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Department of Human Services
This Child Fatality information provided by the Injury & Violence Prevention section of the Office of Disease Prevention & Epidemiology.

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1999 Annual Report
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1999 Oregon Child Fatality Review Annual Report
- Special Topics

2. Suicide/Intentional Self Harm DeathsSuicide/Intentional Self Harm Deaths: 24 in 1997, 16 in 1998, 18 in 1999.

In 1999 there were 18 incidents in which a youth under age 18 engaged in intentional self harm 6 which led to their death. Deaths due to intentional self harm or suicide among children numbered 20 in 1997 and 16 in 1998. Included among the 18 deaths in 1999 were 16 suicides and 2 cases of Russian Roulette. 7 The rate of intentional self-harming behavior among youth aged 15-17 was almost six times that among those aged 10-14 (4 incidents among those aged 10-14, for a rate of 1.7 compared to 14 among those aged 15-17, for a rate of 9.5). Males were five times more likely to die from self harm than females (15 incidents among males compared to three incidents among females). Six incidents occurred while the victim was under the influence of alcohol or other drugs. All of the victims were white. In this group of deaths, 56% (10) were firearm incidents. Six of the guns used were handguns and four were long guns. Seventy percent (7/10) of firearms were stored unlocked with ammunition. The storage location for one gun was unknown. The firearms belonged either to the victims? parents (5), the victim (2) or an adult acquaintance (1).


All 10 firearm incidents involved a male victim. According to the 1999 Oregon Behavioral Risk Factor Survey, 44% of Oregon homes contain firearms.8 Youth access to firearms increases the risk of suicide.

The remaining incidents of self harming behavior include suicide due to hanging (4), jumping from a bridge and drowning (1), insulin poisoning (1), intentionally lighting oneself on fire (1), and a motor vehicle crash. Of the four suicides by hanging, three (75%) were male.


There was a group of three suicides in Eastern Oregon within a short period of time. The temporal and geographic clustering of these three deaths suggests that they were related to each other. In two firearm incidents the children knew each other and were friends.

Sixty-one percent (11) of the youth who died by intentional self harm had a family history of receiving services from SCF, six of the youth had child abuse and neglect referrals.

Ninety-four percent (17) of these children had at least one of these recognized risk factors, and 67% (12) had two or more of these risk factors.Data were available on whether or not the following risk factors for suicide were present in each case: prior arrests or convictions for crime, a history of a prior suicide attempt, history of mental health problems, current mental health treatment, gender or sexual orientation issues, alcohol or substance abuse history, and problems with school attendance and/or grades. Ninety-four percent (17) of these children had at least one of these recognized risk factors, and 67% (12) had two or more of these risk factors. Table 4 shows the number of youth with a history of risk factors. The presence of these risk factors may help identify high risk youth who should be the focus of prevention efforts.
TABLE 4.
Reported risk factors associated with death by self-harm among Oregon youth
aged 10-17,1999 N=18

Risk Factor# Victims with Risk
Prior Arrests/Convictions11
Family Discord8
History of Depression7
School Problems7
Prior Suicide Attempt6
Received Mental Health Treatment6
Abuse/Neglect Referrals to SCF6
History of Alcohol Abuse5
Social/Emotional Disability4
Family History of Suicide3
Source: Child Fatality Review Data

Prevention efforts should focus on youth with identified risk factors.In all cases a death scene investigation occurred; however, some investigative reports on suicides were as brief as two or three sentences. The state CFR team members determined that a more thorough investigation of suicide deaths is warranted. Often investigations included only family members as sources of information. Additional important information could be gathered from sources such as school and the youth?s peers.

The Oregon Plan for Suicide Prevention and additional information on youth suicide are available at the Health Services website under the Center for Disease Prevention and Epidemiology, and then the Injury Prevention and Epidemiology section at: www.ohd.hr.state.or.us/ipe.

Recommendations to Prevent Suicide/Intentional Self Harm Deaths
The Harney County team met to develop a response after youth suicide and attempts.

  • Implement Oregon's Youth Suicide Prevention Plan.
  • Focus suicide prevention efforts on youth with known risk factors.
  • Identify youth at risk for suicide by screening for risk factors such as depression.
  • Screen all youth entering juvenile justice custody for depression and suicide risk and screen at regular intervals during long-term custody.
  • Encourage health care providers to assess firearm access in the homes of suicidal youth.
  • Remove or lock up guns in homes where youth at risk for suicide live.
  • Conduct more thorough investigations of suicides by including information from sources beyond immediate family members at the death scene.
  • Educate authorities that suicide affects more than just the youth who dies. A potential for suicide clusters exists. In response to a suicide in a school or other institution, implement a crisis response plan that includes debriefing, screening, referral, counseling, and support for other youth and parents.

Examples of current safety initiatives

  • Oregon Youth Suicide Prevention Plan
  • "Gatekeeper" training
  • Depression screening and treatment
  • Comprehensive health care at School Based Health Centers
  • American Foundation for Suicide Prevention (AFSP) annual survivor conference
  • AFSP youth suicide prevention public education campaign
  • Suicide Awareness Voices of Education depression awareness campaign


A 13 year old boy shot himself on a Monday afternoon with a 22 caliber rifle that belonged to his father. The youth was a student at a local high school. Several friends of the boy came forward to report that the boy was talking about killing himself but no one reported the suicide threats to adults. The teen was reportedly despondent about problems he was having with school, family and peers. The blood alcohol content just after the death of this teen was 0.07. He also tested positive for marijuana.


6. The term "suicide" which has been used to describe a manner of death is being replaced with "intentional self harm" in the International Classification of Diseases, 10th edition. The ICD-10 classification coding was implemented in coding data from deth certificates in 1999.

7. There is a lack of consistency among Medical Examiners regarding determination of the manner of death among those who harm themselves by placing a loaded firearm to their heads and pulling the trigger. This action, sometimes "played" in a group is known as Russian Roulette. Among Medical Examiners across the U.S., only one state, New Mexico has standardized its approach by classifying Russian Roulette deaths as intentional self harm/suicide.


 
Page updated: September 22, 2007

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