Adolescents

In Japan, national crude suicide mortality rates (CMR-suicides) consistently decreased during the 2010s, whereas adolescent CMR-suicides have increased from the mid-2010s. However, the high-risk groups and their causalities remain to be clarified. Temporal fluctuations of adolescent CMR-suicides disaggregated by gender, age, social standing, and suicide motive were analyzed with joinpoint regression and linear mixed-effect models using two government suicide databases. CMR-suicides among female elementary school students, middle school students, high school students, university students, and <20-year-old individuals with social withdrawal syndrome (SWS) increased from the mid-2010s. CMR-suicides among male elementary school, middle school, and high school students also increased from the mid-2010s, while those of university students were unchanged. In contrast, CMR-suicides of males aged <20 and 20–29 with SWS unexpectedly decreased. Surprisingly, the increasing trends of CMR-suicides of female students were greater than males; consequently, CMR-suicides of female students in middle school and high school became greater than those of male students in the 2020s. The highest suicide risk among those under 20 years of age was observed among part-time high school students. Among individuals 20–29 years of age, those with SWS were in the highest-risk group for suicide, while CMR-suicides of individuals with SWS aged under 20 years were almost equivalent to those of middle school students. The leading suicide motives for elementary school students were family-related, including family discord and parental reprimand (there was no difference in gender in terms of leading suicide motive). Among middle school female students and older, the leading suicide motives were mental issues followed by school-related problems. Among male middle school students and older, the leading suicide motives were underachievement followed by mental issues. CMR-suicides caused by mental issues (for both genders) and underachievement (in males) increased from the mid-2010s. These results suggest that increasing internalizing problems may be a fundamental factor contributing to the currently increasing suicides among adolescents (particularly females) in Japan. Although the recent promotion of inclusive education in Japan has successfully provided educational opportunities for individuals with internalizing problems, these statistics highlight the need for a further enhancement of psychosocial support for adolescents with internalizing problems who are at a high risk for suicide.

Adolescent tobacco use remains a critical public health challenge, requiring innovative early prevention strategies. This study participatively evaluated a medium-fidelity prototype of the No le entres app, designed to prevent tobacco use among adolescents. The prototype was developed based on user-centered design and gamification frameworks, with the aim of ensuring cultural relevance and active user engagement. Qualitative design with content analysis was employed. Four focus groups were conducted in Xalapa, Veracruz: two with health professionals from Medical Specialty Units—Community Mental Health and Addiction Centers (UNEME CECOSAMA), and two with secondary school students. Nineteen professionals and twenty-two adolescents participated. Data were analyzed using MAXQDA 2022, applying both a priori and emergent categories. Professionals valued the app’s innovative approach but recommended improvements in navigation speed, visual design, message clarity, and cultural validation. Adolescents emphasized the need for more engaging features, such as music, rewards, team competitions, and updated graphics. Both groups highlighted the importance of interactivity, personalization, and contextualized content. Findings underscore the value of participatory methods in designing digital health interventions and confirm that involving end users enhances usability and acceptability. The app demonstrates potential for integration into school settings as a preventive tool, with implications for influencing adolescent knowledge, attitudes, and behaviors regarding tobacco use.

The transition to adulthood is challenging for all youth, but this developmental period can present substantial difficulties for youth involved in child-serving systems due to a constellation of adversities and a lack of protective factors present in their lives. Notably, many system-involved youth are disconnected from important relationships and are tasked to navigate the increased demands of adulthood without sufficient support. There is a spectrum of services available for youth transitioning out of system-involvement, but the majority focus on independent living skills, which alone are often insufficient to facilitate a successful transition to adulthood. This paper provides details regarding the importance of building relational permanence—relationships with permanent-supportive individuals—among young adults transitioning out of system involvement. Authors review evidence-based approaches, used by community agencies, which build relational permanence for system-involved youth, while discussing future directions to improve the rigor of research on relational permanence, and action for necessary policy change.