Tag: mental health

The following text summarizes a study on youth suicide.
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A study on youth suicides in Germany reveals that there are fewer suicides during school holidays than during term time. Conversely, more school-age students take their own lives when school resumes, not only after the summer holidays, but after every school holiday throughout the year. Boys and young men are affected most.

Posting details of mental health emergency services before Christmas has become a common feature in social media. 2023 has been no exception. But while we talk about mental health more than we used to do, suicide prevention in particular does not usually receive a lot of attention: For most, it is an uncomfortable topic to talk about. This might be a reason why, as a society, we mostly overlook the fact that suicide rates actually drop during the Christmas holidays. But this comes at a cost, as there are more attempted and completed suicides during the New Year. Yet, mental health warnings about that day – or other holidays for that matter – seem to be rare. A Canadian-German team of health economists has investigated the distribution of suicides across the year in children and adolescents, with a clear result.

Fewer youth suicides during school holidays, more youth suicides after school holidays

Vincent Chandler (Université du Québec en Outaouais, Canada), Dörte Heger and Christiane Wuckel (both of Leibniz Institute for Economic Research in Essen, Germany) have looked at the impact of school holidays on suicide rates in children and adolescents in Germany between 2001 and 2015. They found that fewer school-age children and teenagers died by suicide during school holidays. Conversely, more young people took their own lives as classes resumed after a holiday. Boys and young men are more at risk than girls and young women, as the researchers’ article in the Economics of Education Review shows. Rather appropriately, it is entitled “The perils of returning to school”.

Data from German federal states are particularly useful

When Chandler, Heger and Wuckel started their study, a rise in suicide rates after school holidays had already been found in other studies. However, these mostly covered summer holidays. For most countries, this means that we cannot reliably tell what exactly it is that triggers youth suicides at the end of a summer holiday. Is it really the end of the holiday and the start of a new school year? Or is it the end of summer, which means that there is less daylight and adolescents pursue fewer outdoor activities?

All German federal states have a summer holiday of about six weeks, but these weeks occur at different times in different places. In 2023, for instance, North-Rhine-Westphalia was the first German state to start its summer holiday on 22 June, returning to school on 7 August. Bavaria, on the other hand, started on 31 July, returning on 12 September. The individual states are therefore not subject to the same seasonal effects. Moreover, German schools have holidays of one to two weeks at multiple times throughout the school year: Apart from the summer holidays, most states have autumn, Christmas, winter, Easter, and Whitsun holidays. If returning to school triggers suicides, surely this effect should be visible after every holiday.

Data are derived from German official causes of death statistics

Chandler, Heger and Wuckel used data from the German official causes of death statistics, which list causes of death according to the international classification ICD-10. The age of the children and teenagers included in the study ranged from six to nineteen years. As a basic unit of measurement, the researchers opted for the probability of a youth suicide occurring on any day in any German federal state. If, for example, on 10 May 2007 one or more suicides occurred in Bavaria, that particular day was assigned the value “1” for Bavaria. If no suicide occurred, the day was coded “0”. To make sure that increases and decreases in the probability of youth suicides were indeed associated with school holidays or the return to school, the team collected data on the following aspects as well:

• Gender
• Type of school holiday (autumn, Christmas, winter, Easter, Whitsun, summer)
• Transition periods (last days of holiday or school, first days of holiday or school)
• Weather (sunshine and precipitation in the month and state in question)
• Economic factors (unemployment rate in the month and state in question)
• Year
• Month
• Day of the week.

Greatest decrease in youth suicides in Whitsun, autumn and summer holidays

Chandler, Heger and Wuckel calculate an overall probability of 3.77 % that a youth suicide will occur on any day in a given federal state. During school holidays, this probability is lower. The Whitsun holiday sees the most striking decrease, as probability goes down by 1.90 percentage points, meaning that, during the Whitsun holiday, it is no longer 3.77 %, but 1.87 %. During the autumn holiday, it drops to 2.82 %, during the summer holiday, 3.11 %. Results for the Christmas, winter and Easter holidays follow the same pattern. However, findings for those holidays are not significant. This means that, statistically, we cannot rule out that these results are due to chance.

End of holidays and return to school pose the greatest danger

School holidays do not arrive unexpectedly. Children and teenagers know very well when they begin and their stress levels go down accordingly. Hence, the number of youth suicides already decreases in the last two days of school before a holiday. Conversely, in the last two days before classes resume, the probability of young people taking their lives increases by 0.46 percentage points. Instead of 3.77 % the probability on those days is therefore 4.23 %. And it gets worse: In the first two days of school, figures rise by 1.21 percentage points, to 4.98 %. Compared to the average probability of 3.77 %, this means that the probability of youth suicides rises by 32 %.

Stress and anxiety take a toll

But what makes school stressful to the point that it enhances suicidal tendencies? As is the case with mental health issues in general, youth suicides can certainly not be traced back to a single factor causing them. However, the researchers suggest that stress and performance anxiety in schools can play a part. Expectations of parents and teachers may lead to significant levels of stress. Bullying could be another factor: In Germany, as many as 8.6 % of pupils report that they have been bullied.

Boys and young men are more at risk

According to the researchers’ data (personal communication), completed suicides occur more frequently in boys and young men than in girls and young women. As a result, the decrease in suicide probability during the holidays is about four times stronger in males than in females. The increase during the first two school days, however, is also stronger in boys and young men: Where figures rise by 24.6 % for girls and young women, they rise by 36.5 % in males. The researchers list several possible reasons for the fact that males seem more affected:

• Schools might be failing young men more than they fail young women. In other words, the system of education seems to be less suited to boys and young men.
• Girls and young women might have a better social network to help them cope with stress.
• A good part of bullying amongst girls takes place online. The stress associated with this might therefore not stop during school holidays, such that suicide incidence will remain more or less the same.
• Females might display other types of self-harming behaviour, like self-injury or eating disorders.

Suicide prevention needs to become a major concern in schools

The findings reported by Chandler, Heger and Wuckel show that we need to do more than post emergency numbers for Christmas. Schools and educational systems as a whole need to be aware of the mental health problems of young people – especially since some of those problems are bred within the schools themselves. The authors of the study suggest the introduction of hybrid schooling opportunities, which can reduce stress in certain students. Teacher training needs to include mental health education as well as specific information on suicide prevention.

We might not always know who is at risk – but sometimes we do. We therefore need to raise awareness that the first days of school after a holiday are the most dangerous time in terms of youth suicides. We must be aware of what is happening if want to be able to offer support to young people at risk of suicide.

Chandler, V., D. Heger & C. Wuckel (2022). The perils of returning to school – New insights into the impact of school holidays on youth suicides. Economics of Education Review 86, 102205.