Characteristics Associated With Mental Health Treatment Prior to Suicide Among Youth in the United States

To examine individual and contextual characteristics associated with receipt of mental health treatment prior to youth suicide. Data from the US National Violent Death Reporting System, Area Health Resource File, and Social Vulnerability Index were used to examine characteristics associated with receipt of mental health treatment within 2 months before death among youth suicide decedents aged 5 to 17 years from 2013 to 2020 (N = 6,229). The association between individual (demographic, precipitating circumstances, and clinical characteristics) and contextual-level variables (county health resources, Social Vulnerability Index) and mental health service use was modeled using logistic regression. Mental health treatment was received by 31.6% of youth suicide decedents (n = 1,967) in the 2 months before suicide. Male individuals and youth from all racial and ethnic minority groups were less likely to receive mental health treatment in the 2 months prior to suicide, as were youth residing in non-metropolitan counties and living in counties characterized by high compared to low levels of social vulnerability. A history of family problems, a recent crisis, criminal/legal problems, and suicidal thoughts and attempts were associated with increased odds of receiving mental health services. Youth suicide decedents who were male, members of a racial or ethnic minority group, and residing in counties that are non-metropolitan and/or socially disadvantaged were less likely to have received mental health services in the months prior to death. Suicide prevention efforts that focus on improving access to care are essential for these vulnerable populations at risk for suicide.