This oral presentation examines youth (11 to 19 years old) suicides that occurred between 2000 and 2006 in the province of Quebec. We compare suicides committed by teenagers who received services from youth centers (YC), either under the Young Protection Act (YPA) or Juvenile Justice (young offenders). In total, 488 suicide cases were inventoried by the Coroner office for this period. The YC identified 105 teenagers (21%) who were receiving services at the moment of or before their death. Among the youths who committed suicide, those who had received services from YC at some point in their lives had more often taken one or more psychotropic substances (29.5%) compared to the others (15.4%). While no difference is seen in the suicide methods between youths who received services from YC and those who did not, young offenders use methods of suicide other than hanging (road accidents, firearms) more often than non-offender teenagers (52% of juvenile offenders resort to hanging, whereas it makes up 71% of all suicides). Similarly, youths that have been under YPA have more often resort to hanging (83% of them use this method, compared to 71% of all suicides). These differences might indicate a higher lethality of suicide methods used by juvenile offenders compared to teenagers who received youth protection services. Implications for prevention that arise from these results will be discussed with the participants.

Non-lethal self-destructive behaviours such and suicide attempts are important health problems with increasing prevalence throughout age segments of adolescents. Surprisingly few attempters, however, are referred for follow-up treatment in child and adolescent psychiatry, and among those who actually have been referred, many will not comply with treatment and thus drop out prematurely. Dialectical Behaviour therapy (DBT), originally developed by Linehan for parasuicideal adult women with borderline personality disorder has been adapted by Miller et al for adolescents. The DBT-A, is composed of weekly individual therapy, weekly multifamily skills training and telephone coaching. Five RCT studies have shown adult DBT to be superior to control treatments in reducing deliberate self-harm behaviours, whereas the DBT adolescent version is yet not evaluated in controlled studies. In this workshop, DBT for adolescents will be reviewed and results from a pilot study of patients  treated at Oslo University Hospital in Norway will be presented.

Introduction: The prevention of parasuicidal behaviours among teenagers is a goal of the National Mental Health Plan. The majority of young people with parasuicidal behaviours have no contact with health services and, therefore, the prevention programs in the schools are important. The objectives of this study are to prevent parasuicidal behaviours among teenagers, make teachers aware of this issue and discuss the existing community resources. Methodology: The study was developed in two schools from Coimbra (northern region of Portugal). The Problem-Solving Inventory (Vaz Serra, 1987) and the Rosenberg’s Self-Esteem Scale (1965) were used. The sample was composed of 106 teenagers in the 1 phase and 111 in the 2 phase. There were training and practice sessions on the promotion of self-esteem and problem-solving between the first and the second data collection. An information session was held with the teachers on parasuicidal behaviours and adolescence and the strategies in the case of parasuicidal behaviours at the education institution were discussed. Results: The 106 teenagers, with a mean age of 14 years, registered mean values in problem-solving. After the intervention, the total scores improved in the 111 teenagers who participated in the 2nd phase, especially in the dimensions of internal/external control of the problems, and self-accountability and fear of the consequences, with a decrease in the factor help-seeking. Despite the increase in self-esteem, the differences are not statistically significant. For teachers, the main difficulties are the identification of signs and their intervention in monitoring the identified situations.
Discussion: The majority of teenagers demonstrated good problem-solving strategies and self-esteem, whereas the school showed difficulties in coping with the risk signs and/or the parasuicidal behaviours. It is thus necessary to intensify the connection between the education institutions and the health structures.

Introducion: A significant rise in suicide rates among teenagers and young adults has been observed, especially between ages of 18 and 24. To understand how the suicide risk changes over time can help with more efficient suicide prevention strategies for this population. Objetives:The objective of this study was to observe suicide risk changes during a two year period in a college student sample using . Method: 68 students (36 females and 32 males, mean age of 19) were selected from 426 initial assessment on the basis of their initial level of risk creating a risk group and a contrast group. Students were freshmen on their first evaluation. They were re-assessed two years later. The Suicide Behavior Questionnaire Revised (SBQR) and the Positive and Negative Suicide Ideation Questionnaire (PANSI) were used on both occasions. Results: The mean comparison of SBQR and PANSI showed a suicide risk maintenance (stability) for the group at suicidal risk. The PANSI global results showed a significant increase in risk factors for the contrast group in two years, with a decrease of protective factors and an increase of risk factors for this group. The T-tests for each group independently also showed a significant increase of risk factors for the contrast group and a decrease of protective factors for both groups on PANSI subscales. Conclusions: Suicide risk did not change for the suicide risk group in two years showing the need of active intervention for students at risk. The changes of risk factors for the contrast group demands more studies to identify the risk factors that had contributed to rase the risk of suicide. These results show the need to implement universal suicide prevention startegies at universities as soon as possible, considering those entering with risk and that risk is likely to increase over time for those initially not at risk.

STOP SUICIDE has been created by young people in reaction to the suicide of a friend. We realized that suicide of young people wasn’t an anecdotic problem in spite of the silence that reigned in all parts of the population (family, friends, education system, health system) about this problematic. STOP SUICIDE’s actions are turned toward this cause and are effective at different levels. They can be understood as primordial and primary prevention. As primordial prevention, we try to give to the prevention of suicide, and particularly for the youth, a legal basis in Switzerland, that isn’t included with psychic diseases and to reduce the accessibility of firearms. As primary prevention, our goal is that young people know that there are plenty of solutions to avoid suicide. To make that possible, we work with public authorities, hospitals, social services, schools, Universities, and directly with groups of young people. STOP SUICIDE’s work with institutions has the aim to generalise activities with classes that give the possibility for classmates to discuss suicide and to make them realise that they can talk about it with friends, family or with professionals, anonymously or not, in the structures that exist. The theme of suicide is approached directly with formal discussions and debates, and indirectly, too, by the organization of art contests (with winners only) and open expositions of the students’ creations in schools, or with theatrical performances. This is also important for us to show the authority the importance and the value of these activities and to remain close of the young population’ sensibility. Therefore, we visit groups of young people that call us to install the debate and to promote the help solutions that exist. More recently, we planed to create chat sessions and to develop activities on popular social networks on the Internet about the problematic to get still more close of young people. These activities in every level of the society promote suicide prevention.

Introduction – Self-cutting behaviour is increasing in western countries, especially among young people. This hidden and recurrent behaviour is often used to stop emotional suffering. In previous studies, our research unit, since 1992, found strong correlation between sexual abuse and self-cutting. Objectives – Our aim is to characterize a social and clinical profile, as well as to find childhood traumas, vulnerabilities, risk factors, psychopathology and cognitive schemas.  Methods – The study is based on a semi-structured questionnaire (EACOS) designed by our research unit, including socio-demographic and clinical components. Based on a 17-year clinical experience involving 446 young suicide attempters (15-24 years), we studied the self-cutters sample, patients admitted to the Emergency Room for that reason (n=33 - 7, 4%), comparing them with other suicide attempters (mainly medication and pesticides), using standard statistical measures.  Results – We emphasize, with significant statistical differences, the following characteristics in the self-cutters sample when compared with the others: they are urban young people, with higher academic qualifications, less religious, more drug abusers, more familial psychiatric disorders, more financial income, more vulnerability to the Werther effect, more previous medical consultations, more feelings of self-punishment, more satisfaction with surviving despite their report of more suicidal plans, which is a peculiar finding.
Conclusions – Based on our data, there is strong correlation that childhood traumatic life events lead to multiple vulnerabilities in personality development and coping skills, concerning the general suicide attempt scenario. However, self-cutters represent a very difficult challenge in psychotherapy, because they seem to pursue a maladaptive behavior, a secret career of coping with private suffering.  The mental schemas are specially paradoxical and complex.