A report published in March by the American Academy of Pediatrics (AAP) showed an increase in hospital visits by young people for suicidal ideation (SI) and suicide attempts (SA). In the report, researchers analyzed billing data from emergency room and outpatient visits from 45 children’s hospitals across the United States. Numbers for SI and SA visits rose across all youth age groups between 2008 and 2015. The most significant increases were found in adolescents age 12-17.

Key Findings From the Study

• 115,856 instances of SI and SA encounters were identified.
• SI and SA visits accounted for .66% of all visits in 2008 and 1.82% of all visits in 2015. That’s an increase of almost 25%, or 0.16 percentage points.
• SI and SA visits per year increased by an average 0.25 percentage points for adolescents age 12-14.
• The percentage of SI and SA visits per year increased by an average 0.27 percentage points for adolescents age 15-17.
• For girls, SI and SA visits increased by an average 0.14 percentage points per year.
• For girls, the annual percentage of SI and SA visits increased by an average 0.10 percentage points.
• Researchers observed seasonal variation in visits:
  • SI and SA visits were highest in school months
  • SI and SA visits were lower in summer months

National Public Radio reporter Tara Haelle interviewed the study’s principal investigator, Gregory Plemmons of Vanderbilt University, who 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,” he told Haelle.

However, other researchers note that though there is great value in retrospective analyses of large volumes of data, there are significant limitations to studies of this variety. NPR’s Haelle 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,” she observed. “Despite being the third-leading cause of death in adolescents [ed note: recent data shows suicide to be the second leading cause of death in adolescents], suicide is still relatively rare, making it harder to study causes.”

Know the Risks

It’s important to understand the risk factors associated with teen 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 opiods

What Can You 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. If it does turn out your teen is simply being dramatic, then consider it a cry for help. Either way, you need to get to the root of the problem. You need to understand why they feel the need to draw attention to themselves in such an extreme manner.

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. At the same time, make 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. However, 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 to recognize 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.