Adolescent suicidal behaviors, self rated health and multiple health risk behaviors: Exploring new perspectives in suicide prevention research

We sought to evaluate the extent to which self-rating of health, gender, and the co-occurrence of other health risk behaviors were related to suicidal behaviors among adolescents. Cross-sectional survey data of Colorado middle and high school students aged 12 to 18 years were analyzed using logistic regression. Main outcome variables were suicide ideation, suicide planning, and suicide attempt. Predictors included self-rated health, self-reported health behaviors, perception of body image, expression of sadness and hopelessness, self-reported sexual abuse, self-reported access to lethal weapon, and expression of school safety concerns. Adjusted results showed respondents with poor health rating had significantly higher odds of suicidal ideation (OR: 2.22), suicidal planning (OR: 1.35), and suicide attempt (OR: 2.23). Reporting of hopelessness was the most consistent predictor of suicidal behaviors with odds ratios ranging from 5.57 (for suicidal ideation) to 17.40 (for suicidal attempt). Factors associated with different adolescents’ suicidal behaviors were different for boys and girls. Findings suggest the need to consider gender differences as regards self assessment of health in order to improve the effectiveness of suicide interventions among adolescents.