Teen girls drove increase in suspected suicide attempts during pandemic, CDC report finds

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[This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)]

Teen girls drove significant increases in emergency department (ED) visits for suspected suicide attempts over the last year, according to the Centers for Disease Control and Prevention (CDC). 

The agency released a new Morbidity and Mortality Weekly Report on Friday, finding that weekly ED visits for suspected suicide attempts among girls aged 12-17 increased by 50.6% by March 2021, compared to 2019, whereas visits among adolescent boys increased 3.7%.

However the trends don’t necessarily suggest more deaths occurred, and the study wasn’t designed to pin the cause of the increase to the pandemic. Provisional data indicated an overall decline in the suicide rate from the third quarter of 2019 to 2020, and the rate among people aged 15-24 didn't see a significant change, researchers wrote.

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The agency used data from the National Syndromic Surveillance Program (NSSP) to examine trends in emergency department visits for suspected suicide attempts from January 2019-May 2021 among people aged 12-25, at three intervals during the COVID-19 pandemic. Data include about 71% of the country’s emergency departments in 49 states. ED visits for suspected suicide attempts included visits for nonsuicidal self-harm.

While visits for suspected suicide attempts decreased in spring 2020 compared to the same period a year prior, visits began climbing by May 2020 among adolescents, and particularly among girls. During late July to late August 2020, visits among adolescent girls were up 26.2% over the year prior, and increases persisted as the pandemic progressed, climbing to 50.6% by March 2021. Visits among boys increased 3.7%.

"Compared with the rate during the corresponding period in 2019, the rate of ED visits for suspected suicide attempts was 2.4 times as high during spring 2020, 1.7 times as high during summer 2020, and 2.1 times as high during winter 2021," the study reads. "This increase was driven largely by suspected suicide attempt visits among females."

The number of visits among adolescent boys and those aged 18-25 "remained stable" with rates in 2019, though rates increased. Researchers said the findings bolster prior studies indicating young girls have "consistently higher" self-reported suicide attempts than boys, and such trends predated the pandemic.

"However, the findings from this study suggest more severe distress among young females than has been identified in previous reports during the pandemic, reinforcing the need for increased attention to, and prevention for, this population," study authors wrote.

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Researchers suggested adolescents are at high-risk for suspected suicide attempts due to factors like isolation owing to virtual classes, substance use, worries over family health and hurdles in mental health treatment. Heightened ED visit rates for suspected child abuse and mental health problems during 2020 potentially exacerbated the increase in suspected suicide attempts. Adults working from home, spending more time with children, may have better recognized kids’ suicidal behaviors and had a higher likelihood of taking kids to the hospital, researchers suggested.

The report had its limitations; it’s not nationally representative, it couldn’t distinguish between first-time visits and follow-up visits and data on race and ethnicity was not available, so analyses among racial/ethnic groups weren’t possible, among other limitations.

"Suicide prevention requires a comprehensive approach that is adapted during times of infrastructure disruption, involves multisectoral partnerships and implements evidence-based strategies to address the range of factors influencing suicide risk," researchers wrote.