Suicidality among children and youth in Nordic child welfare services: A systematic review

Abstract

Existing research has established child welfare (CW) clients as a vulnerable group for developing negative life trajectories, including mental health problems, work- and education-related challenges and premature mortality. Knowledge of later life conditions including suicidality of clients within child welfare services (CWS) in the Nordic countries is scarce. The overall aim is therefore to gain updated knowledge on how children and youth who have received or are receiving CWS interventions from the Nordic CWS fare in relation to suicidality. The population, intervention, comparator, outcome (PICO) framework guided the search through five multidisciplinary bibliographical databases. The population were former and current CWS clients; comparators were from the general population. Six cohort studies were identified (i.e., one Finnish study and five studies from Sweden), all showing evidence of a significantly elevated risk for suicide and suicide attempt in former CWS clients. CWS clients systematically fare worse concerning suicide and suicide attempt compared to their peers from the general population. In particular, former CWS clients should be recognized as being at high risk for suicide and suicidal behaviour later in life. These findings have substantial implications for CWS practice and service delivery regarding long-term follow-up.