Suicide prevention among young people

Omschrijving

In the Netherlands, approximately 1 in 6 young people experience serious thoughts of suicide (2). Efforts to prevent suicidal ideation, suicide attempts and suicide among youth are crucial, and involving young people themselves in developing suicide prevention strategies is essential. This thesis therefore explores various aspects of suicide prevention across different levels. The cover of this thesis is inspired by a statement I heard from Maarten Dallinga (a Dutch journalist and creator of the podcast ‘Verstrikt’ (English: Entangled) on his personal struggle with suicidal ideation) at a gathering focuse on youth suicide prevention: “Often, the best way to support someone who feels lost is not by pointing them toward the light, but by standing beside them in the darkness. Letting them speak, listening, being there, can offer comfort and hope, ultimately giving them the courage to see the light again.”

DEFINITIONS
The World Health Organization (WHO) defines suicide as: ‘an act with a fatal outcome, which the deceased, knowing or expecting a potentially fatal outcome, had initiated and carried out with the purpose of bringing about wanted changes’ (3). On daily basis, by suicide we usually mean the act of intentionally ending one’s own life (4,5). However, there are many inconsistencies worldwide and in the literature regarding the conceptualization of suicide and even more regarding suicidal behavior and/or suicidal ideation (6,7). Suicidal behavior is a complex concept which often includes suicidal ideation, suicide planning, and suicide attempts (8). Suicidal ideation refers to thoughts about ending one’s life, suicide planning involves more concrete thoughts and/or actions towards a method to end one’s life, and a suicide attempt is an act with a certain degree of intention to actually end one’s own life (4,5). However, there can be overlap in terminology between a suicide attempt and self-harm (8,11,12). In many countries, such as the United States, self-harm is frequently classified into self-harm without suicidal intent and self-harm with suicidal intent, with a non-fatal suicide attempt being seen as self-harm with the intention to die (11). However, there is considerable debate about whether behavior can always be intentional or deliberate and how this can be determined retrospectively. According to a widely accepted definition from the UK’s National Collaborating Centre for Mental Health NICE guidelines, self-harm refers to intentional self-poisoning or self-injury, regardless of the motive or level of suicidal intent (7,13). Furthermore, categorizing suicidal ideation as suicidal behavior is complex, and there is ongoing discussion regarding whether suicidal ideation should be classified as part of suicidal behavior or treated as a separate category (8,14–16). Due to the many differences in nomenclature and terminology, we will specify as accurately as possible in this dissertation what we mean by suicidal ideation, suicide attempts, suicidal behavior, and self-harm.