Suspected suicide attempts surged among youth during pandemic, study shows

The rate of suspected suicide attempts by self-poisoning among children and adults aged 10 to 19 in the U.S. rose by 30% in 2021 compared with pre-pandemic rates, according to a new study published Thursday.

The largest surge was among the youngest in that age group — the rate rose 73% for 10- to 12-year-olds and about 49% for 13- to 15-year-olds, compared to 11% for 16- to 19-year-olds. Among girls and young women — who are already more likely to attempt suicide than males in these age groups — the rate spiked by about 37%, in contrast to 5.6% for boys.

“I can tell you that from my clinical practice, this is what we’re seeing also,” Christopher P. Holstege, one of the study authors and a professor of emergency medicine and pediatrics, said at a press briefing. “That’s partly what prompted this [study]. We’re seeing very young ages, ages that I didn’t used to see attempting suicide by poisoning…. And to see a 73% increase in the 10- to 12-year old age group, it was pretty stunning from our perspective.”

The study, published in the Centers for Disease Control and Prevention’s online journal Morbidity and Mortality Weekly Report, looked at de-identified data coded as intentional suspected suicide among this age group from all U.S. poison control centers from January 2016 to September 2022. Researchers from the Blue Ridge Poison Center at the University of Virginia School of Medicine split the cases into smaller age group categories and analyzed trends in the frequency and rates of suspected suicide attempts by self-poisoning. They compared yearly and monthly changes in these suspected attempt rates, using 2019 as a pre-pandemic reference year, to assess the potential impact of the pandemic on suspected youth suicide attempts.

These findings fit into a troubling trend of an increase in suicides and suspected suicide attempts among adolescents and youth, especially girls and young women, exacerbated by the pandemic. In 2020, suicide was the second leading cause of death among children 10 to 14 years old, and the third leading cause among 15- to 24-year-olds, according to CDC data.

Suspected suicide attempts by 12- to 17-year-old girls increased by more than 50% in February to March 2021 compared to the same time in 2019. They also spiked by varying degrees at other times throughout the pandemic, according to CDC data that looked at emergency visits nationwide. Girls and women tend to have higher rates of suicidal ideation and suicide attempts than boys and men in the U.S., in what’s known as the gender paradox; when both genders do attempt suicide, girls and women are also more likely to attempt suicide by self-poisoning.

While the study did not look at disparities in suspected suicide attempts by self-poisoning based on race and ethnicity, these factors have compounded the age and gender disparities in suicides in the U.S., most notably in recent years. From 2018 to 2021, suicide rates among 10- to 24- year-olds who were Black rose by over 36%, according to CDC data. These rates increased for all non-whites in the same age group, by 16.7% for American Indians or Alaska Natives, 10.6% for Asians, and 8.2% for Hispanic or Latinos, and nearly 14% for multiracial people, while decreasing for white people.

At the start of the pandemic and the stay-at-home orders, in March 2020, researchers saw an initial drop in reported cases of suspected attempted suicide by self-poisoning, closely followed by a rise by July 2020. This seasonal trend, known as the “honeymoon effect,” is common in crises like natural disasters and war, they noted. It’s possible, for instance, that “during the pandemic, people are so just focused on survival that they temporarily are not worried about the other things that were causing them anxiety and depression,” Benjamin Hansen, a research associate at the University of Oregon who has studied suicide trends among teens during and before the pandemic, told STAT.

Researchers’ analysis showed a sharp spike in overall suspected suicide attempt rates in 2021 compared with previous years. Over-the-counter products were much more involved in overdoses in suspected suicide attempt cases in 2021 and 2022 than in 2019.

“As someone who takes care of these children, it’s concerning to see some of the over-the-counter products that are utilized,” said Holstege. He noted the challenges of controlling access to products that “have some pretty significant toxicity” but that youth can easily pick up at the drugstore.

Despite the availability of substances frequently involved in overdoses and other modes of self-poisoning outside the home, caregivers can also do their due diligence in reducing or restricting access, Holstege said. They can keep medications locked up, and be aware of herbal and alternative remedies in the home, as even essential oils, when ingested, “can be quite dangerous.”

To mitigate the surge in suspected suicide attempts, the authors recommended policymakers prioritize partnerships with families, teachers, mental health professionals, and others in youth’s communities. They wrote that making suicide prevention resources like mental health care, the national suicide and crisis lifeline, and local and state tools more accessible to young people is key, as well as reducing access to potentially lethal substances and teaching coping skills.

If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.