Suicide among the young - the size of the problem

It is widely recognized that official suicide rates conceal the real scale of non-accidental self-injurious fatal behaviour, including among children and young people. There are many reasons for this including the constraints of registration policy and practice, uncertainty about the circumstances surrounding a death, an unwillingness-often for the family's sake-to affix a suicide label on a child, and perhaps the belief that the term "suicide" is not quite accurate. The present study examined all records over a 17-year period from an inner London coroner's office in order to make some quantitative assessment of the extent to which non-accidental self-injurious deaths might be underestimated by suicide returns among those under 20 years. It is suggested on the basis of this examination that the real rate of what might be termed "suicide" among this group may be up to three times the official recorded level. This finding received general confirmation from a smaller-scale comparison in an out of London location. (C) 1999 The Association for Professionals in Services for Adolescents.