Rates of suicide among males increase steadily from age 11 to 21: Developmental framework and outline for prevention

The paper has three purposes. First, explanations for the steady age-related increase in the rate of suicide among male youth from ages 11 to 21 are offered based on a review of epidemiological- and case-control evidence. It is concluded that depression and substance use disorders are major contributors to the age-related pattern in suicide. A general increased capacity for serious acts of aggression from ages 11 to 21 might also contribute to this pattern in suicide. Second, evidence that substance abuse and depression both contribute to, and are exacerbated by, difficulties in negotiating age-salient tasks is summarized. In this context, suicides among young males are posited to mark the endpoint of the bidirectional interplay of psychopathology and developmental difficulties. Third, informed by this developmental perspective, the authors make recommendations to reduce suicides in male youth, emphasizing strategies that may interrupt cycles of depression and/or substance abuse and developmental failure. Strategies to reduce the potential for fatalities, notably method restrictions, are also discussed.