Why are Youth Suicides Increasing?

By: Hana Rahman MPH, National Center for Health Research

Suicide rates increased by 37% in the United States between 2000-2022.1 Although still lower than older adults, the increase in youth suicides has been especially worrisome. The increase in preteen suicides has been especially shocking, increasing from the 11th leading cause of death in preteens between 2001 and 2007 to the 5th leading cause of death between 2008 and 2022. This has been attributed to the increase in preteen girls’ suicides; suicide in male preteens has consistently ranked as the 5th leading cause of death since 2001.2

Much of what we know about trends in U.S. teen suicides is based on the Youth Risk Behavior Surveillance System (YRBS), a school-based survey for ninth through twelfth graders that is collected every 2 years by the Centers for Disease Control and Prevention. The survey asks about health behaviors that youth have experienced in the previous 12 months. This survey reports that 2,241 preteens died by suicide from 2001 to 2022.3 Researchers have also observed a significant increase in suicide rates since the onset of the COVID-19 pandemic. A one-month survey starting on February 21, 2021 found that emergency department visits for suspected suicide attempts were 50.6% higher among girls aged 12 to 17 years and 3.7% higher among boys than during the same time period in the prior year.4 

Suicide Rate Disparities 

It’s important to understand which traits pose the greatest risk to youth mental health. Data from the last 10 years suggests there is a great need to better understand suicide risk among racial and ethnic subgroups, as well as the multiracial youth who comprise the fastest-growing racial group in the US. Lesbian, gay, bisexual, transgender, and queer (LGBTQ)+ youth are also at especially high risk.

In 2019, suicide was the third leading cause of death for Black youth between 5 and 19 years old.4 Black preteens had the highest rates of suicide and Hispanic preteens had the highest percentage increase.3  YRBS data also showed that Black youth were more likely than all other groups to make suicide attempts, but were less likely to report suicidal ideation (thoughts or plans).4 YRBS data for American Indian/Alaskan youth show that their suicide death rate is 3 times higher than overall rates among all children and adolescents in the United States and the highest rates of suicide death of all racial and ethnic groups of boys and girls.4

Deaths by suicide more than doubled among Asian American and Pacific Islander youth (AAPI) but very little information exists about the risk factors that caused this increase.4 The few studies suggest that these youth often suffer from acculturative stress, which is the stress immigrants may feel when attempting to assimilate to their immigration country’s cultural norms.5 The studies need to be replicated and improved so that this high suicide rate can be better understood.

Many studies have shown that lesbian, gay, and bisexual preteens are more likely than cisgender preteens to be diagnosed with anxiety, depression, and report having suicidal ideation.6 These studies suggest that mental health disparities in LGBTQ+ youth are due to dealing with various minority stressors like stigmatization, rejection, and feeling ashamed about their sexual orientation. Similarly, one study conducted in 10 states (Colorado, Delaware, Hawaii, Maine, Maryland, Massachusetts, Michigan, Rhode Island, Vermont, Wisconsin) and nine school districts (Boston, Broward County, Cleveland, Detroit, District of Columbia, Los Angeles, New York City, San Diego, San Francisco) found that when compared with cisgender students, transgender students were more likely to report suicidal thoughts and ideation. In fact, nearly 35% of transgender students reported attempting suicide in the last 12 months.7

Methods of Suicide

There are many reasons for the increases in suicide, and the increase in youth suicide is often attributed to the negative impact of social media8 and sometimes attributed to the increase in suicide among youth taking antidepressants. 9 However, from a practical viewpoint, suicide is more likely when a suicidal person has access to weapons or drugs that can be lethal.10 In the last 12 years, the largest increase in preteen suicides was by firearms.3 A 2021 study of almost 68,000 firearm-related deaths among US youth aged 5 to 24 years found that firearm suicides are more common in neighborhoods with higher concentrations of people living at or below the federal poverty line.11 Historically, these communities are disproportionately composed of American Indian and Alaska Native, Black, and Hispanic or Latino communities.11

Death certificate data from January of 1999 to December of 2020 found that firearms are the leading method of adolescent suicide.12 From 2011 to 2020, the proportion of suicide deaths involving firearms increased from 40% to 51% among black male adolescents compared to 49% to 52% among white male adolescents.12  This indicates the need to better understand to what extent access to firearms affects youth suicides.

Male adolescents residing in gun-owning homes are more likely to commit suicide using firearms. The increase in firearm suicide among both female and male adolescents from 2007 to 2020 may also reflect a surge in new gun owners and youth exposure to gun violence.13  A large portion of U.S. adults (5.4 million) live in homes with guns, exposing more than 5 million children.13 Adolescent firearm suicides are significantly more likely to occur in homes that do not store guns safely.

Strategies for Reducing Suicide 

Firearm storage practices vary widely, due to the type of firearm owned and reasons for ownership.14 Evidence suggests that adolescents who die by firearm suicide are significantly more likely to live in homes with firearms and that firearms used for adolescent suicides are most often owned by parents.14 Keeping firearms unloaded and locked up so that they are inaccessible to those who should not have access has been endorsed broadly for the prevention of firearm-related harm.15  Adolescent firearm suicides are significantly more likely to occur in homes with unsafe gun storing practices yet despite this, unsafe gun-storing practices persist as a significant nationwide problem.

Clinical strategies for reducing youth suicide include early pediatric screening for mental illness that considers include factors related to discrimination, youth caregiver acculturation gap, sexual and gender minority status, family cultural conflict, inter-generational trauma, individual experiences of racism, and acculturative stress.15 Additionally, evidence-based treatments like attachment-based family therapy have shown significant reductions in suicidal ideation. This therapy can be particularly effective because it includes and targets parent behaviors that may increase the likelihood of youth becoming suicidal.16 This type of therapy has been studied for over 15 years and produced promising findings for LGBTQ+ and Hispanic youth, resulting in lower self-reports of depressive symptoms, and less avoidance in relationships with parents.17

Community and school-based interventions can help reduce preteen suicide rates. A Canadian study that examined Native populations found that suicide rates were significantly lower in communities that were actively preserving their own culture.18 For example, preteen/youth suicides were less likely in Native communities that had buildings designated specifically for cultural practices where community members could congregate.18 A review of interventions for youth suicide between 2015 and 2019 found that youth who participated in community/school interventions that had a family or parent training component or skills training focused on the ability to control one’s feelings under uncomfortable circumstances were less likely to be considering suicide 6 months later.19

Future Initiatives

How can we reduce the number of preteens and teenagers who attempt or commit suicide?  Research is needed to evaluate the impact of age; race; gender; and culture, as well as use of social media and antidepressants and access to firearms, and which types of programs are most effective with which groups of adolescents.

 

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff. 

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