College Student Suicide in the United States: Incidence Data and Prospects for Demonstrating the Efficacy of Preventative Programs

Epidemiological reports of suicide of college students in the United States that have appeared in the literature since 1928 include seven single institution and two multi-institution reports. In order to compare this data, the crude rates were corrected to account for demographic variables known to influence suicide rates, especially age, sex, and temporal period. The Standard Mortality Ratio (smr) is an established technique that takes these factors into account. When the published reports of student suicide were converted to smrs, only one institution had an elevated smr. The aggregate smr was 97, which indicates a rate of suicide quite close to that of the age-and sex-matched comparison groups. The multi-institutional data had smrs consistently under 100. The statistics of infrequently occurring events illustrate why the stability of estimates of student suicide rates depend primarily on the number of suicides observed and hardly at all on the number of student-years at risk. Thus, the small number of college student suicides at any one campus makes it virtually impossible to identify differences in rates or to assess directly the influence on suicide of environmental factors or preventive programs. Departures from college for reasons of physical and emotional health occur with considerably higher frequency and may be better correlated with suicide. In order to evaluate more adequately factors that influence college student suicide, one can either have cooperative multi-institutional studies or do indirect analysis using more frequently occurring phenomena that are correlated with suicide.