Youth Mental Health Narratives
Discovering novel variables for NVDRS data
Key Findings
"What was the victim's story that led to their death?" It is hard to answer this question with the existing NVDRS coding guide, as events are often stored in boolean variables and limited to events that happened 1 month ago, thus, information about recurrences of events and the chronological order of events are lost. We recommend adding temporal information to events and allow for time-series analysis from the free-text narratives. Below are the top 3 interesting findings drawing from our analysis:
- 1.20% of victims had repeated relationship problem with partner events occur prior to suicide. The median time between the 2 problem events is 2.5 days, and the median time between the last relationship problem to death is 60 days.
- 2.Suicide attempts snowball into more problems: another suicide attempt (28% / 7 days), relationship problem with partner (17% / 3 days), arguments with family (3% / 60 days), buying a weapon (6% / 14 days)
- 3.The most frequent last events prior to death were a prior suicide attempt (936 victims / 42 days median), relationship problem with partner (497 victims / 14 days median) and depressed mood or mental health (272 victims / 30 days median).
Methodology
How did you decide what area related to youth mental health to explore?
Patient stories are rarely documented as part of the patient chart. As one research study puts it: "The stories of people who attempt suicide are insufficiently reflected in suicide research in psychology" (Rimkeviciene 2016). In fact, according to many studies, including the NVDRS coding guide, many studies focused on only the most recent events that happened at most one month ago. Two excerpts of recent research papers are shown:
"About half of people who die by suicide visit their primary care provider (PCP) within 1 month of doing so, compared with fewer than 1 in 5 contacting specialty mental health." (Dueweke 2018)
"...suicide-related outcomes within one-week or one-month in individuals with current suicidal ideation (SI) or a recent suicide attempt (SA)." (Lengvenyte 2021)
To better guide suicide prevention, we must first be informed of the series of events that victims gone through days, weeks or even months prior to death. We hope to inspire future research to look into the patient story with a broader timeframe as well as population timeline trends to more effectively prevent suicides.