The vast majority of young people who self-harm or experience suicidal thoughts appear to have only mild or moderate symptoms of mental distress, according to a new study published in BMJ Open.
Measures to reduce suicide risk in young people should focus on the whole population and not just those who are most distressed, say the authors.
The researchers analysed levels of common mental distress (CMD) in volunteers aged 14-24 years at two UK centres. Cohort 1 was the Neuroscience in Psychiatry Network (n=2403), and cohort 2 was the ROOTS sample (n=1074).
They found a dose-response relationship between levels of CMD and risk for suicide. The majority of participants experiencing suicidal thoughts (ST) and non-suicidal self-injury (NSSI) had CMD scores ≤2 SDs above the population mean (78% and 76% in cohort 1 and 66% and 71% in cohort 2). Higher scores indicated the highest risk but were, by definition, infrequent. Pathway mediation models showed that CMD mediated the longitudinal course of both ST and NSSI.
Commenting on the findings, Professor Peter Jones, senior author, from the University of Cambridge said: “These findings show that public policy strategies to reduce suicide should support better mental health for all young people, not only those who are most unwell.”
“Even modest improvements in mental health and wellbeing across the entire population may prevent more suicides than targeting only those who are severely depressed or anxious,” he said.