children s health issues
Suicidal Behavior in Children and Adolescents
Introduction
Suicidal behavioris an action intended to harm oneself and includes suicidal gestures, suicide attempts, and completed suicide.Suicidal ideationis thoughts and plans about suicide.Suicide attemptsare acts of self-harm that could result in death, such as hanging or drowning. A stressful event may trigger suicide in children who have a mental health disorder such as depression. Children at risk of suicide may be depressed or anxious, withdraw from activities, talk about subjects related to death, or suddenly change their behavior. Family members and friends should take all suicide threats or attempts seriously. Health care professionals try to determine how serious the risk of suicide is. Treatment may involve hospitalization if the risk is high, drugs to treat other mental health disorders, and individual and family counseling. (See also Suicidal Behavior in adults.) Suicide is rare in children before puberty and becomes more common in adolescence, particularly between the ages of 15 and 19, and of adulthood. However, preadolescent children do commit suicide, and this potential problem must not be overlooked. In the United States, suicide is the second leading cause of death in 10- to 24-year-olds and the 9th leading cause of death among 5- to 11-year-olds. It results in 2,000 deaths per year. Suicide has had a particularly large impact on the Black community, as the rate nearly doubled in Black children in elementary school between 1993 and 2012. It is also likely that a number of the deaths attributed to accidents, such as those due to motor vehicles and firearms, are actually suicides. Many more young people attempt suicide than actually succeed. The Centers for Disease Control and Prevention recently provided information about increasing trends in suicide across a number of groups and time periods: For females (ages 10 through 14), the overall suicide rate increased from 0.5% in 1999 to 2% in 2019. For males (ages 10 through 14), the overall suicide rate increased from 1.9% in 1999 to 3.1% in 2019. Additional findings highlight suicide-related statistics about high school students in the United States in 2015: Between 2001 and 2015, visits to the emergency department for self-inflicted injuries, suicidal thoughts, or attempted suicide increased across all age groups. The sharp increase in suicide attempts was first noted in 2011, even while the actual number of suicides remained stable. From 2006 to 2015, there were over 40,000 suicides in 10- to 19-year-olds. During that same period, 118,000 children and adolescents in that same age group required medical treatment for nonfatal suicide attempts. Many factors may contribute to the increase in suicide attempts among children and adolescents, among them the increases in adolescent depression (especially in girls), increased parental opioid prescriptions, exposure to increasing suicide rates among adults in their circle, conflict-filled relationships with parents, and academic stress. Frequently, suicide attempts involve at least some ambivalence about wishing to die and may be a cry for help. Among adolescents in the United States, boys outnumber girls in completed suicide by more than 4 to 1. However, girls are 2 to 3 times more likely to attempt suicide. The COVID-19 pandemic contributed to increases in suicides in children and adolescents. Emergency department visits for suspected suicide attempts were 22% higher for all adolescents during the summer of 2020 than they had been just one year earlier, and 39% higher during the winter of 2021. Higher rates were reported in girls (26% higher during the summer and 51% during the winter). Suicide is the second or third leading cause of death among adolescents in the United States. 