ABSTRACT
Suicide deaths and suicidal behaviors among adolescents are a significant public health burden. They often occur in the context of treatable mental health and substance use problems (Beautrais, 2003; Brent et al., 1988; Shaffer et al., 1996), are associated with a large number of productive years lost to society, and significantly impact the lives of suicide survivors, often in traumatic ways (Jordan & McMenamy, 2004). Nonlethal suicidal behaviors are associated with increased risk for additional nonlethal suicidal behavior (Goldston et al., 1999; Joiner et al., 2005) and increased rates of suicide death (Lonnqvist & Ostamo, 1991), and are a major reason for child psychiatric hospitalizations and emergency room presentations (Peterson, Zhang, Santa Lucia, King, & Lewis, 1996). Nonsuicidal self-harm behavior also has been an area of increasing public health concern and appears to be related to significant psychological distress among young people (Nixon, Cloutier, & Aggarwal, 2002; Nock & Prinstein, 2004, 2005).
