Child and young adolescent suicide in New Zealand.

OBJECTIVE: To describe the epidemiology and characteristics of all suicide deaths among under 15-year-olds in New Zealand over a 10-year period.
METHOD: In a 10-year retrospective study the features of all 61 children and young adolescents aged less than 15 years who died by suicide in New Zealand from 1989 to 1998 were examined by review of coronial files.
RESULTS: Suicide among under 15-year-olds is very rare but increasing. Suicide risk increases with age: the majority of those who die are aged 14 years (57.4% of the total) or 13 years (26.2%). Boys (72.1%) and Maori (57.4%) predominate. Most suicides occurred in children not living in intact biological families (67.2%). Hanging was the predominant method (78.7%). One in three children left suicide notes. One in four had a history of contact with social welfare authorities. There was a family history of suicide in 10% of cases. A minority had a documented history of prior suicide attempts (13.1%) or mental health problems (23%). One in four (23%) was reported to have made threats of suicide within the year prior to their death. A majority of deaths appeared to have been precipitated by relatively minor family arguments or disciplinary events, which, however, occurred in the context of actual or anticipated disruptions or transitions in family living arrangements or school circumstances, or severe family problems.
CONCLUSIONS: In general, the impression of young adolescent suicide was of a disadvantaged, vulnerable and distressed group of adolescents growing up in extremely difficult circumstances. Maori children predominate in this group. There is clearly a need to verify these impressions with an in-depth investigation of the familial and social circumstances of children who die by suicide. Such investigations might best be conducted by annual mortality review and monitoring of all young adolescent suicides.