Along with her team, Dr. Marie-Claude Geoffroy, a researcher at the Douglas Research Centre, Associate Professor at McGill University’s Department of Psychiatry, and Canada Research Chair in Youth Suicide Prevention, has just published a systematic review investigating the factors that contribute to youth suicide. The article, entitled “Risk and protective factors for suicide mortality in youths – a systematic review and meta-analysis,” was published on July 2, 2026, in JAMA Network Open.
This work was conducted in collaboration with Dr. Srividya N. Iyer, also from the Douglas Research Centre. doi:10.1001/jamanetworkopen.2026.21622
KEY TAKEAWAYS
This systematic review and meta-analysis examined risk and protective factors for suicide mortality among children, adolescents, and young adults aged 24 years and younger. Drawing on 90 reports from 68 studies, it represents the most comprehensive synthesis to date focused specifically on youth suicide deaths rather than suicidal thoughts or nonfatal self-harm. The strongest risk factors were mental health disorders, especially schizophrenia, mood disorders, bipolar disorder, depression, and a history of self-harm. Prior psychiatric hospitalization and recent contact with mental health services were also strongly associated with suicide mortality. Social adversity, including child maltreatment, out-of-home placement, justice-system involvement, low educational attainment, and socioeconomic disadvantage, substantially increased risk. Conversely, indicators of family stability were associated with lower risk.
WHY THIS MATTERS
Suicide remains one of the leading causes of death among young people worldwide, yet most previous research has focused on suicidal ideation, suicide attempts, or mixed-age populations. Understanding factors linked specifically to suicide deaths is essential for developing targeted prevention strategies. The findings show that youth suicide mortality reflects more than individual mental illness alone. It emerges at the intersection of psychiatric vulnerability and social adversity. This highlights the need for prevention efforts that extend beyond clinical treatment to address broader social determinants of health and childhood experiences.
WHAT THEY DID
The researchers conducted a systematic review and meta-analysis following PRISMA guidelines. They searched MEDLINE, PsycINFO, Embase, and CINAHL through March 2025 and screened more than 9,400 records. Studies were included if they compared young people who died by suicide with living controls and examined potential risk or protective factors. A total of 68 studies met inclusion criteria. The team extracted 846 individual factors and organized them into five domains: mental health and self-harm, physical disorders, health-care contacts, prenatal/perinatal factors, and socioecological determinants. Where sufficient data existed, random-effects meta-analyses were conducted.
WHAT THEY FOUND
Mental disorders showed the largest associations with suicide mortality. Schizophrenia was linked with more than a 22-fold increase in odds of suicide death, while mood disorders, bipolar disorder, and depression were also strongly associated. Previous self-harm increased the odds of suicide death more than fourteenfold. Indicators of health-care use were powerful markers of risk. Psychiatric inpatient admission was associated with nearly a 32-fold increase in odds, and contact with mental health services in the year before death was associated with more than sevenfold higher odds. Social factors also played a major role. Maltreatment, out-of-home placement, youth justice involvement, parental justice involvement, residential instability, and low educational attainment were all linked to elevated suicide risk. Protective factors were less frequently studied, but living with both parents and parental marriage consistently reduced risk.
WHAT IT MEANS
The findings suggest that effective youth suicide prevention requires a dual approach. Clinically, there is a need for early identification and treatment of mental disorders, rapid intervention following self-harm, and continuity of care during high-risk periods such as psychiatric hospitalization and discharge. At a population level, reducing childhood adversity, improving educational and social opportunities, strengthening family supports, and addressing socioeconomic disadvantage may have significant preventive benefits. Youth suicide prevention should therefore integrate mental health services with broader social and public health interventions.
WHAT’S NEXT
The authors call for research that better explains how social adversity and mental health interact across development to increase suicide risk. They also highlight important evidence gaps regarding bullying, protective factors, and pathways leading from childhood adversity to suicide mortality. Future studies should prioritize underrepresented populations, including Indigenous youth, sexually and gender-diverse youth, and young people in low- and middle-income countries. The authors argue that innovative prevention efforts should focus not only on managing psychiatric risk but also on creating supportive, stable environments that promote resilience throughout childhood and adolescence