Tokai University and partners survey 100 suicide attempt survivors — Inability to confide leading cause in teens

A joint research group including Professor Katsunaka Mikami of the Department of Psychiatry, Department of General Medicine, Tokai University School of Medicine, and Chief Masahide Usami of the Department of Child and Adolescent Psychiatry, National Kohnodai Medical Center, Japan Institute for Health Security, investigated 100 patients under the age of 18 who were admitted to the Tokai University Hospital Advanced Emergency Medical Center following a suicide attempt. The study focused on clinical characteristics of these patients, such as whether they had confided their suicidal ideation (the desire to die) to anyone before their attempt. The results revealed that 76% had not spoken to anyone, and 86% had not told their families. This indicates that the "inability to confide" is a critical challenge in child suicide prevention. The findings were published in Child Psychiatry & Human Development.

In Japan, suicide is the leading cause of death among males and females aged 10 to 19, making child and youth suicide a severe social issue. However, there has been insufficient verification regarding the extent to which children who actually attempted suicide were able to confide their suicidal ideation to those around them prior to the attempt. Most previous studies were based on questionnaires. There was virtually no research confirming these details directly from children and their guardians in emergency medical settings immediately following a suicide attempt.

The joint research group conducted a study targeting 100 patients under the age of 18 (75 females, 25 males) who were transported and admitted to the Tokai University Hospital Advanced Emergency Medical Center following a suicide attempt between February 2019 and November 2024.

A team of psychiatrists examined the individuals and their guardians as part of routine medical care, evaluating psychiatric assessments and diagnoses, history of psychiatric visits, history of self-harm, history of suicide attempts, the individuals to whom they confided their suicidal ideation, school environment, and the methods and motives behind the suicide attempts.

The survey showed that 76% of the participants (73.3% of females, 84% of males) had not disclosed their suicidal ideation to anyone prior to the attempt, with no significant difference between sexes. Furthermore, 86% of the participants (84% of females, 92% of males) were unable to talk to their families (no significant difference).

Only 24% of the participants answered that they "had someone to confide in," with "family" being the most common confidant, followed by "friends." The most frequent reason given for the suicide attempt was "unclear or ambiguous," highlighting a prominent number of cases where the individuals could not verbalize their suffering.

Additionally, 94 of the participants were students or children, of whom 59.6% were currently experiencing or had previously faced difficulties in school life. Regarding the means of the suicide attempt, overdose accounted for the highest percentage, though males chose methods other than overdose at a significantly higher rate than females.

This study brings to light the reality that children who reach the point of attempting suicide are unable to confide in those close to them beforehand, regardless of gender. It also suggests that these children had been in a state where they could not seek help over a long period.

In preventing child suicide under such circumstances, simply "encouraging them to seek advice" is insufficient. There is a need to create an environment that supports them even at stages when they cannot put their feelings into words. Specifically, building family relationships through everyday conversation, creating safe spaces in schools, and establishing multi-disciplinary support systems across the entire community are deemed vital.

Journal Information
Publication: Child Psychiatry & Human Development
Title: Silent Suicidal Ideation: Low Rates of Disclosure Among Children and Adolescents Who Attempt Suicide
DOI: 10.1007/s10578-026-02008-4