Ottawa County Youth

Suicide Prevention Coalition

2011

REPORT

1

Please Note:

The data in this report is part of a pilot effort

to develop a youth suicide prevention plan

for Ottawa County. The data contained in

this report is preliminary due to changes

made in the data collection process part

way through the 2011 calendar year.

2

Table of Contents:

Page

General Information 3

2011 Data Overview 7

Youth Suicidal Behaviors 17

Repeated Episodes 33

Suicides – All Ages 39

Ottawa County Youth Assessment

Survey Results 48

Significant Associations 59

Contact Information 63 3

Surveillance sub-committee

Members:

Donna Cornwell, OCHSCC

Lee Hoeksema, OC Sherrif

Marcia Knol, OCHD

Sandy Boven, OCHD

Lupita Reyes, LLOC

Pat Rasch, Parish Nurse 4

Data Collection Partners

Law Enforcement

Hospitals

Medical Examiner

Community Mental Health

Ottawa County Youth Assessment

Survey

1,721

total

entries

5

UniqueID Organization

Race/Origin Sex County

Code

Age Date Category

Means

ID:

Enter unique

8 digit code #:

First initial of

first name +

First initial of

last name +

8 digit birth date

(Jan 8, 1992 =

01081992)

Type of Agency:

C: Community

Mental

Health

H: Health Care

L: Law

Enforcement

M: Medical

Examiner

Enter Letter

Code for

Race:

W: White

A: Asian,

Middle Eastern,

Pacific Islander

B: Black/

African American

N: Native

American

Indian

H: Hispanic/Latino

O: Other

U: Unknown

Enter

Sex:

F: Female

M: Male

T:

Transgender

Resident of

Ottawa

County:

Y: Yes

N: No

Enter Age

in Years:

Age in years

at

Time of

Encounter

Enter Date of

Encounter:

mm/dd/yyyy

Enter Suicide

Category Code:

I: Suicidal

Ideation

(Seriously

Considering

Suicide)

N: Suicidal

Intent (has a

suicide plan)

A: Suicidal

Attempt (act to

harm self with

intention to end

one’s life)

C: Completed

Suicide

(intentional

taking of one’s

life)

Enter Method

Utilized:

(When a suicide

is attempted or

completed, enter

method code)

1: Self-Inflicted

Injury, Cut

2: Self-Inflicted

Injury, Shot

3: Poisoning,

Overdose

4: Asphyxiation

5: Hanging

6: Jump

7: Motor Vehicle

8: Other

9: Unknown

Data Collection Template

6

2011 Overview of Youth

Encounters

7

Total = 831 Youth Encounters (defined as < age 25)

Gender N % Race/Ethnicity N %

Female 485 58.4% White, Non-Hispanic 707 84.9%

Male 345 42.6% Unknown 26 3.1%

Age Group African American 46 5.5% Before High School

(< age 14) 57 6.9% Hispanic/Latino 34 4.1% High School

(14-18) 361 43.3% Other 19 2.3% Post High School

(19-24) 468 49.9%

2011 Calendar Year

8

2011 Calendar Year

Total = 831 Youth Encounters (< age 25)

Behavior N % Organization N %

Ideation 535 64.4% CMH 207 25.8%

Attempt 291 35.0% Healthcare 445 47.2%

Suicide 5 0.6% Law Enforcement 237 26.6%

Ottawa Res. Med. Examiner 5 0.4%

Yes 712 85.6%

No 120 14.4% *11.4% of encounters had more than 1 organization involved.

9

Research shows:

Half of all lifetime cases of mental

illness begin by age 14.

Scientists are discovering that changes

in the body leading to mental illness

may start much earlier, before any

symptoms appear.

National Institute of Mental Health (NIMH), “Treatment of Children with Mental Illness” 10

2011 Youth Encounters:

Age

0

10

20

30

40

50

60

70

80

90

100

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 2411

2011 Youth Encounters:

Age by Gender

0

10

20

30

40

50

60

70

80

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

FEMALE

MALE

12

2011 Youth Encounters:

Month

0

10

20

30

40

50

60

70

80

90

100

UNIQUE ID

13

2011 Youth Encounters:

Day of Week

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

MON TUE WED THU FRI SAT SUN 15

Key Points: Overall Spike in activity at age 14 – especially females

More encounters with females than males

Mid week more prevalent than weekend

Need a full year of ID for prevalence by month

16

2011 Suicidal Behaviors

17

Suicidal Ideation: seriously considering suicide

535

18

Suicide Attempt: an act to harm self with intention

to end one’s life

291

19

Suicide: Youth intentional taking of one’s life

5

20

2011 Youth Encounters:

Behavior by Age Group

0

50

100

150

200

250

300

<14 14 - 18 19 - 24

IDEATION

ATTEMPT

SUICIDE

High School After HS Before HS 21

2011 Youth Encounters:

Behavior by Age Group

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

<14 14 - 18 19 - 24

IDEATION

ATTEMPT

SUICIDE

High School After HS Before HS 22

2011 Youth Encounters:

Behavior by Gender

0

50

100

150

200

250

300

350

FEMALE MALE

IDEATION

ATTEMPT

SUICIDE

23

2011 Youth Encounters:

Behavior by Race

0

50

100

150

200

250

300

350

400

450

500

WHITE BLACK HISPANIC OTHER

IDEATION

ATTEMPT

SUICIDE

24

2011 Youth Encounters:

Behavior by Race

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

WHITE BLACK HISPANIC OTHER Overall

IDEATION ATTEMPT SUICIDE

25

2011 Youth Encounters:

Behavior by Day

0

10

20

30

40

50

60

70

80

90

100

MON TUE WED THU FRI SAT SUN

IDEATION

ATTEMPT

27

2011 Youth:

Method of Attempts

0

20

40

60

80

100

120

140

160

180

28

2011 Youth:

Method of Attempts by Sex

0%

10%

20%

30%

40%

50%

60%

FEMALE

MALE

30

2011 Youth:

Method of Attempts by Race

0%

10%

20%

30%

40%

50%

60%

WHITE

BLACK

HISPANIC

OTHER

31

Key Points: Ideation/Attempts

All behavior categories increase with age

Higher proportion of females attempt than males

Sundays: attempts and ideation nearly equal

Hispanic: attempts and ideation nearly equal

Over 90% of all attempts use “Poison/Overdose”

or “Cut”

32

2011 Repeated Episodes

33

2011 Youth:

Repeated Episodes

89.4%

10.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Once

More thanonce

N = 403

(among those with

a unique identifier)

Among all youth encounters:

34

2011 Youth:

Repeated Episodes by Race

22.2%

10.3% 9.5%

0.0% 0%

5%

10%

15%

20%

25%

Black

White

Hispanic

Other

Among all encounters, the proportion with 2 or more episodes:

35

2011 Youth:

Repeated Episodes

74.4%

18.6%

7.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Twice

Three times

Four or more

Range: 2 to 22

Among those with 2 or more episodes:

36

2011 Youth:

Repeated Episodes by Category

55.8%

37.2%

7.0%

0%

10%

20%

30%

40%

50%

60%

Only Ideation

Ideation & Attempt(s)

Only Attempts

Among those with two or more episodes:

37

Key Points: Repeated Episodes This data is preliminary and based on a partial year

Higher proportion of repeats among Black youth

12.7% of females repeat versus 8% of males

38

2011 Suicides: All Ages

39

Total = 25 Completed Suicides

Gender N % Age Group N %

Female 8 34.8% < 25 5 25.0%

Male 17 65.2% 25-39 2 8.0%

Race/Ethnicity 40-49 5 25.0%

White 25 100.0% 50-59 6 24.0%

Hispanic 0 0.0% 60+ 7 28.0%

Other 0 0%

2011 Suicides:

All Ages

40

2011 Suicides:

Age Group

0

1

2

3

4

5

6

7

Under 20 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 andover

41

2011 Suicides:

Age Group by Gender

0

1

2

3

4

5

Under 20 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 andover

Male

Female

42

2011 Suicides:

Month

0

1

2

3

4

5

Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep

Bar contains youth suicide

43

2011 Suicides:

Day of Week

0

1

2

3

4

5

6

MON TUES WED THUR FRI SAT SUN

44

2011 Suicides:

Method by Gender

0

2

4

6

8

10

12

SHOT HANG POISON/O.D. ASPHYX. TRAIN

Male

Female

45

All Suicides: Historical Trend

0

5

10

15

20

25

30

Count All Ages

Rate per 100,000

46

Key Points: Most suicides over age 24: 75%

More male suicides: 68%

Method is more “violent”: 76% Shot/Hanged

Race: White

Historically, rate is stable to slightly increasing

47

Ottawa County

Youth Assessment Survey

Youth Assessment

Survey

• What is the Youth Assessment Survey?

• Content Areas:

– Physical Activity, Nutrition, Body Weight

– Safety and Violence Related Behaviors

– Substance Use

– Risk and Protective Factors

– Sexual Behavior

49

Depression

During the past 12 months, did you ever feel so

sad or hopeless almost every day for two weeks

or more in a row that you stopped doing some

usual activities.

Yes

No

50

Attempts

During the past 12 months, how many times

(if any) did you attempt suicide?

0

1

2-3

4 or more 51

New for 2011: Ideation

During the past 12 months, did you ever

seriously think about attempting suicide?

Yes

No

52

New for 2011: Plan

During the past 12 months, did you make a plan

about how you would attempt suicide?

Yes

No

53

Keep in Mind…

• Can’t: YAS is an observational study so can’t

make predictions or cause/effect conclusions

• Can:

Get proportion estimates and inferences

Identify possible contributing factors by

probability

Find associations

55

Depression and Suicide

In the past year:

21.8%

13.2%

8.5%

4.5%

0%

5%

10%

15%

20%

25%

Felt so sad or hopelessfor two weeks and

stopped doing usualactivities

Ever seriously thinkabout attempting

suicide

Made a plan about howI would attempt suicide

Attempted suicide oneor more times

2005

2007

2009

2011

56

Depression and Suicide In the past year:

28.9%

17.4%

10.8%

6.4%

14.6%

9.2%

6.1%

2.6%

0%

5%

10%

15%

20%

25%

30%

Felt so sad or hopelessfor two weeks and

stopped doing usualactivities

Ever seriously thinkabout attempting suicide

Made a plan about howI would attempt suicide

Attempted suicide oneor more times

Female Male

57

Depression and Suicide In the past year:

18.8%

11.5%

7.4%

3.8%

24.6%

15.4%

9.8%

5.4%

21.6%

12.8%

8.4%

4.2%

0%

5%

10%

15%

20%

25%

30%

Felt so sad or hopelessfor two weeks and

stopped doing usualactivities

Ever seriously thinkabout attempting suicide

Made a plan about how Iwould attempt suicide

Attempted suicide one ormore times

8th

10th

12th

58

Digging Deeper in the 2009 YAS

Used Multiple Logistic Regression to model which questions in the survey may be associated with students reporting:

Feeling sad or hopeless almost every day for two weeks in the past 12 months.

A suicide attempt 1 or more times during the past 12 months.

59

Key Findings: Depression 7 new or existing variables…

Gender: Female Male

Access to Tobacco

Perceive Risk in Binge Drinking

Perceive Neighborhood as Unsafe

Harmed by a Parent

Perceive High Peer Use of Marijuana

Can Talk to Parent

Increases odds of depression: Decreases odds of depression:

60

Key Findings: Attempted Suicide 7 new or existing variables:

Gender: Female Male

Missing School Because Felt Unsafe

Lots of Family Yelling/Insults

Perceive Parents Don’t See Youth Smoking as

Wrong

Harmed by a Parent

Binge Drinking

Better Grades in School

Increases odds of attempts: Decreases odds of attempts:

61

“Profile”: Depression:

• 10th or 12th grade

• Female

• Hispanic

• Lower grades in school

• Involved in fights

• Skip school

• Have had sex

• Multiple sexual partners

• Mult. access sources to cigs

• Harmed by a parent

Attempt:

• 10th grade

• Female

• Hispanic

• Obese

• Lower grades in school

• Involved in fights

• Skip school

• Have had sex

• Multiple sexual partners

• Miss school – unsafe

• Harmed by a parent

• Binge drinking 5+ past month

62

Analysis and Presentation by:

Ottawa County Health

Department

Marcia Knol, Epidemiologist

Kaitlyn Ratkowiak, Intern GVSU

Phone: 616.494.5598 E-mail: mknol@miottawa.org

63