Adolescent self-harm and suicidal behavior and young adult outcomes in indigenous and non-indigenous people
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The aim of this study was to examine the associations between self-harm and suicidal behavior in indigenous Sami and non-Sami adolescents and mental health and social outcomes in young adulthood. Data were obtained by linking the Norwegian Patient Registry (2008–2012), the National Insurance Registry (2003–2013), and the Norwegian Arctic Adolescent Health Study, a school-based survey inviting all 10th grade students in North Norway (2003–2005). In total, 3987 (68%) of all 5877 invited participants consented to the registry linkage, of whom 9.2% were indigenous Sami. Multivariable logistic regression was used to explore the associations between self-harm only, suicidal ideation with and without self-harm, and suicide attempts in adolescence (≤16-year-old), and later mental health disorders, long-term medical, social welfare benefit receipt, or long-term unemployment in young adulthood. Self-harm and suicidal behavior in Sami and non-Sami adolescents were associated with increased risk of later mental health disorders, long-term welfare benefit receipt, and long-term unemployment. These associations were attenuated by adolescent psychosocial problems. No major differences between the indigenous Sami participants and their non-Sami peers were found. Young suicide attempters experienced the highest risk, with adolescent suicide attempts being significantly associated with all four adult outcomes after adjustment. Self-harm and suicidal behavior in adolescence are markers of mental health disorders and unfavorable social outcomes in young adulthood, mostly accounted for by adolescent psychosocial problems. In contrast to other indigenous peoples, no indigenous health disparities were found, indicating that the indigenous Sami adolescents were not worse off.
KeywordsSuicidal behavior Adolescent Indigenous Epidemiology Longitudinal
Data from the Norwegian Patient Register (NPR) have been used in this publication. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Norwegian Patient Register is intended or should be inferred.
This work was funded by the Sami Norwegian National Advisory Unit on Mental Health and Substance Use (SANKS). UiT The Arctic University of Norway, the Centre for Sami Health Research, and the Norwegian Institute of Public Health funded the NAAHS study. The registry linkage was funded by the University Hospital of North Norway and Nordland Hospital. The authors would like to thank all the participants of the NAAHS study.
Compliance with ethical standards
Conflict of interest
CE has received research support from the Sami Norwegian National Advisory Unit on Mental Health and Substance Use (SANKS). MTS and SK report no financial or potential conflicts of interest.
The students and their parents were given written information about the study, and the students provided written consent. The Norwegian Data Inspectorate and the school authorities approved the NAAHS. The Regional Medical Ethical Committee approved the NAAHS and the registry linkage. The Norwegian Institute of Public Health and Statistics Norway carried out the linkage.
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