Prevention of suicide by youth health care

The objective of this study was to examine the effect of freely accessible consultation hours in secondary schools by youth health care departments, on population rates for suicide and parasuicide. To this end, an ecologic case-referent study design was used, with data from the Netherlands Bureau of Statistics, the National Hospital Discharge Register, the High-School Students Study, the youth health care departments in the Netherlands and relevant census. Cases were 137 suicide victims aged 15-19 y and 182 12-18 y old subjects admitted to hospital because of parasuicide and additionally coded as having had surgery as a consequence of the attempted suicide or having a pertinent psychiatric disorder. The relevant census in the regions of the participating youth health care departments served as referents. The High-School Students Study included 4997 students aged 12-18 y of which 303 reported having attempted suicide at least once. In the ecologic case-referent studies the adjusted Odds Ratio for completed suicide in regions with open consultation hours was 0.98 (95% CI 0.69-1.38) and the weighted Odds Ratio for parasuicide was 1.30 (95% CT 0.97-1.75). Analysis of the data of the High-School Students Study resulted in an Odds Ratio of 0.96 (95% CI 0.72-1.26). The overall homogeneous Odds Ratio for (para)suicide in regions with open consultation hours for all three studies was 1.00 (95% CI 0.97-1.04); the heterogeneous Odds Ratio was 1.08 (95% CI 0.95-1.09). This study does not support the hypothesis that regions, where youth health care departments have instituted freely accessible consultation hours in secondary schools, show lower rates of suicide or parasuicide compared to regions where no consultation hours were implemented.