Increasing cases of pediatric suicidality highlight the ongoing mental health crisis among youth. Suicide attempts, ideation and self-injury have become the most common mental health conditions seen in children’s hospitals’ emergency departments, according to data from Children’s Hospital Association’s Pediatric Health Information System (PHIS). Between 2016 and 2022, children’s hospitals saw a 166% increase in emergency department visits for suicide attempts and self-injury among children from ages 5-18.
“Not only are the numbers increasing, but we are also seeing worse acuity—children don’t get to us until their illness is more advanced, such as having persistent suicidal ideation instead of initially fleeting thoughts,” says Heather Huszti, chief of psychology at Children’s Hospital of Orange County (CHOC).
Approximately 2 million adolescents attempt suicide each year. Among U.S. pediatric deaths, more than 25% are by suicide. It is the second leading cause of death for children and young adults ages 10 to 24, causing more death than any single major illness and second only to unintentional injuries. Each year, some 6,500 deaths in this age group account for 14% of all suicides in the U.S.
“As tempting as it might be to pin this increase on one specific thing, it is likely to be a complex interaction of several factors. Children’s hospitals must continue to invest in and advocate for children’s mental health,” Huszti says.
Who’s affected?
While rare in children younger than 10 years, suicide death rates increase markedly during adolescence and young adulthood. According to the CDC’s Youth Risk Behavior Survey Data Summary and Trends Report, among high school students in 2021:
- 18% made a suicide plan.
- 10% attempted suicide.
- 3% were injured in a suicide attempt.
Mental health issues and suicidality affect children across the board, but subsets of students have very different experiences, with some faring worse, according to the CDC report.
Gender
In 2021, 10% of female students attempted suicide. Thirty percent of girls said they seriously considered attempting suicide, double the rate among boys.
Race and ethnicity
Suicide is now the leading cause of death for Asian American youth. More than a quarter of American Indians and Alaska natives said they had seriously considered a suicide attempt. Black children under 13 are two times more likely to die by suicide than their white peers, and the rate of death by suicide among Black youth has increased faster than any other racial or ethnic group.
Sexual identity
Almost 25% of LGBTQ+ students attempted suicide during the past year. Close to 70% experienced persistent feelings of sadness or hopelessness.
Responding to the crisis
Health care organizations and children’s hospitals are innovating care, adding services and reimaging the future of behavioral health care to meet immediate needs.
In 2021, Children’s Hospital Association (CHA), American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry declared a national state of emergency in children’s mental health. The declaration called on policymakers at all levels of government and advocates for children and adolescents to increase funding, address regulatory challenges, address acute care needs and more.
CHA has also joined with Cardinal Health Foundation and the Zero Suicide Institute to create Preventing Youth Suicide: A Cardinal Health Foundation National Collaborative. The first-of-its-kind collaborative seeks to develop a data-driven approach to improve the identification and care of children at risk for suicide. The collaborative awards grants to children’s hospitals and health systems as they implement a framework developed by the Zero Suicide Institute and commit to a system-wide transformation to better care for children at risk of suicide.
In addition, CHA partnered with other organizations to launch the advocacy initiative Speak Our Minds, which urges Congress to enact legislation and increase funding to address the crisis.
Resources and strategies
Along with creating partnerships, children’s hospitals and health systems are developing resources, tools and strategies for combatting youth suicide.
- Youth Suicide Prevention and Intervention Best Practices and Policy Implications from Nationwide Children’s and Springer.
- Blueprint for Youth Suicide Prevention from AAP and American Foundation for Suicide Prevention.
- Guide for Schools on Student-Directed Suicide Prevention Program from Cincinnati Children’s.
- Care of the pediatric patient with suicidal ideation course from CHA’s Pediatric Learning Solutions (PLS).
- Virtual learning series designed to drive action and implementation.
- Peer-to-peer online community intended to facilitate communication about programs, staff support, cost of care and other behavioral health topics.
- Pediatric behavioral and mental health course library from PLS.
- Advocacy-related work to improve the entire system, including a documentary and reference materials.
- Restricting lethal means report.
- Collection of solutions from children’s hospitals covering early intervention, workforce, community partnerships and emergency care.
6,500
10 to 24-year-olds die by suicide each year
2 million
adolescents attempt suicide each year
20%
of high schoolers say they think seriously about suicide
