Long-Term Trends in Suicidal Ideation and Suicide Attempts Among Adolescents and Young Adults

September is National Suicide Prevention Month in the U.S. In honor of this month, we’ll share resources and highlight ways that everyone can make a difference in the life of a teen or adult who may be at risk of suicide. In this post, we’ll offer data on trends in suicidal ideation and suicide attempts among adolescents and young adults between 2008 and 2017.

Please read the first two articles in this series, Suicide Prevention Month: When It Comes to Suicide, We Can All Save a Life, which contains helpful information about suicide and suicide prevention from a police officer with years of experience helping people live through suicide-related crisis moments, and Suicide Prevention Month: Five Action Steps, which contains five effective steps you can take to help someone you believe is contemplating or at risk of suicide.

Teen Suicide: Facts and Figures

A report published in March 2018 by the American Academy of Pediatrics (AAP) showed a startling increase in hospital visits by young people for suicidal ideation (SI) and suicide attempts (SA) between 2008 and 2015. Researchers conducted a retrospective analysis of administrative billing data on emergency room and outpatient visits collected by the Pediatric Information System Database, a collective data-sharing network that includes over 45 children’s hospitals across the United States. Numbers increased for SI and SA visits across all youth age groups, with the most significant increases found in adolescents age 12-17.

This article is an update on that report, with supplemental data from new studies that include statistics and data from 2008-2017 for young adults, in addition to the original information from 2008-2015 for adolescents. First, we’ll recap the key findings from the AAP study, then offer the latest data from the new report.

Notable Findings from the 2018 AAP Report

• Researchers identified 115,856 instances of SI and SA emergency room and outpatient visits
• SI and SA visits accounted for .66% of all visits in 2008 and 1.82% of all visits in 2015 – an increase 0.16 percentage points, or almost 25%
• Annual percentage of SI and SA visits increased by an average 0.25 percentage points for adolescents age 12-14.
  • That’s an increase of 176% between 2008 and 2015
• Annual percentage of SI and SA visits increased by an average 0.27 percentage points for adolescents age 15-17.
  • That’s an increase of 103% between 2008 and 2015.
• Annual percentage of SI and SA visits increased by an average 0.14 percentage points for boys.
  • That’s an increase of 104% between 2008 and 2015
• Annual percentage of SI and SA visits increased by an average 0.10 percentage points for girls.
  • That’s an increase of 139% between 2008 and 2015.
• Researchers observed seasonal variation in visits:
  • SI and SA visits were highest in school months
  • SI and SA visits were lower in summer months

In an interview with National Public Radio (NPR),  the study’s principal investigator, Gregory Plemmons of Vanderbilt University, weighed in on the results:

“The number one thing to take home is that it’s important to talk about this and important to ask about it.”

However, other researchers note that though there is great value in retrospective analyses of large volumes of data, there are also significant limitations to studies of this variety. NPR also interviewed Dr. Laurel Williams from the Texas Children’s Hospital in Houston about takeaways from the AAP report:

“This type of study is very good at revealing trends but cannot address causality. Despite being the third-leading cause of death in adolescents, suicide is still relatively rare, making it harder to study causes.”

Note: since the publication of this AAP report, suicide has become the second leading cause of death for people age 10-19 in the U.S., accounting for 19.2% of deaths.

The New Data for Young Adults

After publication of this report in March 2018, a different group of researchers decided to look at the same categories – i.e. rates of suicide and suicidal ideation – from a different source. They used the 2017 National Survey on Drug Use and Health (2017 NSDUH). Their analysis, published in April 2019, focused past-month suicidal thoughts, plans, and attempts in young adults age 18-25. Previous data clearly identified the long term, upward trend in suicidal ideation and suicide in adolescents age 12-17 between 2008 and 2015. This goal of this study was to determine if a similar trend was present in young adults from 2008-2017.

Here’s what they found for the period 2008-2015:

• Thoughts of suicide, by age:
  • 18-19: increased 46%
  • 20-21: increased 68%
  • 22-23: increased 55%
  • 24-25: increased 29%
• Plans for suicide, by age:
  • 18-19: increased 76%
  • 20-21: increased 113%
  • 22-23: increased 117%
  • 24-25: increased 34%
• Suicide attempts,by age:
  • 18-19: increased 22%
  • 20-21: increased 87%
  • 22-23: increased 108%
  • 24-25: increased 24%
• Completed Suicides,by age:
  • 18-19: increased 56%
  • 20-21: increased 35%
  • 22-23: increased 32%
  • 24-25: increased 33%

This data clearly shows that over the same time period, suicidal thoughts, ideation, and attempts increased dramatically for young adults as well as for adolescents. In addition, a report published by the American Foundation for Suicide Prevention shows that the upward trend in suicide for adolescents age 12-17 between the 2008 and 2015 continued to 2017. While the data in that report groups the age ranges differently than the 2018 AAP report, it shows an increase of over 15% in suicide deaths for people age 15-24 between 2015 and 2017.

What all this data means is that for adolescents and young adults, suicide is on the rise. And it has been for over a decade. Anyone involved in the lives of adolescents or young adults should understand this fact. They should also know the risk factors, warning signs, and what they can do if they think an adolescent or young adult they know is contemplating suicide.

Know the Risks

It’s important to understand the risk factors associated with suicide. Issues and events that can lead to suicidal ideation or self-harm include, but are not limited to:

• Family history of suicidal behavior
• Family or personal history of emotional, behavioral, or psychiatric disorders.
• Personal history of alcohol or substance use disorder
• Loss of close family members or friends
• Lack of family or social support
• Conflict with close family members or friends
• Experiencing bullying, either online or in real life.
• Self-identifying as LGBTQ
• Loss of a close family member or friend to suicide
• Access to lethal means, such as firearms or prescription medications such as opioids

What You Can Do

The most important thing you can do if you suspect your teen is at risk of attempting suicide is start an honest and open dialogue with them about what’s going on. Ask questions and listen carefully to the answers. If your teen openly discusses suicide or harming themselves, it’s crucial to validate their emotions and their point of view while offering your unconditional love and support.

In the beginning, don’t try to fix things. Just listen.

It’s true that some teens make dramatic statements for attention and have no intention of harming themselves. Even in these cases, you need to take every mention of suicide or self-harm at face value and treat it seriously. The slightest chance you’re wrong isn’t worth the risk they’re really planning to do something drastic. And if it does turn out your teen is simply being dramatic, consider it a cry for help. You need to get to the root of the problem and understand why they feel the need to draw attention to themselves in such an extreme manner.

Here are three steps to take if you’re worried your teen is considering self-harm or suicide:

1. Talk to your teen. Try to have the discussion in an objective, dispassionate manner, while making sure your teen knows you’re there to support them no matter what.
2. Schedule a professional evaluation. A fully trained and licensed mental health professional can determine if there are underlying factors at play, such as an emotional, substance use, or other psychiatric disorder. You can find a qualified professional in your area with this psychiatrist finder provided by the American Academy of Child and Adolescent Psychiatry.
3. Get Treatment. If a professional mental health assessment indicates your teen needs the help of a psychiatrist or therapist, then discuss the options with your family. Outpatient therapy, partial hospitalization, intensive outpatient therapy, or residential treatment programs are all valid options, depending on your teen’s level of need.

IN CASE OF EMERGENCY, CALL 911

Awareness, Communication, and Compassion

At the moment, no scientific data exists to explain the significant increase in hospital visits by young people for suicidal ideation and suicide attempts over the seven years examined in the AAP report. Various experts cite potential causal factors such as social media, academic pressure, cyber-bullying, and sexting. These theories make sense at face value. But to date, no clinical studies link these 21^st century phenomena to the disturbing upward trend identified by the AAP researchers. One way to understand the value of the data presented in the AAP study is that it can raise awareness on the part of the parents, school officials, and mental health professionals who interact with adolescents every day.

Ideally, this heightened awareness will lead adults to communicate openly and compassionately with teenagers about what’s happening in their lives. Normalizing conversations around mental health issues can help remove the traditional stigma associated with seeking help for emotional problems that can lead to suicidal ideation or suicide attempts, such as depression, anxiety, trauma, and stress. We know our teenagers struggle with these conditions. We also know they often suffer in silence because they’re afraid to speak out. The responsibility for initiating these conversations lies with adults. It may not seem like teenagers want to talk about their deepest fears and innermost pain, which is completely understandable. However, this is where life experience, wisdom, and knowledge come in. Adults have the emotional capacity and mental wherewithal to frame sensitive conversations in ways that are positive, productive, and possibly life saving.

Suicide and Self Harm Hotlines

Teens who need help can call or text the following numbers:

• The National Suicide Prevention Lifeline (24/7/365): 1-800-273-8255
• The Trevor Project Phone (24/7/365): 1-866-488-7386
  • Note: The Trevor Project was originally created to support LGBTQI+ teens in crisis. However, they will help anyone who calls.
• The Trevor Project Text (7 days/wk, 6am-am ET, 3am-10pm PT): Text START to 678678
• The Trevor Project Chat: CLICK HERE
• The Crisis Text Line (24/7/365): Text CONNECT to 741741
• The Youth Yellow Pages TEEN LINE (6pm-10pm PT) 310-855-4673
• The Youth Yellow Pages TEXT: Text TEEN to 839863