Suicide is a leading cause of death among American teens, and the rate of suicide attempts and self-harming behavior is on the rise in recent years.

From 2007 to 2015, the rate of suicide attempts and suicidal ideation doubled in children and teens, according to MedPage Today. The breakdown for related emergency department visits among age groups was as follows:

• 5-11 years old: 43%
• 12-14 years old: 24%
• 15-17 years old: 33%

A separate study showed that youth ages 10-19 experienced the biggest jump in emergency department visits for suicidal ideation, self-directed violence, or both, between January 2017 to December 2018. The rate of increase was 34% among females 10-19 years old and 62% among same-age males. The study’s authors say that additional research is needed to understand why emergency department visits decreased during the summer months.

Some experts, such as Leah Harter, licensed mental health counselor and director of Counseling Center of Park City, Utah, told MedTruth that tensions about grades build up throughout the school year, and that along with “cabin fever” can contribute to teen tragedies, including suicide attempts.  

While mental health professionals agree that there’s no single cause of suicidal ideation, according to Casey Wolfington, licensed psychologist and community behavioral health director of Eagle Valley Behavioral Health in Vail, Colorado, some of the most pressing contributing factors are the impact of social media and technology, lack of behavioral health services and the stigma attached to seeking help.

“Social media and technology have been linked with the concept of relational poverty, where there is reduced connection among family members, friends and social support, leading to feelings of loneliness and isolation,” Wolfington told MedTruth. 

“A good example is a parent who may be sitting next to their child in the living room but consumed with returning emails from work. The lack of boundaries with regard to technology can impact everyone’s ability to connect and create meaningful relationships. Additionally, the immediacy of technology can impact adults and teens. A parent may say, ‘Hold on, I have to respond to this email super quick.’ And this may model that all things need to be addressed immediately. Then when a kiddo is in distress, they too are looking to address this immediately, which could lead to impulsive and risky behavior,” he said.

In addition to growing sociocultural distress and pressures, greater awareness of mental health issues may also be contributing to increasing youth emergency department visits. 

“In my opinion, there were suicide attempts and cutting behavior (before). I just think we’re getting better at identifying kids at risk,” Harter said. “It’s not a secret — we tell them to let an adult know. And there is more growth around parents saying, ‘I need to be more in touch with my kids.’ They’re getting more proactive about getting help.” 

Sexual Orientation and Youth Suicide Attempts

New research published in March in the journal Pediatrics found that suicide attempts among non-heterosexual teens are decreasing as greater numbers of teens self-identify in this regard. Between 2009 and 2017 the rate of teens reporting a sexual minority orientation doubled from 7% to 14% while the rate of suicide attempts slightly declined each year (0.8% annually) amongst this population.

Still, in 2017 non-heterosexual teens were more than three times more likely to attempt suicide compared to their heterosexual counterparts, a disparity the study authors say has been linked to social stigma. The authors suggest further research regarding suicide prevention for sexual minority teens, but also advocate that schools train healthcare providers to provide “culturally competent care.”

Interventions

Some communities are taking action.

Greg Daly, SWAT commander with the Avon, Colorado police department, told MedTruth that prior to the launch of a county-wide behavioral health initiative in 2017, police procedures required handcuffing people in crisis and taking them to the police station until a mental health professional could evaluate them. When paramedics responded to crisis calls they would most often deliver them to the emergency department.

Now, specialized crisis management clinicians from Hope Center of Aspen and Eagle River Valley, Colorado, accompany police or paramedics. The clinicians help calm patients, establish a safety plan, link patients to therapeutic resources, and follow up with patients days later. Most of the time these interventions prevent a trip to the emergency department, Chris Montera, chief executive officer of Eagle County Paramedic Services, told MedTruth. Hope Center also provides 12 school-based clinicians to middle and high schools at no cost.

Meanwhile, Eagle Valley Behavioral Health is building its own crisis center and walk-in clinic, and it currently offers integrated behavioral health services, in which primary doctors evaluate both physical and mental health during routine checkups. 

“This integration creates an environment of holistic wellness, which serves to normalize behavioral health services,” Wolfington, community behavioral health director of Eagle Valley Behavioral Health, said.

“When we increase acceptance and compassion and provide resources, we can have a huge impact on a variety of issues including suicide,” she said. “At EVBH, we strive to create a community where we spend as much time, effort and resources on our behavioral health as we do our physical health. We hope that through this, we can reduce stigma, reduce shame, enhance openness, and dramatically increase resources.”

Since 2017, Wolfington said, the number of suicide attempts among both teens and adults requiring medical treatment has decreased. And while there’s still a “high percentage” of teens seeking help for suicidal thoughts, they now have access to effective treatment options other than emergency department visits.

Park City, Utah’s Christian Center has brought in more counselors, workshops and support groups to address the mountain community’s growing needs. In 2018, it provided 442 therapy sessions for teens, and in 2019, it gave 770 sessions to teens.

Harter said improving mental health takes “everyone being on alert,” including doctors and teachers. She said kids need to feel heard, supported and validated. As a result, Park City High School offers support groups for students. And the state of Utah runs SafeUT, a 24/7 crisis chat and tip line app with services provided by the University of Utah.

Resources for Preventing Self-Harm and Suicide

If you or someone you know is having suicidal thoughts or otherwise considering self-harming behavior, call the National Suicide Prevention Lifeline immediately at 1-800-273-TALK (8255). Caring professionals are available 24/7.

The Crisis Text Line is also available for free 24/7. Text “HOME” to 741741 and a trained crisis counselor will respond via text.