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CNN
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Suicide is the leading cause of death among young people in the United States, and new research suggests that the majority of young people who die by suicide have no recorded mental illness diagnosis in their medical history.
Nearly three in five young people who committed suicide between January 2010 and December 2021 had never been previously diagnosed with a mental illness, according to a study published Tuesday in the medical journal JAMA Network Open, suggesting that mental illness may be going unnoticed or untreated in some young people.
The new study included data on people ages 10 to 24 collected from the Centers for Disease Control and Prevention’s National Violent Death Reporting System, including more than 40,000 suicides.
Only 40.4% of young people who died had a documented diagnosis of a mental illness, such as clinical depression, schizophrenia, or anxiety disorder.
“We found that some young people who commit suicide were less likely to have a documented mental illness, including those who used firearms, ethnic and racial minorities, males, and children younger than 14 years old,” study co-author Dr. Jennifer Hoffman, an emergency physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and an assistant professor of pediatrics at Northwestern University Feinberg School of Medicine, said in a news release.
“Our findings show there is a critical need to ensure equitable access to mental health screening, diagnosis and treatment for all young people,” she said.
The data showed that the odds of having a documented mental illness diagnosis varied by racial and ethnic group and among youth who used firearms.
The odds of being diagnosed were lower among American Indian/Alaska Native and black youth compared with white youth, and lower among Hispanic youth compared with non-Hispanic youth.
Hoffman and his colleagues from Emory University School of Medicine and other US institutions also found that the odds were lower among young people aged 10 to 14 compared with those aged 20 to 24, and that the odds were lower among men and boys compared with women and girls.
The researchers found that 33.2% of youth who died from a firearm had a recorded mental illness diagnosis, compared with 61.6% of youth who died from poisoning, 45.8% of youth who died from hanging, strangulation, or suffocation, and 44.2% of youth who died from other causes.
“Reducing the risk of youth firearm suicide requires counseling to encourage parents to store guns safely in the home, and this message should be conveyed not only in clinics but also in communities and schools,” Hoffman said. “Safe storage laws, also known as Childhood Firearm Access Prevention Acts, have also been proven effective in reducing firearm suicide rates, and more states should enact these types of life-saving laws.”
The data showed that the majority of suicides (64.8%) occurred at home, nearly half of the deaths (46.8%) were caused by firearms, and the most common triggers were intimate partner and family relationship problems.
Dr. Nina Mena, an Atlanta-based psychiatrist who sees patients ages 3 and up, said she sees this “all the time” in her practice: Children expressing suicidal thoughts after an argument with a parent or other family member, or after a device is taken away as a result.
“A lot of young people have poor coping skills, poor emotional regulation and poor distress tolerance, and they become very upset. They don’t know how else to feel, and they feel a void, like there’s nothing else in their life, which leads them to feel or talk about suicidal thoughts,” said Mena, who is also chief medical officer for CHRIS 180, a nonprofit that provides trauma-sensitive behavioral health services.
When this happens, “you need to take it seriously every time,” she says. “Make sure they’re in a safe place, that there are no firearms, sharp objects, drugs or anything else they could use to kill themselves. And then, once they’ve calmed down, ask them, ‘Hey, you said you wanted to kill yourself when you were angry. Did you really feel that way?’ And even if they say they didn’t, send them to therapy, because they need the coping skills to know the right words to use.”
Another study published Tuesday in the journal JAMA Network Open found that suicide rates among U.S. preteens increased significantly, by 8.2% annually, from 2008 to 2022. The increase followed a downward trend from 2001 to 2007.
Previous research has found that suicide and homicide rates among children and young people ages 10 to 24 in the United States in 2021 were the highest they’ve been in the past decade. And more people died by suicide in the United States in 2022 across all age groups than in any year on record since at least 1941.
In the new study, researchers from the National Institutes of Health and other U.S. institutions analyzed data from the CDC’s web-based Statistical Query and Reporting System, which listed suicide as the underlying cause of more than 2,000 deaths among 8- to 12-year-olds from January 2001 to December 2022.
“The disproportionate increase in suicide rates among women compared to men further supports existing evidence that historically large gender gaps in youth suicide rates are narrowing,” the researchers wrote. “Suicide was the 11th leading cause of death among preteen females from 2001 to 2007 and the 5th leading cause from 2008 to 2022, while suicide has consistently been the 5th leading cause of death among preteen males.”
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The researchers also found significant racial disparities, with black preteens experiencing the highest suicide rates and Hispanic preteens experiencing the largest increases in suicide rates across both time periods.
Two new studies detailing rising suicide rates, racial disparities and potentially undiagnosed mental illness highlight the need to improve access to mental health care and services, especially for Black and brown youth, Mena said.
“When people experience discrimination or racism, they don’t necessarily seek treatment because they’re taught to ‘be strong’ and ‘deal with it,'” she says. “Because Black people may experience this as a community, it may not be recognised as a risk for mental illness, even though it’s certainly considered trauma that can lead to depression, anxiety, PTSD, etc.”
