Suicides of Young People Who are Incarcerated Also Demand Attention
Media reports of the suicide of Jeffrey Epstein place a spotlight on the prevalence of suicide by people who are in jail or prison. While an investigation is underway into the circumstances surrounding his death, we can also use this moment to examine the high rates of suicide among incarcerated youth, and what can be done to prevent it.
The National Institutes of Health (NIH) reported in 2018 that suicide was the second leading cause of death among those 10- 34 in the United States. The rate of suicide is exponentially higher for youth who are incarcerated, two to five times the rate of the general population. NIH provided an overview of the research and stark statistics:
The 2011 Youth Risk Behavior Survey estimated that 15.8% of youth in the general population, aged 15 to 19 years, had seriously contemplated suicide in the past year, and 7.8% made at least one attempt (Centers for Disease Control and Prevention, 2012). The National Comorbidity Survey estimates lifetime rates of 12.1% for suicidal ideation and 4.1% for attempts among youth aged 13 to 18 years (Nock et al., 2013)…The first published national survey of suicide among incarcerated juveniles reported that approximately 57 per 100,000 detainees completed suicide, a rate 4.6 times greater than general population rates (Memory, 1989). More recently, the suicide rate was estimated at 21.9 per 100,000 youth in juvenile justice facilities (Gallagher & Dobrin, 2006) compared with approximately 7 per 100,000 adolescents aged 15 to 19 years in the general population.
Many young people in our justice system have histories of trauma and depression. They come into the justice system having suffered sexual abuse, physical abuse and neglect at rates far higher than the general population. Over half and perhaps as many as 70% are estimated to have at least one mental health diagnosis. Instead of a comprehensive, well-functioning mental health system in the community, youth become involved in the justice system which is ill-equipped to deal with their trauma and mental health needs.
We know that family and community support are key to good mental health. For those with a history of trauma, the extensive brain development that takes place during adolescence is an opportunity for new brain pathways and a positive trajectory toward a healthy adulthood. Unfortunately, negative environmental influences also play a role in setting the future trajectory. The justice system too often removes youth from family and community, placing them far from home and in stark, deprived or punitive environments. Placing youth in juvenile or adult institutions causes and exacerbates depression.
The recent report by the National Academies of Sciences, The Promise of Adolescence, provides additional explanation for the high rate of suicide among teens who are incarcerated: abusive conditions — particularly solitary confinement — and disproportionate levels of incarceration of youth who identify as LGBTQ and who are already at heightened risk of suicide.
While more research may be helpful, adolescent developmental science, and common sense, are sufficient to tell us that solitary confinement is harmful to the developing adolescent brain and may lead to depression, suicidal ideation and death.
…studies of incarcerated adults consistently demonstrate that those who experience solitary confinement are at greater risk for mental illness and suicide… considering that many incarcerated youth prior to incarceration experienced trauma or suffered from an undiagnosed mental illness, youth are likely to be particularly vulnerable to the harmful effects of solitary confinement, and it is likely that solitary confinement exacerbates their pre-existing conditions.
The NAS report also points to disparities in the system among high-risk groups.
…the 2015 Youth Risk Behavior Survey data…show higher risk for suicidal thoughts and behaviors among sexual minority youth. Greater than 40 percent of LGB students have seriously considered suicide, and 29 percent report suicidal behavior during the past 12 months…Although to date there are no nationally representative data on suicide risk among transgender youth, a recent representative study of California students showed that the prevalence of self-reported suicidal ideation was nearly two times higher for transgender students compared to the general student population.
Understanding the causes of suicide by teens in our justice system leads to the solutions:
· provide preventive, comprehensive mental health care in the community for all youth, including those who identify as LGBTQ;
· support youth relationships with family and community; and
· for youth who are in placement, ensure the facilities are developmentally appropriate and free of abusive conditions such as solitary confinement.
We have a unique opportunity in this moment to channel our outrage to prevention. We have the knowledge to prevent the death of teens in our care and must find the will to reform our justice system to prevent teen suicides while in custody.