Private Schools: Protective Against Suicidal Behaviors?

Pauline Anderson

May 06, 2014

NEW YORK ― Private school students are much less likely to report suicidal plans, thoughts, and attempts compared with their public school counterparts, according to the results of what is believed to be the first ever such survey of private school students.

Released here at the American Psychiatric Association's 2014 Annual Meeting, the results showed that of the total sample of 8407 private school children, 10.1% said they entertained thoughts of suicide; about half of those (5.2%) reported suicidal plans, and 2.8% reported suicide attempts.

According to lead researcher Rosemary Baggish, MEd, MPH, founder and director, Mental Health in Independent School Communities, a consultation service for independent schools, these figures are about a third less than for public school children.

"As far as prevalence goes, there is one third less prevalence in our data, so fewer thoughts, plans, and attempts."

Protective Factors

However, she said, she is not that surprised by this finding.

"There are many wonderful, protective factors in private schools, including such things as small schools and closer adult supervision, but these are just hunches; our data can't support this."

She later added that she looks forward to further studies to identify the factors that contribute to developing a "protective shield" for students in private schools.

For the study, students in grades 9 to 12 in 18 private schools completed the Independent School Health Check survey (ISHC) during the 2012-2013 school year. The ISHC is a self-report tool that has 108 items about behaviors and feelings related to academics, school experiences, and social and home life.

Data for public school students are from the US Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System. The 2 surveys are essentially the same in terms of information pertaining to suicide.

The private school study sample was about half female, predominately white (63%), and it geographically overrepresented students in the Northeast (47%). About 0.7% of the sample identified themselves as transgender.

The study showed that of the 235 suicide attempts, 27% of the students did not have a plan. Just more than 19% of the suicide attempts required medical attention, which indicates "the severity" of the attempt, said Baggish. She added that she and her colleagues have no way of knowing from this survey about completed suicides.

Students reporting suicidal thoughts were twice as likely (odds ratio [OR], 2.6) to make suicide attempts, and those who had suicide plans were almost 4 times as likely (OR, 3.9) to do so. Students who were transgendered were more likely to report a suicide attempt (OR, 5.82).

The study showed that suicide attempts were associated with negative self-ratings in mood, social support, and risk behaviors. For example, elevated risk for a suicide attempt was associated with "sad or hopeless feelings" of being bullied and smoking more than 10 days in the past month.

Conversely, variables such as having "minimal anxious feelings"; having an adult who expresses an interest in the student; having a "sense of belonging at school"; and not drinking alocohol or smoking were associated with reduced risk for suicide attempts.

Baggish noted that "sad and hopeless" was also a very strong variable linked to suicide attempts in the public school group.

One risky behavior that was strongly associated with suicide attempts was "purchasing an essay on the Internet." Researchers do not know why this variable "kept popping up," but Baggish said she wanted to share this unexpected result with the audience.

Interestingly, the study showed that high pressure from parents and teachers is actually protective against suicidal feelings.

"One way to interpret this is that parents care enough to have expectations of their kids, or that parents believe in them," said Baggish.

Although the students in the survey were both day and boarding students, the researchers have not yet separated out the data.

Suicide among young people is gaining increasing attention. Since 2005, there have been more than 6000 publications on adolescent suicide, Baggish added.

Asked to comment, session moderator Sri Venkata Uppalapati, MD, a psychiatry resident at the University of Kansas Medical Center in Kansas City, said that investigating suicidal thoughts, plans, and attempts in the private school population is "very important," because these children come from a "totally different socioeconomic background" than public school children.

"Oftentimes, you don't hear about the children from private schools because everyone thinks all is hunky dory and nothing is going on with them," said Dr. Uppalapati. From his experience, though, he said, "it's not like they don't have their own set of problems."

Rosemary Baggish has disclosed no relevant financial relationships.

American Psychiatric Association's 2014 Annual Meeting. Abstract SCR09-1. Presented May 4, 2014.

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