Assessment & Research

Suicidal behavior in children and adolescents with mental retardation.

Walters et al. (1995) · Research in developmental disabilities 1995
★ The Verdict

One in five youths with intellectual disability admitted for psychiatric care showed suicidal behavior—universal screening is essential.

✓ Read this if BCBAs working with youth with ID in inpatient or residential settings.
✗ Skip if Clinicians serving only typically-developing clients.

01Research in Context

01

What this study did

The team read 90 hospital charts of youths with intellectual disability. They counted how many showed suicidal acts or talk.

No tests or treatments were given. It was a simple head-count in one inpatient unit.

02

What they found

One in five youths had suicidal behavior noted in the chart. The acts showed up in every IQ level, both boys and girls, and with any added mental-health label.

Staff had missed many cases until admission.

03

How this fits with other research

Hong et al. (2024) looked at 1,461 ASD or ID patients in the psychiatric ER three decades later. They still saw high risk, but now beds were lacking, so 30% went home without help. The core message—watch this group—remains the same; the service gap grew.

Sievert et al. (1988) studied the same hospital type and found lots of depression. Lalli et al. (1995) add that depression can slide into suicidal actions, so screening must go beyond mood checks.

Grindle et al. (2012) remind us that self-injury without suicidal intent is also common in ID. Their review says to treat both operant and emotional triggers. The 1995 count tells us to add suicide screens to that same plan.

04

Why it matters

If you work with youth who have ID, add one quick suicide-risk question to every intake, handoff, and morning round. It takes one minute and may catch the 20% who otherwise stay silent.

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Add one suicide-risk question to your standard intake checklist today.

02At a glance

Intervention
not applicable
Design
case series
Sample size
90
Population
intellectual disability
Finding
not reported

03Original abstract

Despite increasing attention to psychiatric disorders in the mentally retarded, suicidal behavior remains an underreported phenomenon in this population, particularly in children and adolescents. This study was aimed at documenting the existence of suicidal behavior among 90 consecutive admissions to a specialty unit for dually diagnosed children and adolescents in a medical school-affiliated children's psychiatric hospital. Archival chart review yielded a total of 19 patients, or 21%, for whom suicidal behavior was a presenting complaint upon admission or during hospitalization. Suicidality was distributed across gender, level of mental retardation, and psychiatric diagnosis. Additional findings of note with regard to family dysfunction and/or abuse history are summarized. Clearly, in this sample, children and adolescents with mental retardation were capable of formulating and engaging in potentially fatal acts. Results of this study suggest that suicidal behavior is an underrecognized, yet significant phenomenon in children and adolescents with mental retardation and psychiatric disorder.

Research in developmental disabilities, 1995 · doi:10.1016/0891-4222(94)00029-8