Adolescents Especially Vulnerable to Suicide Clusters
A potential hurdle for clinicians and communities following adolescent suicides is to promote preventability while simultaneously reducing feelings of guilt.
According to the US Centers for Disease Control and Prevention, suicide is one of the leading causes of death in the United States, second only to accidental deaths, among people aged 10 to 24, comprising 16.8% of deaths in that age range.1
This age group may also be especially vulnerable to a related phenomenon: suicide clusters. Suicide clusters are defined as multiple suicidal behaviors or suicides that fall within an accelerated time frame and sometimes within a defined geographic area. One of the most recent suicide clusters occurred in Santa Clara County in Palo Alto, California, during which time 6 teenagers in Palo Alto took their lives over a 9-month period during 2009 and 2010, and 4 more teens completed suicide throughout 2014 and 2015.
These recent occurrences are examples of point clusters, which “occur in a specific place and over a relatively small period of time,” Jason R. Randall, MSc, PhD(c), a researcher and doctoral candidate in the Department of Community Health Sciences at the University of Manitoba, told Psychiatry Advisor. Mass clusters occur over a relatively short period of time but are not isolated to a specific location. Geographic clusters take place in a specific area over a longer span of time. “An example of [a geographic cluster] is the Golden Gate Bridge, where a significant number of people have died over a span of decades,” Dr Randall said.
A formal request from the California Department of Public Health for assistance from the CDC recently prompted the agency to launch an epidemiologic investigation there2 in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA).
While experts generally agree that suicide clusters do occur, there is less clarity about why they occur. “Two possible explanations for suicide clusters are that adolescents observe and model each other's suicidal thoughts and behaviors, or that adolescents prone to suicidality may tend to hang around with each other to begin with,” Caroline Abbott, a researcher and doctoral student in clinical psychology at the University of Delaware, told Psychiatry Advisor. “Peer groups during adolescence are incredibly important and influential,” she said.