Editor’s note: If you or someone you know is struggling with suicidal thoughts or mental health issues, please call the 988 Suicide and Crisis Lifeline, or visit the hotline’s website.
According to a new study, the number of children seen in the emergency room for suicidal thoughts has risen steadily – and the increase began even before the Covid-19 pandemic, which led to record demand for psychological services for children.
The effects of the pandemic have drawn renewed attention to suicide among adolescents and young children. In June, the Biden administration called the recent rise in rates of depression, anxiety and suicidal thoughts among children an “unprecedented mental health crisis.”
The study, published Monday in the journal Pediatrics, used data from hospitals in Illinois. The researchers looked at the number of children aged 5 to 19 who sought help for suicide in emergency departments between January 2016 and June 2021.
During this period, there were 81,051 emergency room visits by young people that were coded for suicidal ideation. About a quarter of those visits turned into hospital stays.
The study found that ER visits with suicidal thoughts increased by 59% from 2016-17 to 2019-21. There was a corresponding increase in cases where suicidal ideation was the primary diagnosis, from 34.6% to 44.3%.
Hospitalizations for suicidal thoughts increased by 57% between fall 2019 and fall 2020.
“It really shows how much of an issue mental health issues really were before the pandemic. I mean, we’ve seen this huge increase in [emergency department] visits for children of all ages, honestly, in 2019, and that’s very concerning,” said study co-author Dr. Audrey Brewer, attending physician in advanced general pediatrics and primary care at the Ann & Robert H. Lurie Children’s Hospital in Chicago. “We saw more kids than usual that we… wouldn’t necessarily have thought they would have problems with suicidal ideation. We saw 5 year olds.
“To see them come to the emergency room for mental health reasons or for visits related to suicidal ideation is very concerning.”
Brewer thinks the true numbers are likely much higher than what the study found, because not all children who struggle with suicidal thoughts go to the ER.
Experts say this is not a problem unique to one state.
Dr. Nicholas Holmes, senior vice president and chief operating officer of Rady Children’s Hospital in San Diego, said the increase in the number of children seeking help in its healthcare system was “profound”.
“Over the past nine years, where we were seeing about one to two patients a day who were suffering from a behavioral health crisis, we now see more than 20 a day,” said Holmes, who was not involved in the new search.
He said Rady, the largest children’s hospital on the West Coast, is fortunate to have an inpatient child and adolescent psychiatric unit.
To help more of these children, the Holmes Hospital System is working with County Health and Human Services to help create a pediatric-focused mental and behavioral health campus. It will double the size of Rady’s inpatient behavioral health unit, in addition to strengthening services for children who need therapy but do not need hospitalization.
Other places in the United States are not so lucky. There’s a nationwide shortage of beds for kids who need mental health help, research shows. A 2020 federal survey found that the number of residential treatment facilities for children fell 30% from 2012.
The shortage of care has been accompanied by a significant increase in the prevalence of mental health problems that can lead to suicide. In 2019, 1 in 3 high school students and half of all female students reported persistent feelings of hopelessness and sadness, up from 40% in 2009. Disease Control and Prevention.
The new study can’t pinpoint exactly why so many young people are going to hospital with suicidal thoughts, but Brewer thinks it may be a combination of factors.
Many children hospitalized with suicidal thoughts had other mental health issues like anxiety, depression and substance abuse, she said.
Children also respond to trauma in their lives and social influences on their health such as poverty, historical trauma and marginalization, problems at school, online bullying and social media pressures, in addition lack of access to counseling and therapy.
Brewer said adults can intervene when a child is thinking about suicide. She advises carers to be on the lookout for problems at school or with friends and watch for a child who isolates himself or shows signs of more anxiety or aggression than usual.
“They may act out or have trouble sleeping. Irritability and being more withdrawn and isolating are a lot of things that we will often think about,” Brewer said.
It never hurts to seek help from a pediatrician on how to help a struggling child.
“It’s important that parents feel empowered to really sit down and listen to their children and talk to them. Really try to understand and understand what’s going on with them and help foster positive relationships,” Brewer said.
She said she hopes mental health care will become less stigmatized and more accessible to children.
“We really need to develop more of a strategy to help support all sorts of different ways and really focus on some of these traumas and social influences of health,” Brewer said. “We need to make sure that more children will have safe places to grow and thrive.”
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