Adolescent and youth suicide is a universal public problem. That is what the World Health Organisation says. Suicide is the leading cause of unnatural deaths in Spain among young people aged 15-29, and the second leading cause of all deaths after malignant tumours. Among adolescents, those living in residential care have more risk factors for suicidal behaviour, which are motivated by traumatic childhood experiences, low self-esteem, poor social skills, etc. So strategies and resources for working with this particular group need to be developed. However, the preparation of appropriate interventions requires information about the situation and, so far, very little has been analysed. 

To address the lack of information, researchers from the University of the Basque Country (UPV/EHU), together with Biobizkaia, carried out a study. Suicidal behaviour and the tendency to self-harm without suicidal intent were analysed in 185 adolescents from 25 care facilities in Bizkaia, Gipuzkoa and Navarre. “As we had very little data until now, we did a piece of innovative research, and the results reveal the need not only to carry out preventive work, professionals also need to receive more training,” explained the PhD holder in psychology Alexander Muela.  

Firstly, the work carried out by researchers at the Faculty of Psychology and the Faculty of Medicine and Nursing explored suicidal behaviour. Among other questions, they investigated whether the individuals concerned have suicidal thoughts, whether they self-harm to commit suicide or whether they actually try to commit suicide. 26.5% of the adolescents participating in this research indicated that they had attempted suicide at some point. As for suicidal thoughts, 36.2% of adolescents report having had them at some time, and it is worth noting that only 37.6% of them have sought help. However, more than half feel that they have no one they can turn to for help.

Secondly, half of the adolescents in residential care who were included in the study say that they self-harm without suicidal intent. As for the reasons that lead them to self-harm, 92% of them claim to have used it as an emotion regulation strategy. “This highlights the need to work on emotional education. We need to equip young people with strategies and resources to regulate emotions,” explained Alexander Muela.

The UPV/EHU study also reveals significant differences in terms of gender. For example, 53.8% of the participating girls confess to having had suicidal thoughts at some point. Among boys, on the other hand, the percentage falls to 18%. And 69.9% of those who have self-harmed without suicidal intent are girls, 28% are boys and 2.1% are non-binary adolescents.

Professionals in children’s homes lack knowledge

The researchers also wanted to gather the opinions of the professionals working in children's residential care facilities. In fact, there are hardly any data on their knowledge and competence. So 225 professionals at residential care facilities for adolescents were asked whether they felt prepared to identify and respond appropriately to suicidal behaviour in young people. Most admitted that they have limited knowledge, especially regarding detecting signs of suicide risk or about knowing how to talk to or question suicidal young people. Only 22.8% of professionals believe they have a sufficient or high level of knowledge. According to Alexander Muela, the lack of training of those working with young people at risk is surprising: “The data clearly show that they are not trained to work in a preventive way. Their main response is to go to health centres in the event of an emergency, but we can't leave it all to the healthcare system; we have to work on prevention so that young people don't get to that point.”

The authors of the study believe that the first step in working on prevention is the training of professionals working with young people, both in residential care facilities and in formal and informal education. They also highlight the need for early implementation of preventive work. Research has shown that suicidal behaviour starts to increase from the age of 13 onwards.

Additional information

Alexander Muela-Aparicio has a PhD in Psychology and is a tenured lecturer in the UPV/EHU’s Faculty of Psychology. He belongs to the department of Clinical and Health Psychology whose main lines of research are psychotherapeutic intervention in child abuse, suicide, evidence-based psychological interventions, and the implementation and evaluation of programmes to ensure the well-being of children in Pre-school Education. He is a member of the Osaklinik consolidated research group, approved by the Basque Government’s Department of Education.