Editor’s Note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the National Suicide Prevention Lifeline at 800-273-8255 to connect with a trained counselor or visit the NSPL site.
The mental health of Americans has suffered during the Covid-19 pandemic, and new research shows the damage wasn’t limited to adults.
The number of suicides among adolescents between the ages of 10 and 19 increased in five states during the pandemic, according to research looking at 14 states published in the journal JAMA Pediatrics on Monday.
Data from Georgia, Indiana, New Jersey, Oklahoma, Virginia and California also showed an increase in the proportion of adolescent deaths by suicide relative to suicides by people of all ages, the authors found. Conversely, Montana had a decrease in adolescent suicides and the proportion of adolescent deaths by suicide during the pandemic, while Alaska had a decrease in proportion only, the research found.
“Suicide-risk screenings have yielded higher positive rates” during the pandemic than beforehand, the authors said. And in 2021, the American Academy of Pediatrics declared a state of emergency concerning children’s and adolescents’ mental health.
To measure the impact of this heightened risk, the researchers partnered with public health departments in 14 states and looked into death certificate data on more than 85,000 people who died by suicide. The authors compared two time periods: 2015 to 2019 and 2020, which is the pandemic year they analyzed.
The findings highlight the need to pay attention to any behaviors adolescents show that can signal suicidal thoughts, said Marie-Laure Charpignon, the first author of the study and a doctoral student in statistics at the Institute for Data, Systems and Society at the Massachusetts Institute of Technology. “We’re all kind of blind within our own families or households,” she added. Sometimes “we see what we want to see, or what we have the opportunity to see in the limited amount of time we have.”
Why certain states had an increased number of adolescent suicides is a “tricky question,” and the answer could depend on many factors, Charpignon said.
Knowing whether the deaths of adolescents’ caregivers during the pandemic influenced the increase in adolescent suicides requires further research with local health departments, Charpignon said. Whether virtual or hybrid school settings in these states during the pandemic could have negatively affected adolescents’ mental health, and therefore their suicide risk, is also unknown, Charpignon said.
Having this geographical data could help public health experts reconsider where they allocate mental health services, she added.
This research isn’t the first to look into adolescent suicidality in the United States during the pandemic. Emergency department visits for suspected suicide attempts among youth, especially girls, ages 12 to 17 started to increase in May 2020, according to a US Centers for Disease Control and Prevention study. The same study found that from February 21, 2021, to March 20 of the same year, visits increased by 50.6% among girls and 3.7% among boys in that age range, when compared with the same time period in 2019.
Peers and caregivers should watch for any negative changes in how adolescents express themselves or how often they communicate, Charpignon said. Concerned parents can talk with health professionals and their children’s teachers, in case they have noticed any behavioral changes, she added.
Suicide risk factors also include mental or substance abuse problems or a family history of them; negative life events; family history of suicide; familial abuse of any type; household guns; impulsive behaviors; and exposure to others’ suicidal behaviors, according to Johns Hopkins Medicine.
Other common warning signs – which could also indicate depression – according to Johns Hopkins Medicine, include the following:
- “Changes in eating and sleeping habits”
- Loss of interest in activities or school
- “Neglecting one’s personal appearance”
- “Obsession with death and dying”
- More complaints of physical ailments linked to emotional distress
- “Problems focusing”
- “Lack of response to praise”
- “Verbal hints such as ‘I won’t be a problem much longer’ or ‘If anything happens to me, I want you to know…’”
- Giving or throwing away cherished belongings
- Cheeriness after a depressive episode
Expanded access to suicide risk assessments and grief counseling for coping with loss of caregivers could be helpful interventions for adolescents at risk for suicide, according to the study authors.
The researchers have recently examined adolescent suicides in all other states and plan to submit those findings for peer review April 25, Charpignon said. Further research that looks at racial and ethnic differences is also needed, the authors said, since “pandemic-period suicidality may be differentially affected by race and ethnicity.”