAT TIME, I DIDN'T
REALLY KNOW WHAT I WANTED LIFE
TO BE, AND I WAS YOUNG, RIGHT?
AND ALSO DURING THAT TIME, I HAD
A LOT OF SEPARATION THAT I
EXPERIENCED.
SO MY BROTHER, HE WAS MOVED DOWN
TO NORTH CAROLINA TO LIVE WITH
OUR FATHER, AND I REFUSED TO GO
TO NORTH CAROLINA.
MY FATHER AND I HAVE NOT ALWAYS
HAD THE BEST OF RELATIONSHIPS.
SO I ENDED UP STAYING IN
MASSACHUSETTS AND LIVED WITH MY
GRANDMOTHER, AND NOT ONLY THAT,
WE LOST OUR CAT, I KNOW THAT
SOUNDS VERY SILLY, BUT IT JUST
FELT LIKE ONE LOSS AFTER THE
OTHER WAS BEING EXPERIENCED AT
THAT TIME.
AND MY GRANDMOTHER, BEING THE
SMART WOMAN THAT SHE WAS, ENDED
UP HAVING AN ARMY OF SUPPORT
THAT SURROUNDED ME.
AND DURING THIS TIME, EVEN
THOUGH I HAD THAT SUPPORT
SYSTEM, I WASN'T ALWAYS AS VOCAL
AS I WANTED TO BE OR THOUGHT I
SHOULD BE, BECAUSE I WAS 14 AND
TRYING TO DEAL WITH GRIEF, AND
NOT REALLY UNDERSTANDING THE
THOUGHT THAT I WAS HAVING.
AND UNFORTUNATELY I ENDED UP
HAVING SUICIDAL THOUGHTS.
I ENDED UP THINKING I WOULD BE
BETTER NOT BEING HERE.
I ENDED UP THINKING THAT I
WANTED TO KILL MYSELF AND I
DIDN'T WANT TO BE PRESENT
ANYMORE.
BUT FOR SOME STRANGE REASON,
JUST WOULDN'T VOICE THOSE THINGS
TO FOLKS.
BUT MY GRANDMOTHER, AGAIN, BEING
VERY WISE THAT SHE WAS, HAD MY
COOL COUSINS THAT WERE IN THEIR
20s CHECK IN WITH ME ON A
REGULAR BASIS, AND ONE OF MY
COUSINS RECOGNIZED THAT I WASN'T
THE SAME ARIELLE AS WHAT I USED
TO BE.
SO SHE SPOKE WITH MY
GRANDMOTHER, AND THEY GOT ME
HELP.
I ENDED UP GOING TO THERAPY, AND
WORKING THROUGH THE GRIEF.
I STILL GRIEVE, AS I'M SURE MANY
PEOPLE HAVE OR DO WHEN THEY LOSE
SOMEONE.
I MISS MY MOTHER A GREAT DEAL.
BUT I WAS ABLE TO WORK THROUGH
THAT VERY DARK SPACE THAT I WAS
IN.
SO THERE RESEARCH IS NOT ONLY A
PROFESSIONAL LOOK THAT I HAVE
BUT ALSO SOMETHING VERY NEAR AND
DEAR TO MY HEART BECAUSE I HAVE
BEEN THERE, I HAVE BEEN IN THAT
DARK SPACE, AND I HOPE AND PRAY
THAT MY WORK CAN ACTUALLY HELP
OTHERS GET OUT OF THAT DARK
SPACE AND MOVE FORWARD.
SO AS I ALREADY STATED, I WENT
TO PENN STATE.
I WAS PUSHED BY MY GRANDMOTHER A
GREAT DEAL TO KEEP ON MOVING
FORWARD AND GOING FORWARD.
AND NOT ONLY MY GRANDMOTHER, MY
OTHER FAMILY MEMBERS AS WELL.
I WENT TO PENN STATE, I AM A
NITTANY LION, TRUE BLOOD ALL THE
WAY THROUGH, WENT TO THE OTHER
SCHOOL, OHIO STATE, SORRY, GUYS.
AND GOT MY MASTER'S DEGREE AND
THEN TO BE 100% HONEST, I REALLY
GOT BURNT OUT.
I GOT BURNT OUT FROM SCHOOL.
SO I ENDED UP TRYING TO FIGURE
OUT, WAS THIS PH.D. THING WHAT I
REALLY WANTED TO DO.
SO I GOT A RESEARCH POSITION AT
NATIONWIDE CHILDREN'S HOSPITAL
AND STARTED WORKING IN THE FIELD
OF SUICIDE WITH MY MENTOR AND
VERY CLOSE DEAR FRIEND,
DR. JEFFREY BRIDGE, AND HE
TAUGHT ME ALMOST EVERYTHING I
KNOW, I WOULD SAY, AND THEN ALSO
AT THAT TIME, I WAS ADJUNCT
TEACHING AT COLUMBUS STATE
COMMUNITY COLLEGE AND I REALIZED
THAT I REALLY LOVED DOING THE
RESEARCH AND THE TEACHING AND
WANTED TO CONTINUE TO MOVE
FORWARD B BUT I NEEDED AN EXTRA
PUSH TO BE 100% HONEST AND THAT
WAS JEFF TELLING ME, ARIELLE, GO
TO SCHOOL.
SO I ENDED UP GOING BACK FOR MY
PH.D. AT OHIO STATE, DID A POST
DATE OF BIRTH IN SAN ANTONIO,
WHERE MY SON WAS BORN.
HE IS A TEXAN.
AND THEN WENT BACK TO CHILDREN'S
HOSPITAL IN COLUMBUS, OHIO TO DO
ANOTHER POSTDOC, WHERE I WAS
ABLE TO INITIATE MY OWN
INDEPENDENT LINE OF RESEARCH.
AND NOW I AM AT THE UNIVERSITY
OF ROCHESTER MEDICAL CENTER.
SO AGAIN, LOTS OF TWISTS, LOTS
OF TURNS, BUT I AM WHERE I AM
FOR A REASON I DO BELIEVE THAT
100%.
AND THIS IS MY FAMILY.
I ALWAYS LIKE TO SHOW THEM
BECAUSE ON REALLY BAD DAYS, THEY
ARE THERE EVERY SINGLE DAY,
100%, PUSHING ME TO KEEP ON
GOING AND MOVING FORWARD, AND
WITHOUT THEM, I DON'T KNOW WHERE
I WOULD BE.
SO I ALWAYS LIKE TO SHOUT THEM
OUT AND TO GIVE THEM A LITTLE
BIT OF A PIECE OF MY
PRESENTATION AS WELL.
SO NOW THAT I'VE TALKED ABOUT ME
PERSONALLY, I WOULD LIKE TO
START GETTING INTO THE DETAILS
OF THE STATS AND THE FIGURES,
BUT BEFORE DOING SO, I WANT TO
MAKE SURE WE'RE ALL ON THE SAME
PAGE WITH DEFINITIONS.
BECAUSE SOMETIMES WHEN YOU HEAR
THESE WORDS, NOT EVERYONE MAY BE
THINKING IN THE SAME LIGHT.
SO I WANT TO MAKE SURE THAT WHEN
I SAY THEM, YOU ALL UNDERSTAND
WHAT I AM REFERRING TO.
SO SUICIDE, WHAT DO I MEAN BY
THAT?
SUICIDE IS THE DEATH OF AN
INDIVIDUAL THAT IS CAUSED BY AN
INJURY TO ONESELF WITH EXPLICIT
OR INFERRED INTENT TO DIE.
SUICIDAL IDEATION IS WHEN YOU
HAVE THOUGHTS ABOUT SUICIDE, AND
THOSE CAN RANGE FROM WISHING YOU
WERE DEAD, WISHING YOU COULD GO
TO SLEEP AND NOT WAKE UP, ALL
THE WAY TO ACTUALLY THINKING
ABOUT A PLAN, A METHOD, AND
HAVING THAT INTENT.
SO THERE CAN BE A RANGE IN TERMS
OF SUICIDAL THOUGHTS.
SUICIDE ATTEMPT IS A NON-FATAL
SELF INJURIOUS ACT, AND YOU HAVE
TO HAVE THAT STATED OR INFERRED
INTENT TO DIE.
SO WITH THOSE THREE, IT
ENCOMPASSES SUICIDAL BEHAVIOR.
ANOTHER RELATE TERM THAT YOU'LL
HEAR THROUGHOUT THE PRESENTATION
IS SELF-HARM BEHAVIOR, ALSO
KNOWN AS NON-SUICIDAL
SELF-INJURY.
THIS IS WHEN SOMEONE PURPOSELY
HURTS THEMSELF, AND IT'S USUALLY
PHYSICAL HARM, AND IT IS WITHOUT
THE INTENT TO DIE.
SO THAT'S THE DIFFERENCE BETWEEN
SUICIDAL BEHAVIOR AND SELF HARM
BEHAVIOR.
ALTHOUGH RESEARCH HAS SHOWN THAT
THERE IS AN ASSOCIATION BETWEEN
THE TWO.
SO THE PROBLEM OF YOUTH SUICIDE.
IN 2020, SUICIDE WAS ACTUALLY
THE TENTH LEADING CAUSE OF DEATH
FOR ALL AGE GROUPS, BUT FOR
YOUTH 10 TO 19 YEARS OF AGE, IT
WAS ACTUALLY THE THIRD LEADING
CAUSE OF DEATH, AND ACCOUNTED
FOR ALMOST 2800 LIVES LOST.
AND IF YOU TAKE IT ALL TOGETHER,
THAT NUMBER IS ACTUALLY MORE
THAN SEVEN LEADING CAUSES OF
DEATH.
WHEN YOU LOOK AT SUICIDE IN THIS
AGE GROUP, 10 TO 19 YEARS, FOR
THE PAST 10 YEE YOU WILL SEE
THAT THERE IS QUITE A DIFFERENCE
WHEN YOU LOOK AT SEX.
SO MALES ARE MORE LIKELY TO DIE
BY SUICIDE AND IT'S ABOUT THREE
TIMES HIGHER IN MALES
SPECIFICALLY, AND ABOUT 75% OF
DEATHS THAT ARE SUICIDE-SPECIFIC
ARE FOR MALE THAN FOR KNEE MAIL.
FEMALE.
HOWEVER, I WILL DEFINITELY TELL
YOU THIS GAP IS STARTING TO
CHANGE.
SO THIS IS DATA PLOTTED FROM
2000 TO 2020.
AND WHAT YOU CAN SEE HERE IS
THAT THE GREEN LINE IS THE
OVERALL LINE, AND IT HAS
INCREASED FOR THIS AGE GROUP
OVER THE PAST 20 YEARS AT 42%.
AND MALES HAVE ALSO INCREASED AT
28%.
BUT FEMALES HAVE ACTUALLY
INCREASED 114% IN THE PAST 20
YEARS.
SO THIS INCREASE IS ABOUT FOUR
TIMES HIGHER THAN THAT INCREASE
OF MALES.
AND THEN WHEN YOU LOOK AT
SELF-HARM BEHAVIOR, THE CDC
ACTUALLY TRACKS THIS AS WELL,
AND THIS SLIDE IS FROM 2001 TO
2020.
THE BLUE LINE IS THE RATE OF
SELF-HARM, AND THE BARS, THE
GOLD BARS ARE ACTUALLY THE
NUMBER OF ED PRESENTATIONS, SO
THE EMERGENCY DEPARTMENT
PRESENTATIONS FOR SELF-HARM
BEHAVIOR.
AND WHAT YOU CAN SEE HERE IS
FROM 2001 TO 2020, WE HAVE
ACTUALLY EXPERIENCED A 181%
INCREASE IN THE NUMBER OF
PRESENTATIONS IN OUR EMERGENCY
ROOMS ACROSS THE U.S. FOR
SELF-HARM BEHAVIOR FOR 10 TO
19-YEAR-OLDS.
AND JUST TO GIVE YOU SOME
INSIGHT ON WHAT THOSE NUMBERS
ARE, IN 2001, IT WAS ABOUT 1500
CASES IN THE EMERGENCY ROOMS
AROUND THE U.S., AND FOR 2020,
IT WAS ACTUALLY ABOUT 4200 YOUTH
IN THIS AGE RANGE.
SO WHAT ABOUT THE YOUNGEST OF
THE YOUNG?
THAT IS MY AREA OF INTEREST, I
MUST SAY I AM A LITTLE BIT
BIASED.
I DO FOCUS IN ON THE YOUNGER AGE
GROUP, AND THE REASON BEING IS
BECAUSE WHEN WE GET TO
ADOLESCENCE, THERE ARE SOME
INTERVENTIONS THAT ARE PRESENT.
THERE ARE A LOT MORE LAYERS THAT
YOU HAVE TO PEEL BACK WITH
ADOLESCENTS, AS I'M SURE SOME OF
YOU CAN ATTEST TO WHEN THINKING
ABOUT YOUR ADOLESCENT YEARS OR
EVEN WHILE YOU'RE RAISING
ADOLESCENTS.
AND I THINK FOR THE YOUNGEST OF
THE YOUNG, WHICH WHEN I
REFERENCE IS 5 TO 12 YEARS OF
AGE, I FEEL AS IF FAMILY
ACTUALLY CAN PLAY A BIG ROLE IN
INTERVENTION, AND THAT IS
SOMETHING THAT IS VERY NEAR AND
DEAR TO MY HEART, BEING A HUMAN
DEVELOPMENT AND FAMILY STUDIES
PERSON.
SO THAT'S ONE OF THE REASONS WHY
I REALLY FOCUS ON THIS YOUNGER
AGE RANGE.
AND ALSO, WE DON'T KNOW A LOT
ABOUT THIS YOUNGER AGE RANGE,
AND I THINK THAT IS SOMETHING
ELSE THAT WE NEED TO FOCUS OUR
ENERGIES ON SO THAT WE CAN
ACTUALLY THINK ABOUT
INTERVENTIONS FOR THEM AS WELL.
UNFORTUNATELY THIS AGE RANGE HAS
ALSO SEEN INCREASES IN SUICIDAL
BEHAVIOR OVER THE YEARS.
SO IN 2009, AS CAN YOU SEE HERE,
IT WAS ACTUALLY THE EIGHTH
LEADING CAUSE OF DEATH FOR KIDS
5 TO 12 YEARS OF AGE, AND
ACCOUNTED FOR 82 DEATHS IN
TOTAL.
IN 2014, IT ROSE TO THE SIXTH
LEADING CAUSE OF DEATH.
IN 2019, IT BECAME THE FIFTH
LEADING CAUSE OF DEATH, AND
ACTUALLY ACCOUNTED FOR DOUBLE
THAT NUMBER OF DEATHS THAN WHAT
WE SAW IN 2009.
SO IN THAT 10-YEAR SPAN, WE SAW
DOUBLE THAT NUMBER.
AND IN 2020, IT WAS ACTUALLY THE
FIFTH LEADING CAUSE OF DEATH AND
ACCOUNTED FOR 180 YOUTH WHO
ACTUALLY DIED BY SUICIDE IN THIS
AGE RANGE.
THIS IS JUST ANOTHER WAY TO LOOK
AT THAT DATA.
I PLOTTED IT OUT FROM 1990 TO
2020, AND AGAIN, JUST TO GIVE
YOU SOME INSIGHT, NUMBER OF
DEATHS IS THE COLUMNS, SO THE
GOLD COLUMNS, AND THE BLUE LINE
IS THE RATE OF SUICIDE.
AND FROM 1990 TO 2020, WE HAVE
ACTUALLY SEEN A 195% INCREASE IN
THE NUMBER OF SUICIDE DEATHS FOR
YOUTH 5 TO 12 YEARS OF AGE.
SOME FOLKS DO LOOK AT THIS
DECREASE WHICH IS PRESENT, SO
THERE IS A DECREASE WHICH
OCCURRED FROM 2018 TO 2019.
IT WAS ABOUT 11% IN TERMS OF THE
DECREASE.
BUT THEN UNFORTUNATELY, FROM
2019 TO 2020, WE SAW A 10%
INCREASE THAT OCCURRED.
WHEN YOU LOOK AT SELF HARM
BEHAVIOR, WHAT DOES THAT ENTAIL
IN THIS YOUNGEST AGE GROUP?
SO AGAIN, AS YOU SAW WITH OTHER
SLIDES, THE BARS AT THE NUMBER
OF PRESENTATIONS FOR THE ED
WHEREAS THE RATE IS THAT BLUE
LINE, AND WHAT WE'VE SEEN FROM
2001 TO 2020, WE'VE SEEN A 411%
INCREASE IN THE NUMBER OF ED
PRESENTATIONS FOR SELF-HARM
BEHAVIOR IN OUR 5 TO 12 YEARS
OLDS.
SO IT'S NOT SPECIFIC TO ONE AGE
GROUP.
THAT IS SOMETHING THAT I DO WANT
TO PREFACE.
AND UNFORTUNATELY, WE ARE SEEING
DRASTIC INCREASES IN THIS REALLY
YOUNG AGE GROUP.
WHEN YOU LOOK AT GROUPS IN
TOTAL, SO 5 TO 19-YEAR-OLD, AND
YOU LOOK AT RACE OVER THE PAST
20 YEARS, WHAT YOU'LL SEE HERE
IS THAT UNFORTUNATELY FOR
INDIGENOUS YOUTH, THEY HAVE
ALWAYS HAD HISTORICALLY THE
HIGHEST RATE OF SUICIDE DEATHS.
AND THAT HAS GONE ON FOR MANY,
MANY YEARS NOW.
WHEN YOU LOOK AT THE INCREASE,
LIKE FROM 2000 TO 2020, WHAT
YOU'LL SEE IS THAT FOR WHITE
YOUTH SPECIFICALLY, WE'VE SEEN A
40% INCREASE FOR OUR INDIGENOUS
INDIVIDUALS OR OUR INDIGENOUS
YOUTH, WE'VE SEEN A 44%
INCREASE.
FOR OUR ASIAN PACIFIC ISLANDER
YOUTH, WE'VE SEEN A 62%
INCREASE, AND THEN FOR OUR BLACK
YOUTH, THEY'VE ACTUALLY SEEN THE
LARGEST INCREASE, AT 78%.
WHEN YOU LOOK AT HISPANIC AND
NON-HISPANIC YOUTH, WE ALSO SEE
DIFFERENCES THERE AS WELL FOR
OUR 5 TO 19-YEAR-OLDS.
THIS IS FOR THE PAST 10 YEARS
JUST SO YOU ALL ARE AWARE.
FOR OUR MALES, OUR HISPANIC
MALES FROM 2010 TO 2020, WE'VE
ACTUALLY SEEN A 61% INCREASE,
AND THEN FOR OUR FEMALES, WE'VE
ACTUALLY SEEN A 78% INCREASE IN
THIS SPECIFIC AGE GROUP.
AND LAST BUT NOT LEAST, WHEN YOU
LOOK AT METHOD OF SUICIDE,
YOU'LL SEE HERE THAT MALES ARE
MORE LIKELY TO DIE BY SUICIDE BY
FIREARM, WHEREAS FEMALES ARE
MORE LIKELY TO DIE BY SUICIDE BY
HANGING SUFFOCATION.
HOWEVER, THERE HAVE BEEN SOME
INCREASES THAT ARE QUITE TELLING
AND SCARY, TO BE 100% HONEST,
FOR FIREARMS IN FEMALES.
WE ACTUALLY, FROM THE PAST 10
YEARS, HAVE SEEN AN 80%
INCREASE, AND WE ALL KNOW, IF WE
DON'T KNOW, FIREARM AND HANGING
SUFFOCATION ARE THE MOST LETHAL
MEANS FOR SUICIDE, SO WE'RE
SEEING THIS VERY HIGH INCREASE
OCCUR IN OUR FEMALES, AND THAT
MIGHT BE ONE OF THE REASONS WHY
WE'RE SEEING THESE INCREASES IN
OUR RATES FOR FEMALES
SPECIFICALLY.
SO NOW THAT WE'VE TALKED A
LITTLE BIT ABOUT JUST YOUTH
SUICIDE EPIDEMIOLOGY IN GENERAL,
I'D LIKE TO FOCUS SOME ENERGIES
ON BLACK YOUTH SUICIDE.
AND SUICIDAL BEHAVIOR.
SO IN 2020, SUICIDE WAS THE
THIRD LEADING CAUSE OF DEATH FOR
BLACK YOUTH 5 TO 19 YEARS OF
AGE, AND IT ACCOUNTED FOR
395 DEATHS IN 2020.
AND THIS IS AN 86% INCREASE OVER
20 YEARS.
SO JUST SO YOU GUYS ARE AWARE,
IN 2000, IT WAS ACTUALLY THE
FOURTH LEADING CAUSE OF DEATH,
AND NOW IT IS CONSIDERED THE
THIRD FOR BLACK YOUTH IN THIS
AGE RANGE.
THERE HAS BEEN A GOOD AMOUNT OF
RESEARCH THAT HAS HAPPENED
RECENTLY WHEN EXAMINING BLACK
YOUTH SUICIDE AND SUICIDAL
BEHAVIOR, AND THIS IS JUST SOME
OF THE RESEARCH, THIS IS NOT ALL
INCLUSIVE, I MUST SAY MY
TIMELINE WOULD BE BURSTING WITH
MORE, BUT THIS HAS BEEN SOME OF
THE RESEARCH THAT I HAVE BEEN
VERY MUCH INVOLVED IN AND VERY
EXCITED TO BE INVOLVED IN.
AND SOME THAT I HAVE NOT BEEN
INVOLVED IN SPECIFICALLY.
I'M GOING TO GO THROUGH A LITTLE
BIT IN TERMS OF SOME OF THE
ITEMS ON THIS TIMELINE, BUT JUST
AGAIN SO YOU ARE AWARE, IT IS
NOT ALL-INCLUSIVE.
SO THIS ARTICLE, I HAD THE
PLEASURE TO WORK WITH
DR. JEFFREY BRIDGE AND
COLLEAGUES, AND WE LOOKED AT THE
AGE BY RACE DISPARITY PRESENT IN
BLACK VERSUS WHITE YOUTH.
WHAT WE FOUND IS WHEN WE
ANALYZED THE DATA FROM 2001 TO
2015, WE FOUND THAT OUR BLACK
YOUTH WERE ABOUT TWO TIMES MORE
LIKELY TO DIE BY SUICIDE THAN
THEIR WHITE COUNTERPARTS BETWEEN
THE AGES OF 5 AND 12 YEARS OLD,
WHICH IS THE AGE RANGE THAT I
SPECIFICALLY FOCUS SOME ENERGY
ON.
AND THEN BY 13, AN IT ACTUALLY
SWITCHED, SO THEY WERE LESS
LIKELY TO DIE BY SUICIDE AT THAT
TIME.
AND THEN ANOTHER ARTICLE THAT I
WAS ABLE TO WORK WITH
DR. MICHAEL LINDSAY AT NYU, AND
WE LOOKED AT THE YOUTH RISK
BEHAVIOR SURVEY DATA, AND WE
EXAMINED SELF-REPORTED IDEATION
SUICIDE ATTEMPTS OVER A PERIOD
OF TIME FROM 1991 TO 2017, AND
WHAT WE FOUND IS FOR
SELF-REPORTED SUICIDE ATTEMPTS,
OUR BLACK YOUTH SAW A 73%
INCREASE AND ALSO FOUND THAT
BLACK YOUTH HAD A 120% INCREASE
IN SELF-REPORTED SUICIDE
ATTEMPTS REQUIRING MEDICAL
ATTENTION.
SO THAT WAS VERY TELLING, AS YOU
CAN IMAGINE, AND ALL OF THIS
WORK THAT WE'VE BEEN DOING IN
THE FIELD REALLY CULMINATED INTO
WHAT WE CALL RINGING THE ALARM.
I WAS VERY HONORED TO BE A PART
OF THE EMERGENCY TASK FORCE THAT
WAS ACTUALLY FORMED BY
REPRESENTATIVE BONNIE WATSON
COLEMAN, AND WE GOT TOGETHER IN
A ROOM, WE SAT DOWN, IT WAS
RESEARCHERS, CLINICIANS,
COMMUNITY LEADERS, AND WE WROTE
THIS REPORT ABOUT THE STATE OF
THE CRISIS, BUT NOT ONLY THAT,
WHAT WERE SOME OF THE
RECOMMENDATIONS THAT WE COULD
ACTUALLY GIVE TO OTHERS?
SO WE HAD RECOMMENDATIONS ABOUT
RESEARCH, WE HAD RECOMMENDATIONS
ABOUT POLICY, CLINICAL CARE.
SO THAT NOT ONLY COULD IT BE A
TELL-ALL, SO TO SPEAK, IN TERMS
OF TELLING YOU THE STATS AND THE
FIGURES, BUT ALSO GIVE YOU SOME
RECOMMENDATIONS ON WHERE TO GO
FROM HERE.
SO THAT REPORT IS READILY
AVAILABLE, IT'S ONLINE, PLEASE
FEEL FREE TO CHECK IT OUT IF YOU
HAVE TIME, BUT I THINK THE ONE
THING THAT I'M MOST PROUD OF IS
THAT WE STILL MEET, WE ACTUALLY
STILL ARE HEAVILY INVOLVED IN
THIS MISSION, AND WE STILL ARE
TRYING TO LOOK FOR WAYS TO
ADVOCATE FOR PROGRAMMING, FOR
POLICY, FOR RESEARCH, AND I
THINK WE ARE, AS A TEAM, STILL
VERY HIGHLY INVESTED IN LETTING
PEOPLE KNOW THAT BLACK YOUTH
SUICIDE DOES EXIST, IT'S STILL A
PROBLEM, AND WE NEED TO REALLY
FOCUS SOME ENERGIES ON THAT
PROBLEM SPECIFICALLY IF WE WANT
CHANGE TO OCCUR.
SO LAST BUT NOT LEAST, I AM
GOING TO GO THROUGH A RECENT
ARTICLE THAT I PUBLISHED THAT
LOOKED AT BLACK YOUTH SUICIDE
ONLY.
IN OTHER PAPERS, WE'VE COMPARED
TO OTHER RACIAL GROUPS, AND
AGAIN, I THINK THAT IS MOST --
IT IS APPROPRIATE TO DO, BUT I
REALLY WANTED TO FOCUS SOME
ENERGY ON BLACK YOUTH ONLY.
AND TRY TO FIGURE OUT, OKAY,
WHAT'S GOING ON WITH THE RATES
BY AGE, BY SEX, WHAT ARE THOSE
PRECIPITATING CIRCUMSTANCES THAT
ARE HAPPENING PRIOR TO THAT
SUICIDE DEATH BY AGE AND BY SEX
SO THAT WE CAN ACTUALLY REALLY
START THINKING ABOUT
INTERVENTION AND REALLY FOCUS
SOME ENERGIES IN THAT SPACE.
SO FOR THIS DATA, WE LOOKED AT
DATA FROM 2003 TO 2017, AND WE
BROKE IT DOWN BY AGE GROUP
AGAIN, AND WE LOOKED AT ANNUAL
PERCENT CHANGE.
FOR OUR 5 TO 11-YEAR-OLDS, WE
SAW THAT THEY HAD A CHANGE OF
3.9%.
FOR OUR 12 TO 14-YEAR-OLDS, THEY
HAD AN ANNUAL PERCENT CHANGE OF
2.9%.
AND THEN THE LARGEST ANNUAL
PERCENT CHANGE OCCURRED IN OUR
15 TO 17-YEAR-OLD AGE GROUP, AT
4.9%.
AND THEN WE LOOKED AT THE RATE
BY SEX AND WE FOUND THAT BOTH
MALES AND FEMALES INCREASED,
HOWEVER, FEMALES INCREASED
ALMOST DOUBLE THAT OF MALES.
SO THEIR ANNUAL PERCENT CHANGE
WAS 6.6%, COMPARED TO MALES AT
2.8%.
JUST AS A SIDE NOTE, I WAS BEING
LOOKING AT DATA JUST RECENTLY ON
THE CDC'S WEBSITE, AND SOMETHING
THAT I FOUND QUITE DISTURBING,
TO BE 100% HONEST, WAS THAT WHEN
YOU LOOK AT THE LEADING CAUSES
OF DEATH FOR BLACK GIRLS 12 TO
14 YEARS OLD, SUICIDE IS NOW
TIED AS THE LEADING CAUSE OF
DEATH IN THIS AGE GROUP, FOR
BLACK GIRLS 12 TO 14 YEARS.
AND UNFORTUNATELY, I THINK THIS
GRAPH MAY HAVE POTENTIALLY DONE
SOME FORECASTING, SO TO SPEAK.
IN 2015, SUICIDE WAS ACTUALLY
THE FIFTH LEADING CAUSE OF
DEATH, SO FIVE YEARS AGO.
IT WAS THE FIFTH LEADING CAUSE
OF DEATH FOR BLACK GIRLS 12 TO
14 YEARS OF AGE.
NOW IT'S THE LEADING CAUSE WITH
UNINTENTIONAL INJURY.
SO JUST SOMETHING TO THINK
ABOUT, SOMETHING TO THINK ABOUT
IN TERMS OF AREAS FOR
PREVENTION, AND ALSO JUST,
AGAIN, THE NEED IS THERE.
WE REALLY NEED TO START FOCUSING
IN ON THESE AGE GROUPS, ON THE
SECTIONSSEXES AND BE FOCUSED INR
INTERVENTIONS SO WE CAN ACTUALLY
MAKE SOME CHANGE.
WHEN WE LOOKED AT PRECIPITATING
CIRCUMSTANCES FOR BLACK YOUTH,
THERE WERE A LOT OF SIMILARITIES
BETWEEN OUR 5 TO 11 YEARS OLDS
AND OUR 12 TO 14-YEAR-OLDS.
A MAJORITY OF THEM DIED IN THEIR
OWN HOME.
A MAJORITY HAD A FAMILY PROBLEM
OR CRISIS OR A SCHOOL PROBLEM OR
CRISIS THAT HAD OCCURRED PRIOR
TO THEIR DEATH.
AND THEN THE INJURY THAT CAUSED
THEIR DEATH ACTUALLY OCCURRED
WITHIN 24 HOURS OF AN ARGUMENT.
AND THERE WERE SOME DIFFERENCES.
SO UNFORTUNATELY IN THIS 12 TO
14-YEAR-OLD AGE GROUP, THERE ARE
MORE GIRLS THAT DIED BY SUICIDE
THAN BOYS, AND COMPARED TO OTHER
AGE GROUPS AS WELL, THERE WERE
MORE GIRLS IN THE 12 TO
14-YEAR-OLD AGE GROUP.
AND THEN FOR OUR 5 TO
11-YEAR-OLDS, IF THEY WERE
DIAGNOSED WITH A MENTAL HEALTH
CONCERN, THEY WERE MORE LIKELY
TO HAVE ADHD OR ADD.
FOR 15 TO 17-YEAR-OLD YOUTH,
THEY WERE MORE LIKELY TO HAVE A
BOYFRIEND OR GIRLFRIEND PROBLEM
PRIOR TO DEATH, THEY WERE ALSO
MORE LIKELY TO HAVE A RECENT
CRIMINAL OR LEGAL PROBLEM THAT
HAD OCCURRED.
THEY WERE MORE LIKELY THAN THE
12 TO 14-YEAR-OLDS OR THE 5 TO
11-YEAR-OLDS TO ACTUALLY LEAVE A
SUICIDE NOTE, AND IF THEY WERE
DIAGNOSED WITH A MENTAL HEALTH
CONCERN, IT WAS EITHER
DEPRESSION, DYSTHYMIA OR THEY
HAD SOME SUBSTANCE USE CONCERNS
THAT WERE PRESENT.
WHEN PRECIPITATING CIRCUMSTANCES
BY SEX, THERE WERE ALSO
DIFFERENCES BETWEEN BOYS AND
GIRLS.
FOR GIRLS THEY WERE MORE LIKELY
TO HAVE A RELATIONSHIP PROBLEM
OR A CRISIS OCCUR PRIOR TO THEIR
DEATH.
THEIR DEATH OCCURRED WITHIN 24
HOURS OF AN ARGUMENT.
THEY ALSO WERE MORE LIKELY TO
HAVE A PHYSICAL HEALTH CONCERN,
WHICH I THINK POTENTIALLY MIGHT
BE AN AVENUE FOR INTERVENTION
AND I CAN TALK ABOUT THAT WHEN
WE GET THERE.
THEY ALSO ARE MORE LIKELY TO
HAVE A HISTORY OF SUICIDAL
IDEATION, PLANS, A SUICIDE
ATTEMPT.
THEY ARE ALSO MORE LIKELY TO
HAVE A CURRENT MENTAL HEALTH
CONCERN, HAVE CURRENT OR A
HISTORY OF MENTAL HEALTH
TREATMENT, AND IF THEY WERE
DIAGNOSED WITH A MENTAL HEALTH
CONCERN, IT WAS EITHER
DEPRESSION, DYSTHYMIA OR
ANXIETY.
FOR OUR BOY GROUP, THEY WERE
MORE LIKELY TO HAVE A RECENT
CRIMINAL OR LEGAL PROBLEM, WHICH
AGAIN I THINK IS A POINT FOR
INTERVENTION, AND THEN IF THEY
DID HAVE A MENTAL HEALTH
CONCERN, THEY WERE MORE LIKELY
TO HAVE ADHD AS A DIAGNOSIS.
SO THIS IS A LOT TO TAKE ON, I
UNDERSTAND THAT, BUT I WANT TO
BE VERY, VERY CLEAR, I DO
BELIEVE SUICIDE IS PREVENTABLE.
I BELIEVE IT'S GOING TO TAKE
SOME TIME, IT'S GOING TO TAKE
SOME EFFORT, IT'S GOING TO TAKE
ALL OF US COMING TO THE TABLE,
BUT IT IS PREVENTABLE, AND I
REALLY DO BELIEVE THAT.
I BELIEVE THIS "THIS WAY" SIGN
WAS FACING ALL DIRECTIONS
BECAUSE THAT'S HOW I THINK ABOUT
SUICIDE PREVENTION, TO BE 100%
HONEST, AND NOW I'M GOING TO
TALK A LITTLE BIT ABOUT THAT
SPECIFICALLY FROM MY OWN
PERSPECTIVE.
I WAS WAS VERY HONORED AND AM VY
THANKFUL THAT I WAS ABLE TO
PUBLISH A PAPER WITH MY
COLLEAGUE, DR. ADAM MILLER, AND
WE LOOKED AT HOW CAN WE PREVENT
SUICIDAL BEHAVIOR IN BLACK YOUTH
SPECIFICALLY?
WHAT SHOULD WE BE DOING?
AND WE THOUGHT ABOUT, NUMBER
ONE, WE DON'T KNOW, TO BE 100%
HONEST, AND I THINK THAT'S ONE
OF THE THINGS WE DON'T KNOW.
BUT WE THOUGHT IT WAS NECESSARY
FOR US TO START AT GROUND ZERO.
WE NEED TO REALLY THINK ABOUT
WHAT ARE THESE CULTURALLY
RELEVANT RISK FACTORS,
PROTECTIVE FACTORS WE SHOULD BE
THINKING ABOUT WHEN EXAMINING
BLACK YOUTH SUICIDE.
WE NEED TO FIGURE OUT, ARE THE
THEORIES THAT ARE IN THE FIELD,
ARE THEY ACTUALLY UNIVERSAL FOR
MINORITIZED YOUTH?
AND IF NOT, WHAT ABOUT THEM DO
WE NEED TO POTENTIALLY CHANGE
AND CAN WE CHANGE THEM, OR DO WE
NEED TO ESTABLISH NEW THEORIES
THAT ARE GOING TO HELP OUR
SCIENCE TO GET BETTER TO PREVENT
SUICIDAL BEHAVIOR IN BLACK
YOUTH?
WE ALSO NEED TO KIND OF FIGURE
OUT THIS TRAJECTORY.
SO -- NOT KIND.
WE DO NEED TO FIGURE OUT THIS
TRAJECTORY.
IDEATION TO BEHAVIOR.
THAT'S ALWAYS BEEN THE WAY, SO
TO SPEAK, IN OUR WORLD.
FIRST YOU HAVE THOUGHTS, YOU
THEN YOU HAVE A PLAN, THEN YOU
ATTEMPT.
OR FIRST YOU HAVE THOUGHTS, THEN
YOU ATTEMPT.
BUT FOR BLACK YOUTH
SPECIFICALLY, THAT DOESN'T SEEM
TO BE THE CASE.
IN OUR PAPER, DR. MICHAEL
LINDSAY AND I FOUND THAT EVEN
THOUGH THERE WAS THESE INCREASES
IN SELF-REPORTED SUICIDE
ATTEMPTS AND INCREASES IN
SELF-REPORTED SUICIDE ATTEMPTS
THAT REQUIRED MEDICAL ATTENTION,
THERE WEREN'T INCREASES IN
IDEATION.
SO WE'RE NOT SURE IF IT'S
BECAUSE WE'RE ASKING THE
QUESTION INCORRECTLY, IF THEY'RE
UNDERSTANDING OUR QUESTIONS
CORRECTLY, DO THEY THINK ABOUT
SUICIDAL IDEATION DIFFERENTLY
THAN WHAT WE DO IN THE FIELD,
ARE THE MEASURES THAT WE USE
ACTUALLY ACCURATE?
ARE THEY UNIVERSAL AS WHAT WE
THINK?
SO I THINK THERE IS SOME NEED
FOR INVESTIGATING NOT ONLY THE
TRAJECTORY, BUT ALSO HOW WE'LL
BE ASKING THESE QUESTIONS TO
MAKE SURE THEY'RE CULTURALLY
RELEVANT.
AND LAST BUT NOT LEAST, I THINK
MIXED METHOD APPROACHES ARE 100%
NEEDED.
WE DON'T KNOW A LOT, TO BE 100%
HONEST, WHEN IT COMES TO BLACK
YOUTH SUICIDE AND PREVENTING
BLACK YOUTH SUICIDE, AND WE NEED
TO ASK THE KIDS THEMSELVES
POTENTIALLY WITH THAT LIVED
EXPERIENCE, THE PARENTS WITH
THAT LIVED EXPERIENCE, HOW CAN
WE PREVENT SUICIDE AND DO A GOOD
JOB ON OUR END SO THAT WE CAN
MAKE A DIFFERENCE?
AND THESE ARE JUST SOME OTHER
AVENUES I'VE BEEN THINK ABOUT IN
TERMS OF PREVENTION FOR BLACK
YOUTH SPECIFICALLY, BUT I THINK
SOME OF THESE CAN ACTUALLY BE
TAILORED TO JUST YOUTH IN
GENERAL.
NUMBER ONE, WE HAVE TO ENGAGE
COMMUNITY.
WE JUST HAVE TO.
WE'VE DONE THIS A LONG TIME NOW,
AND SOME HAVE ENGAGED COMMUNITY,
DON'T GET ME WRONG, BUT I DON'T
THINK WE HAVEN'T DONE THE BEST
AS WHAT HE WITH COULD, AND -- WD
REALLY THINK ABOUT SPECIFIC
COMMUNITY SETTINGS WHERE BLACK
YOUTH AND BROWN YOUTH ARE
PRESENT.
SO THINKING ABOUT AFTER-SCHOOL
PROGRAMS, THINKING ABOUT
BARBERSHOPS, BEAUTY SALONS,
URBAN LEAGUES, AND GOING BACK TO
MY STATEMENT, THE JUVENILE
JUSTICE SYSTEM MIGHT BE AN
AVENUE FOR ENGAGING THOSE STAFF
MEMBERS AND LEADERSHIP WHEN IT
COMES TO SUICIDE PREVENTION,
BECAUSE WHAT WE'VE FOUND IS THAT
BLACK BOYS ARE MORE LIKELY TO
DIE BY SUICIDE IF THEY HAD A
RECENT LEGAL CONCERN.
SO WHAT ABOUT DOING SOME GATE
KEEPER TRAINING WITH THEM AND
MAKING SURE THEY'RE AWARE, NOT
ONLY THE LEADERSHIP, BUT THE
KIDS THEMSELVES.
SO THOSE ARE AVENUES I THINK
ABOUT IN TERMS OF PREVENTION.
COMMUNITY, GETTING THEM
INVOLVED, GETTING LEADERSHIP
INVOLVED, AND ALSO GETTING THE
KIDS INVOLVED THEMSELVES.
FAITH-BASED I THINK IS SOMETHING
ELSE WE HAVEN'T DONE A REALLY
GREAT JOB AT ENGAGING.
THERE IS A PROJECT BY DR. SHERRY
MULL UCK AND GEORGETOWN THAT
RECENTLY GOT SOME FUNDING TO
ACTUALLY TEST HAVEN, AND I THINK
IT'S ONE GREAT AVENUE WE HAVE
NOT EXPLORED IN THE SUICIDE
FIELD THAT REALLY CAN CHANGE OUR
TRAJECTORY, AND THEN ALSO
SCHOOL-BASED, THERE ARE SOME
SCHOOL-BASED PROGRAMS OUT THERE.
ONE OF THE PROGRAMS THAT WAS
ACTUALLY ADAPTED FOR BLACK YOUTH
SPECIFICALLY WAS CONDUCTED BY
DR. ROBINSON WHO'S AT DEPAUL,
AND IT'S CALLED THE
ADAPTED-COPING WITH STRESS
COURSE, WHERE SHE ACTUALLY SAT
ADOLESCENTS DOWN AT THE TABLE
AND SAID OKAY, LOOK AT THIS
CURRICULUM, WHAT DO YOU THINK?
AND THEY WERE ABLE TO ADAPT THE
PROGRAM AND NOW I BELIEVE SHE'S
GOT SOME FUNDING TO TEST IT AS
WELL TO SEE IF IT'S ACCURATE, TO
SEE IF IT'S GOING TO BE
BENEFICIAL.
ANOTHER AVENUE THAT I'VE BEEN
THINKING ABOUT WITH MYSELF AND
COLLEAGUES IS SCREENING, RIGHT?
HOW YOUNG DO WE GO AND THAT'S A
WHOLE 'NOTHER ARGUMENT THAT WE
COULD HAVE.
BUT I THINK BECAUSE BLACK YOUTH,
FEMALES SPECIFICALLY IN WHICH
WE'RE SEEING THAT DRASTIC
INCREASE, THEY'RE MORE LIKELY TO
HAVE A PHYSICAL HEALTH CONCERN.
AND FOR ME, IF THEY'RE HAVING A
PHYSICAL HEALTH CONCERN, THEN
THEY MIGHT BE ACTUALLY SEEING
DOCTORS, WHETHER THEY BE
SPECIALISTS OR PRIMARY CARE
PHYSICIANS, AND HOW ABOUT
SCREENING THERE IN THOSE PLACES
FOR DEPRESSION, SUICIDAL
THOUGHTS AND BEHAVIORS?
AND I KNOW SOME PLACES ARE DOING
A GREAT JOB AT THAT.
I KNOW FOR SURE, I CAN SPEAK TO
NATIONWIDE CHILDREN'S HOSPITAL
STARTED SCREENING IN THEIR
PRIMARY CARE AS YOUNG AS -- I
THINK IT'S 10 YEARS OF AGE NOW
AND UP, SO THERE ARE PLACES THAT
ARE STARTING TO DO THAT, AND I
THINK WE JUST NEED TO KEEP ON
GOING, BECAUSE YOU NEVER KNOW.
IF YOU GET A NO, THAT'S GREAT.
BUT IF YOU GET A YES, YOU COULD
BE ACTUALLY SAVING SOMEONE'S
LIFE.
I THINK AGAIN, WE NEED TO THINK
BROADLY, WE NEED TO THINK
OUTSIDE THE BOX IN ORDER TO MAKE
SOME CHANGES.
AND THEN LAST BUT NOT LEAST, I
ALWAYS TELL EVERYONE WHEN I DO A
PRESENTATION, NOT ONLY DO I SHOW
MY FAMILY, I ALSO DO SHOW THIS
SLIDE.
BECAUSE I REALLY DO BELIEVE
THESE NUMBERS CAN SAVE LIVES.
SO AS I'M SURE ALL OF YOU KNOW,
THE NATIONAL SUICIDE PREVENTION
LINE IS NOW 988.
YOU CAN CALL IT, YOU CAN TEXT
IT.
SO YOU DON'T HAVE TO REMEMBER
THAT LONG NUMBER LIKE IT USED TO
BE.
AND THE CRISIS TEXT LINE IS
AVAILABLE, 741-741, 24 HOURS A
DAY, 7 DAYS A WEEK, 365 DAYS IN
A YEAR.
SO JUST HAVING THESE NUMBERS
SAVED IN YOUR PHONE IS AN ACT OF
PREVENTION.
AND I THINK, AGAIN, WE ALL HAVE
THE OPPORTUNITY TO PREVENT YOUTH
SUICIDE AND SUICIDAL BEHAVIOR,
JUST TAKING A PICTURE OF THIS
ONE SLIDE IS THE FIRST STEP.
AND I THINK IT'S REALLY
IMPORTANT FOR US TO KNOW THAT AS
A TEAM, WE CAN DO SOMETHING.
IT IS NOT A STORY THAT HAS TO
END SADLY.
WE CAN SAVE LIVES.
AND WE DO HAVE THE ABILITY TO DO
SO.
WE JUST HAVE TO WORK TOGETHER AS
A TEAM TO GET THERE.
LAST BUT NOT LEAST, THESE ARE
SOME RESOURCES I LIKE TO PUT UP
SO FOLKS CAN HAVE THEM.
SOME ARE SPECIFIC TO CERTAIN
GROUPS OF YOUTH OR GROUPS OF
INDIVIDUALS.
SOME ARE JUST OVERALL.
THE CRISIS LINE IS ON THERE.
AND THEN LAST BUT NOT LEAST, JU
THANK YOUS.
THANK YOU, THANK YOU, THANK YOU
TO MY NATIONWIDE CHILDREN'S
HOSPITAL RESEARCH TEAM.
SOME ARE PRESENT, SOME ARE PAST.
I COULD NOT DO WHAT I DO WITHOUT
THEM.
I WAS THERE FOR 16 YEARS OFF AND
ON, SO I HAVE A LOT OF GREAT
EXPERIENCE BECAUSE OF THAT, AND
I AM SO GRATEFUL FOR ALL THE
FOLKS THAT ARE ON THIS SLIDE.
AND THERE ARE MANY, MANY MORE
THAT I DID NOT INCLUDE, BUT
THANK YOU ALL.
FIVE ACTION STEPS JUST IN CASE
YOU ARE INTERESTED, THAT IS
AVAILABLE ON NIMH'S WEBSITE,
SOMETHING YOU CAN POST IN YOUR
OFFICE OR POST WHEREVER YOU ARE,
SO THAT FOLKS ARE ABLE TO CALL
IF NEEDED WHENEVER IT'S NEEDED.
AND THEN THAT'S MY CONTACT
INFORMATION, AND THAT'S ALL I
GOT.
SO HAPPY TO TAKE ANY QUESTIONS
THAT YOU MAY HAVE.
>>DR. SHEFTALL, THANK YOU FOR
THAT VERY POWERFUL PRESENTATION.
AND YOU KNOW, BEGINNING WITH
SHARING YOUR OWN PERSONAL STORY.
I THINK MANY OF US WHO HAVE
LISTENED TO YOU HERE ARE AWARE
OF THE GRAVITY OF IT, BUT I
THINK YOUR SHARING THE FACTS AND
FIGURES KIND OF BRINGS IT HOME,
JUST HOW SIGNIFICANT OF A
PROBLEM WE'RE FACING AS A
NATION.
YOUR PRESENTATION HAS GENERATED
A LOT OF QUESTIONS.
THIS IS GOOD.
SO THIS GOES THROUGH SOME OF
THOSE THAT HAVE COME IN.
FIRST WAS, A LISTENER SAYS,
REGARDING YOUR PERSONAL STORY,
I'M SO SORRY, THANK YOU FOR
SHARING YOUR PERSONAL STORY.
NO NEED TO APOLOGIZE FOR
MENTIONING A CAT.
IT DOES DEMONSTRATE THE CONCEPT
OF STACKING.
AND HOW THESE THINGS CAN SORT OF
BUILD UPON ONE ANOTHER.
ANOTHER QUESTION.
HAS THE PANDEMIC MAI MADE THIS E
BETTER OR WORSE?
IT ALSO SAYS THANK YOU FOR A
GREAT TALK.
>>SO THERE HAD BEEN SOME
REPORTS THAT HAVE COME OUT WITH
SOME OF THE BIGGER CITIES.
THE 2021 DATA ISN'T OFFICIALLY
OFFICIAL YET.
IT'S COMING, BUT WE DO KNOW
UNFORTUNATELY IN SOME OF THESE
BIGGER CITIES, WE HAVE SEEN
INCREASES IN SUICIDE, THE
SUICIDE RATE SPECIFICALLY.
SO UNFORTUNATELY I BELIEVE WE'RE
GOING TO SEE EVEN MORE INCREASES
IN THIS YOUNGER AGE RANGE.
IF YOU THINK ABOUT ALL OF THE
TRAUMA THAT SOME OF THESE YOUTH
HAVE EXPERIENCED, THE LOSS OF A
LOVED ONE, THE LOSS OF SCHOOL,
THE LOSS OF SUPPORT THAT WAS
NECESSARY FOR THEM THEM TO GET
THROUGH THEIR DAY, THIS DRASTIC
CHANGE IN THEIR SCHEDULE, BEING
IN SCHOOL ONLINE, RIGHT, AND
JUST SO MUCH LOSS, SO MUCH LOSS,
I THINK UNFORTUNATELY, YES, WE
ARE GOING TO SEE CHANGES AND
UNFORTUNATELY IT'S NOT GOING TO
BE FOR THE BETTER.
>>THANK YOU.
ANOTHER QUESTION.
, WHICH WAS, WHAT ARE SOME OF
THE FACTORS THAT ARE CAUSING
SUICIDE IF THEY ARE ENGAGED
IN -- I'M TRYING TO READ THIS --
IF THEY ARE IN ACTIVITIES
ENGAGED IN SCHOOL AND IN
EDUCATION, DOES THAT DECREASE
THE RISK?
SO WHICH ACTUALLY GETS TO
ANOTHER QUESTION, HOW EFFECTIVE
OR WIDESPREAD IS PERHAPS
SCHOOL-BASED INTERVENTIONS?
>>SO I THINK FIRST AND
FOREMOST, PROTECTIVE FACTORS ARE
SOMETHING THAT ARE KEY TO
PREVENTING SUICIDE AND SUICIDAL
BEHAVIOR.
I THINK THAT IS 100% CORRECT.
SO BEING INVOLVED IN SPORTS,
BEING INVOLVED IN
EXTRACURRICULAR ACTIVITIES LIKE
CHORUS, ART, ET CETERA, I THINK
CAN BE VERY HELPFUL BECAUSE THAT
BUILDS THAT SUPPORT SYSTEM
AROUND THAT CHILD.
BUT UNFORTUNATELY, WE DO KNOW
THAT SOME KIDS THAT ARE IN
SPORTS AND SOME KIDS THAT ARE IN
EXTRACURRICULAR ACTIVITIES STILL
HAVE SUICIDAL THOUGHTS.
SO I THINK IT'S REALLY IMPORTANT
THAT WE ARE EDUCATING
INDIVIDUALS THAT ARE HOSTING
THOSE EVENTS OR HOSTING THOSE
SPORTS OR, YOU KNOW, COACHING
THOSE SPORTS, ET CETERA, SO THAT
THEY CAN MAKE SURE THAT THEY'RE
WATCHING THE KIDS AND ENGAGING
WITH THOSE KIDS AND MAKING SURE
THAT THEY'RE OKAY.
IF YOU'RE NOTICING SOMETHING
THAT'S OFF, CHECKING IN WITH
THAT CHILD.
AND THEN I FORGOT THE OTHER PART
OF THAT QUESTION, I APOLOGIZE,
TOM.
>>I THINK YOU COVERED IT
BASICALLY.
>>OKAY.
>>OH, WELL THE OTHER THING IS
JUST LIKE, WHICH IS KIND OF AN
ADD-ON FROM ME, LIKE
SCHOOL-BASED INTERVENTIONS, HOW
EFFECTIVE ARE THOSE.
>>YEAH, SO I WOULD SAY THE
SCHOOL-BASED INTERVENTIONS, IT
DEPENDS.
IT'S TRUE.
THERE'S A NUMBER OF SCHOOL-BASED
INTERVENTIONS THAT ARE OUT
THERE, AND SOME PROBABLY ARE
BETTER THAN OTHERS, I WOULD
DEFINITELY ADMIT TO THAT.
AND I THINK IN TERMS OF LOOKING
AT MINORITIZED YOUTH, SOME MAY
BE BETTER THAN OTHERS.
SO THAT IS SOMETHING TO STILL BE
CONFIRMED.
I THINK -- I CAN JUST SPEAK FOR
OHIO SPECIFICALLY, THEY HAVE
DONE A REALLY GOOD JOB AT
GETTING THE SCIEN SIGNS OF SUICO
SOS, AT THEIR SCHOOLS, MIDDLE
SCHOOLS AND HIGH SCHOOLS AND
CENTRAL AND SOUTHEASTERN OHIO,
AND THAT IS SOMETHING THAT
THEY'VE BEEN CHAMPIONING TO GET
IN EVERY SINGLE SCHOOL THAT THEY
CAN, BECAUSE IT EDUCATES
EVERYBODY WITHIN THAT SCHOOL
SETTING ABOUT THE SCIENCE, AND
WHAT TO LOOK FOR AND WHAT TO DO
WHEN YOU ACTUALLY SEE A SIGN.
IN TERMS OF LOOKING AT HOW WELL
IT DOES, I THINK WE STILL HAVE
TO LOOK AT THAT DATA AND FIGURE
THAT OUT.
BUT WE ARE DOING AT LEAST
SOMETHING IN EDUCATING THOSE
STAFF MEMBERS, THE PARENTS, THE
STUDENTS THEMSELVES, SO THEY CAN
ACTUALLY TAKE SOME ACTION IF
NEEDED.
>>THANK YOU.
CAN YOU GIVE M EXAMPLES OF ANY
COMMUNITY-BASED INTERVENTIONS
THAT HAVE SHOWN A DIFFERENCE IN
DECREASING SUICIDE RATES, A BEST
PRACTICE, IF YOU WILL?
>>YEAH, SO UNFORTUNATELY, NO, I
DON'T HAVE AN EXAMPLE, AS SAD AS
THAT IS.
IN TERMS OF COMMUNITY-BASED, I
THINK IT REALLY BOILS DOWN TO
JUST GETTING EVERYONE ON THE
SAME PAGE.
I THINK NUMBER ONE, WE HAVE TO
EDUCATE IN TERMS OF THAT
COMMUNITY-BASED INSTITUTIONS
KNOW THE PROBLEM IS EXISTS, THAT
IT IS NOT SPECIFIC TO ANY RACE,
ANY GENDER, ANY SEX.
IT EXISTS JUST IN GENERAL.
SO I THINK THAT'S FIRST AND
FOREMOST, JUST EDUCATING THOSE
COMMUNITY LEADERS AND THOSE
WORKERS THAT SUICIDE
UNFORTUNATELY YOUTH SUICIDE, IS
INCREASING, AND WE CAN DO
SOMETHING ABOUT IT.
BUT I THINK IN TERMS OF GETTING
COMMUNITY LEADERSHIP ON BOARD,
LETTING THEM KNOW WHAT ARE THE
THINGS TO LOOK FOR, HOW TO TALK
TO A CHILD IF THEY ARE CONCERNED
ABOUT HOW THEY'RE ACTING OR HOW
THEY'RE FEELING OR WHAT THEY'RE
DOING.
AND THEN ALSO WHAT ARE THOSE
NEXT STEPS NEEDED TO TAKE
ACTION?
SO I KNOW BACK IN OHIO, AGAIN,
WE WERE WORKING WITH THE BOYS
AND GIRLTS CLU GIRLS CLUB TO ACT
EDUCATING THEIR STAFF MEMBERS ON
WHAT ARE THOSE SIGNS TO LOOK
FOR, AND WE DID SO WITH
LEADERSHIP BUT ALSO ALL OF THE
FOLKS THAT WORKED WITH THE KIDS
THEMSELVES.
SO THAT THEY WERE ABLE TO
UNDERSTAND -- BECAUSE THEY'RE ON
THE GROUND, RIGHT?
THEY'RE ON THE GROUND, RUNNING.
THEY KNOW WHAT'S GOING ON, THEY
KNOW WHAT'S HAPPENING.
THEY'VE TALKED WITH JOHNNY AND
JIM AND WHOEVER.
SO THEY UNDERSTAND THAT IF
JOHNNY IS ACTING A CERTAIN WAY,
IT'S OFF.
SO I THINK THEY ARE THE ONES
THAT WE NEED AT THE TABLE, AND
NOT ONLY THAT, I THINK WE NEED
TO GET KIDS' VOICES AT THE TABLE
AS WELL.
I WAS VERY HONORED TO BE A PART
OF A 2-DAY LIKE -- WE CALL THEM
EXPERT PANEL WITH SAMHSA, WHERE
WE HAD YOUTH VOICE PRESENT, AND
THAT WAS LIKE THE BEST PART OF
THE WHOLE ENTIRE EXPERIENCE FOR
ME, IS BEING ABLE TO HEAR THEM,
AND TO BE ABLE TO UNDERSTAND
WHERE THEY WERE COMING FROM AND
WHAT THEY WANTED TO SEE WHEN IT
CAME TO PREVENTION EFFORTS AND
IT WAS SUCH A GREAT EXPERIENCE,
AND I THINK THAT LISTENING TO
YOUTH CAN ACTUALLY HELP US GAIN
SOME PERSPECTIVE ON WHAT SHOULD
BE MOST APPROPRIATE IN COMMUNITY
SETTINGS AND ALSO IN SETTINGS
LIKE WHERE I AM NOW, IN
HOSPITALS AS WELL.
>>THANK YOU.
WE STILL HAVE SEVERAL MORE
QUESTIONS COMING IN.
I WAS WONDERING, DR. SHEFTALL,
IF YOU DON'T MIND, WOULD YOU
MIND PUTTING UP THAT SLIDE AGAIN
THAT ACTUALLY HAD THE CONTACT
INFORMATION?
I THINK IT MIGHT BE GOOD TO HAVE
AS WE'RE GOING THROUGH
QUESTIONS, BUT I THINK I'LL
SHARE THAT BECAUSE I THINK THAT
IS -- NOT JUST PROFESSIONALLY,
BUT PERSONALLY, WE CAN SHARE
THAT WITH ONE ANOTHER.
>>ABSOLUTELY.
>>WE'LL JUST KEEP THAT UP --
NOT THAT ONE, BUT THE -- THE
TEXT NUMBERS AND THE CRISIS
LINE.
>>ABSOLUTELY.
>>LET'S JUST KEEP THAT UP WHILE
WE CONTINUE TO TALK.
SO NEXT QUESTION.
THE ISSUE OF ADHD, UNTREATED,
AND ITS RELATIONSHIP WITH
SELF-HARM BEHAVIORS.
>>YES.
OF YEAH, SO UNFORTUNATELY, IN
THE WORK THAT WE'VE DONE, WE'VE
SEEN THAT ADHD IS THAT DIAGNOSIS
THAT UNFORTUNATELY THESE
ELEMENTARY SCHOOL-AGED YOUTH ARE
MORE LIKELY TO BE DIAGNOSED
WITH, AND THAT IS
COUNTERINTUITIVE BECAUSE
UNFORTUNATELY IN THE FIELD, WE
ALWAYS THINK DEPRESSION,
DEPRESSION, DEPRESSION.
THAT'S WHAT WE SHOULD BE
FOCUSING IN ON.
BUT IT MAY BE THAT WE NEED TO
REALLY START THINKING ABOUT
ADHD.
AND IT MAKES SENSE WHEN YOU
START TO THINK ABOUT IT.
ADHD, KIDS ARE HIGHLY IMPULSIVE,
THEY THINK -- WELL, THEY THINK
WITHOUT -- THEY DO WITHOUT
THINKING, THEY DO UNFORTUNATELY
TEND TO HAVE SOME POTENTIAL
SELF-HARM BEHAVIOR.
NOT ALL KIDS WITH ADHD DO, BUT
SOME DO.
AND IT JUST MAKES A LOT OF SENSE
THAT IT WOULD BE A DIAGNOSIS
THAT WE SHOULD BE FOCUSING IN
ON, OUR ATTENTION ON, BUT WE
HAVEN'T DONE SO IN THE PAST.
AND IT KEEPS ON COMING UP AND IE
RESEARCH THAT WE'VE DONE, AND I
THINK THAT MIGHT BE ANOTHER
OPPORTUNITY FOR INTERVENTION.
IF WE HAVE A CHILD THAT'S COMING
IN FOR A MEDICATION CHECK, WHY
NOT JUST SCREEN THEM REALLY
QUICKLY TO MAKE SURE THAT
THEY'RE OKAY?
AND THAT COULD, YOU KNOW, HELP
CATCH SOMETHING EARLIER ON THAN
FINDING OUT WHEN THE NEXT
MEDICATION CHECK HAPPENS THAT
SOMETHING HAS OCCURRED.
SO AGAIN, ANOTHER OPPORTUNITY
FOR SCREENING AS WELL MIGHT BE
FOCUSING IN ON KIDS THAT HAVE
ADHD SPECIFICALLY.
>>THANK YOU.
AND THAT IS SOMETHING WE'RE
DOING HERE AT THE CLINICAL
CENTER, WHEN ADMITTING PATIENTS,
THAT IS, SCREENING.
ANOTHER QUESTION.
CAN YOU COMMENT ON HOW ATTENTION
TO SOCIAL MEDIA MAY HAVE AN
IMPACT ON THESE YOUNG GROUPS,
AND DO YOU HAPPEN TO HAVE ANY
DEMOGRAPHIC INFORMATION FOR
LOCATIONS ACROSS THE COUNTRY OF
THE GROUPS YOU REFERRED TO?
SO BASICALLY SOCIAL MEDIA, HOW
THAT MAY BE INFLUENCING SUICIDE
AND SUICIDAL BEHAVIORS.
>>YEAH, SO WE DO KNOW, THIS IS
THE WORLD OF SOCIAL MEDIA.
I WILL ATTEST, MY HUSBAND YELLS
AT ME ALL THE TIME.
I DON'T HAVE A TWITTER ACCOUNT,
I DON'T HAVE AN INSTAGRAM, I
DON'T HAVE ANY OF THAT STUFF,
BUT IT IS A THING, RIGHT?
AND I THINK UNFORTUNATELY, IF I
AM UNDERSTANDING CORRECTLY,
SOCIAL MEDIA IS BECOMING MORE OF
A THING YOUNGER AND YOUNGER AND
YOUNGER AS WE START TO SEE THE
GENERATIONS MOVE FORWARD.
SO I THINK IT DOES ACT AS A
POTENTIAL RISK FACTOR.
IS IT THE LEADING CAUSE FOR
SUICIDE IN YOUTH?
NO, I DO NOT BELIEVE THAT.
BUT I DO BELIEVE IT IS A RISK
FACTOR, BECAUSE UNFORTUNATELY,
THERE'S A LOT OF BAD STUFF OUT
THERE, RIGHT?
SOMEBODY WAS TELLING ME RECENTLY
ON YOUTUBE, YOU CAN LOOK UP WAYS
TO ACTUALLY -- AND I'M SORRY IF
THIS CAUSES ANY CONCERN OR ANY
TRAUMA IN ANYBODY THAT'S ONLINE,
BUT YOU CAN LOOK UP WAYS TO
ACTUALLY DIE BY SUICIDE.
ON YOUTUBE.
AND THEY GIVE YOU INSTRUCTIONS
ON HOW TO DO THESE THINGS.
AND THAT ITSELF IS TERRIFYING.
AND THAT WAS NOT AROUND WHEN I
WAS GROWING UP.
THAT WASN'T.
SO HAVING THIS ACCESS
UNFORTUNATELY INCREASES
KNOWLEDGE THAT WE ARE NOT
WANTING KIDS TO HAVE, RIGHT, AND
ALSO I KNOW THERE'S A LOT THAT'S
BEEN STATED ABOUT COMPARING, SO
SOCIAL MEDIA, YOU PUT YOUR BEST
FOOT FORWARD SOMETIMES, AND --
NOT ALL THE TIME BUT MOST PEOPLE
DO, AND SOME KIDS ARE ALWAYS
CONSTANTLY COMPARING THEMSELVES
TO OTHERS, AND HOW DOES THAT
AFFECT THEIR SELF-ESTEEM.
SO I DO BELIEVE IT CAN BE A RISK
FACTOR, BUT I DON'T BELIEVE IT
IS THE ONLY FACTOR THAT PLAYS A
ROLE WHEN IT COMES TO YOUTH
SUICIDE.
>>THANK YOU.
ANOTHER QUESTION.
WONDERFUL PRESENTATION,
DR. SHEFTALL.
APPRECIATE HEARING YOUR PERSONAL
STORY TOO, QUITE POWERFUL
ACTUALLY.
COULD YOU PLEASE SAY MORE ABOUT
SUICIDE AMONGST THE 5 TO
12-YEAR-OLD AGE GROUP?
HOW DO YOU KNOW THOSE ARE
ACCIDENTAL, PARTICULARLY AMONG
THE 5-YEAR-OLDS?
>>YEAH, NO, THAT'S A GREAT
QUESTION.
UNFORTUNATELY, I WILL DEFINITELY
ATTEST, WHEN I STARTED LOOKING
AT THIS AGE GROUP, I WAS VERY
DOUBTFUL, BECAUSE I WAS LIKE,
WAIT, WHAT?
5?
WHAT IS HAPPENING?
WHY?
WHY WOULD THERE EVEN BE CASE
THAT A 5-YEAR-OLD WOULD WANT TO
TAKE THEIR OWN LIFE?
UNFORTUNATELY, OR FORTUNATELY,
WHICHEVER WAY YOU WANT TO LOOK
AT IT, CORONERS AND MEDICAL
EXAMINERS DO A LOT OF WORK
BEFORE THEY DETERMINE A CAUSE OF
DEATH.
AND THAT IS THEIR AREA OF
EXPERTISE, SO I WOULD DEFINITELY
SAY THAT WHEN IT IS A SUICIDE,
THEY HAVE DONE THEIR DUE
DILIGENCE AND DONE THEIR
RESEARCH TO MAKE SURE THAT IS
THE CASE.
I THINK EVEN AT THIS YOUNGER
AGE, THEY WOULD DO EVEN MORE
RESEARCH, HONESTLY, TO MAKE SURE
THAT THEY'RE GETTING IT RIGHT.
SO I THINK IN TERMS OF THAT
OCCURRING, YES, IT DOES, AND
AGAIN, I THINK IT'S JUST
SOMETHING THAT WE HAVE NOT,
MYSELF INCLUDED, HAVE NOT EVEN
THOUGHT OF OR EVEN BEEN EDUCATED
ON.
WHEN I WAS GROWING UP IN THIS
FIELD, I THOUGHT SUICIDE OR
SUICIDAL BEHAVIOR STARTED IN
ADOLESCENTS.
BUT WE ARE FINDING THAT EVEN AT
THIS YOUNGER AGE RANGE, IT DOES
EXIST, AND IT IS UNFORTUNATELY
THE FIFTH LEADING CAUSE OF DEATH
IN THIS AGE RANGE.
>>THANK YOU.
THAT'S VERY DISTURBING, BUT
THANK YOU FOR YOUR WORK IN THIS
FIELD TO UNDERSTAND IT BETTER.
ANOTHER QUESTION.
GREAT TALK.
YOU SPOKE ABOUT THE PHYSICAL
ILLNESS BEING A RISK FACTOR FOR
SUICIDE.
CAN YOU SPEAK ABOUT THE ROLES OF
PEDIATRICIANS IN SUICIDE
PREVENTION?
>>YEAH, I THINK -- FIRST OF
ALL, I LOVE PEDIATRICIANS.
I THINK THEY'RE AMAZING.
THEY DO A LOT OF HARD STUFF.
NOT WHAT I WANT TO DO, TO BE
100% HONEST.
PSYCHIATRISTS AS WELL.
A LOT OF HARD STUFF.
AND I THINK THAT PEDIATRICIANS
SEE THESE KIDS ONCE A YEAR.
SO WELL CHECKS EVERY YEAR, OR
SINUS INFECTION, MAYBE THREE
TIMES A YEAR, RIGHT?
OR WHATEVER.
SO I THINK AS PEDIATRICIANS, WE
GET TO SEE KIDS -- WELL, NOT ME,
BUT PEDIATRICIANS IN GENERAL GET
TO SEE KIDS MORE FREQUENTLY THAN
PROBABLY OTHER DOCTORS DO,
DEPENDENT ON, YOU KNOW, THAT
CHILD'S WELL-BEING AND WHAT THEY
ARE DIAGNOSED WITH.
SO I THINK, AS MUCH AS
PEDIATRICIANS WILL HATE ME
SAYING THIS, IT'S AN AVENUE FOR
INTERVENTION.
I REALLY DO BELIEVE THAT,
WHOLEHEARTEDLY, THAT JUST DOING
A SCREEN OF SOMETHING REALLY
QUICKLY IN THE WAITING ROOM FOR
THESE KIDS CAN ACTUALLY DO A
GREAT SERVICE FOR ACTUALLY
HELPING YOUTH.
I THINK PEDIATRICIANS -- AND
MAYBE I'M SPEAKING OUTRAGEOUSLY
SO PLEASE FORGIVE ME, I THINK
IT'S UNCOMFORTABLE BECAUSE IT'S
SOMETHING THAT YOU MAY NOT BE
TRAINED IN, RIGHT?
DOING SUICIDE SCREENING IS VERY
SCARY SOMETIMES, BECAUSE IF YOU
GET A YES, WHAT DO YOU DO, ARE
RIGHT?
AND I THINK THAT'S UP TO US AS A
FIELD TO EDUCATE PEDIATRICIANS
ON WHAT THE NEXT STEPS SHOULD BE
IF THAT IS A HESITANCY THAT THEY
DO HAVE.
AND THERE ARE SOME GREAT BIG
HUGE, YOU KNOW, PEDIATRIC
FACILITIES LIKE NATIONWIDE
CHILDREN'S HOSPITAL AND HERE
WHERE I AM NOW THAT CAN DO THIS
AND DO THIS REALLY WELL BECAUSE
THEY HAVE SOCIAL WORK ON STAFF,
THEY HAVE A PSYCHIATRIST, THEY
HAVE A PSYCHOLOGIST, ET CETERA,
BUT WHAT ABOUT THOSE SMALLER
ONES, YOU KNOW, WHERE IT'S JUST
THE DOCTOR AND MAYBE THE
RECEPTIONIST, WHAT ARE WE GOING
TO DO THERE, AND HOW CAN WE
ACTUALLY EMPOWER THAT
PEDIATRICIAN AND THAT
RECEPTIONIST TO LET THEM KNOW
THAT THEY CAN ACTUALLY PREVENT
SUICIDE AS WELL.
SO I THINK IT'S JUST A MATTER OF
EDUCATING AND BEING OPEN AND
HONEST AND LISTENING TO
PEDIATRICIANS' CONCERNS AND
MAKING SURE THAT WE ARE
ADDRESSING THOSE CONCERNS SO
THAT THEY FEEL BETTER ABOUT
DOING THAT SCREENING PROCESS.
>>THANK YOU.
WHAT IS THE CORRELATION BETWEEN
BULLYING AND SUICIDE AND YOUTH?
>>YEAH, SO IT'S PRETTY HIGH.
NOT ONLY FOR THOSE THAT
EXPERIENCE BULLYING, BUT THOSE
THAT ACTUALLY ARE THE BULLY.
SO THERE HAS BEEN SOME RESEARCH
OUT THERE THAT'S SHOWN IT GOES
BOTH WAYS.
THE ONE THAT IS BEING BULLIED IS
AT HIGH RISK FOR SU SUICIDAL
THOUGHTS AND BEHAVIORS, BUT THAT
BULLY ALSO IS AT HIGH RISK FOR
SUICIDAL THOUGHTS AND BEHAVIORS.
>>AT THE BEGINNING, YOU SHARED
A LOT ABOUT THE SUICIDE RATES
INCREASING AMONGST ALL YOUTH,
BUT MORE SPECIFICALLY AMONGST
FEMALE YOUTH.
AND WHY DO YOU BELIEVE THAT TO
BE THE CASE WHILE WE'RE SEEING
THIS DRAMATIC INCREASE FROM MALE
TO FEMALE?
>>THANK YOU FOR ASKING THAT
QUESTION.
SO I THINK, HONESTLY, THE
POTENTIAL REASON, I DON'T KNOW
THIS TO BE 100% HONEST, BUT THE
POTENTIAL REASON IS THIS SHIFT
IN MECHANISM.
SO BACK IN THE DAY, SUICIDE USED
TO -- WOMEN OR FEMALES OR YOUTH,
YOUNG GIRLS, WOULD ATTEMPT
SUICIDE BY POISONING.
SO THEY WOULD DO --
UNFORTUNATELY THEY WOULD TAKE A
BUNCH OF PILLS OR THEY WOULD DO
SOMETHING ELSE THAT INVOLVED
MEDICATION OR SOMETHING OF THAT
NATURE, AND IT WAS TIME FOR US
TO ACTUALLY INTERVENE, SO WE
COULD GET THAT CHILD TO THE
EMERGENCY ROOM, WE COULD PUMP
THEIR STOMACH, WE COULD CALL THE
POISON CONTROL WHILE WE'RE ON
THE WAY, SO WE WERE ABLE TO
INTERVENE WITH GIRLS.
AND THAT WAS LIKE THE NUMBER ONE
METHOD FOR SUICIDE FOR QUITE
SOME TIME.
NOW WE'VE SEEN THIS SHIFT, WHERE
GIRLS ARE NOW DYING BY SUICIDE
USING HANGING SUFFOCATION, AND
NOW WE'RE SEEING AN INCREASE IN
FIREARMS.
AND THOSE ARE VERY HIGHLY LETHAL
METHODS FOR SUICIDE.
AND I THINK THAT'S WHY WE ARE
ACTUALLY SEEING THIS INCREASE
PRESENT, IS BECAUSE THE METHOD
HAS ACTUALLY CHANGED FOR GIRLS
SPECIFICALLY.
>>VERY DISTURBING.
THE LETHALITY OF THE METHOD.
WELL, THAT TAKES US UP TO THE
HOUR.
DR. SHEFTALL, I WANT TO THANK
YOU VERY MUCH FOR YOUR
PRESENTATION AND SHARING YOUR
WORK.
OBVIOUSLY TO THE VOLUME OF
QUESTIONS WE GOT, THIS IS OF
GREAT INTEREST TO THE NIH
COMMUNITY.
SO THANK YOU.
THANK YOU FOR YOUR WORK, AND WE
WISH YOU MUCH SUCCESS IN THE
FUTURE, AND PERHAPS WE'LL HEAR
FROM YOU AGAIN IN THE FUTURE.
TO EVERYONE ELSE, I WANT TO WISH
EVERYONE A GREAT AFTERNOON.
THANK YOU FOR JOINING US TODAY.
>>THANK YOU FOR HAVING ME.