ABSTRACT
A recent review of 128 population studies of adolescent suicidal behaviors reports an average prevalence of lifetime suicide attempts among North American adolescents of 12.6%, with an average 1-year prevalence of 7.7% (Evans, Hawton, Rodham, & Deeks, 2005, p. 243). In the United States, suicide is the third leading cause of death among children, adolescents, and young adults (Spirito & Esposito-Smythers, 2006 (review)). According to the 2003 Youth Behavior Risk Surveillance (YBRS) survey, 16.9% of U.S. adolescents reported suicidal ideation in the past year, and 8.5% had made an attempt (Grunbaum et al., 2004). The attempt rates are much higher among homeless and runaway adolescents than in the general population, ranging from 20% to 40% for lifetime attempts (Adlaf & Zdanowicz, 1999; Greene & Ringwalt, 1996; Molnar, Shade, Kral, Booth, & Watters, 1998; Stiffman, 1989; Yoder, 1999). Rates of suicidal ideation among homeless and runaway adolescents range from 14% (Kingree, Braithwaite, & Woodring, 2001) to the mid-50% range (Molnar et al., 1998; Yoder, Hoyt, & Whitbeck, 1998). These broad ranges of suicide attempts and ideation are the result of widely diverse measures and sampling procedures (Evans et al., 2005; Goldston, 2003; O'Carrol, Berman, Maris, Moscicki, Tanney, & Silverman, 1996). Because these are difficult populations to access, many samples have focused on a single city or even a single shelter, resulting in very specific estimates. In this chapter we address suicidal behaviors by psychiatric diagnosis and other risk factors among homeless and runaway adolescents in a variety of settings across four Midwestern states.
