HCA East Florida - September 06, 2019

There's a troubling new health trend among children, according to data from the Centers for Disease Control and Prevention (CDC). After declining 33 percent between 1999 and 2013, the death rate for kids aged 10 to 19 rose 12 percent between 2013 and 2016.

More troubling still: a portion of that rise is attributable to a 56 percent leap in the death rate from suicide between 2007 and 2016.

Experts, understandably, are worried.

"This is a growing trend that does not appear to be slowing down," says Franklin Drummond, MD, MBA, inpatient psychiatrist and medical director at Trident Medical Center in Charleston, South Carolina.[SM1] "I think it's part of the reality of being a child today, and that's a new concept for a lot of people."

What the numbers show

The rise in suicide rates reported by the CDC corresponds with research from America's hospitals. A study published in June 2018 in the journal Pediatrics found that visits to children's hospitals for suicide attempts and suicidal ideation (talking about or threatening to harm or kill oneself) more than doubled between 2008 and 2015. While about 50 percent of those visits were from teenagers 15 to 17 years old, nearly 13 percent came from kids 5 to 11 years old.

Factors that contribute to suicide in children

Risk factors for suicide in children and teenagers include the following:

  • Mental health issues (including depression, anxiety and substance abuse)
  • Previous suicide attempts
  • Family history of suicidal behavior or mental health issues
  • Gay, lesbian or bisexual orientation or transgender identity
  • History of physical or sexual abuse
  • Exposure to violence

Other signs in children and teens that suggest a suicide attempt may be imminent include:

  • Suicidal ideation
  • Feeling trapped, hopeless or purposeless
  • Excessive anxiety, worry, fear or anger
  • Withdrawal from friends, family and society
  • Reckless behavior
  • Mood changes

And the following factors may increase the likelihood of a suicide taking place:

  • Access to weapons or other means of self-harm (such as medications or poisons)
  • Alcohol and drug use
  • Exposure to suicide (of a family member or friend)
  • Social stress and isolation

Younger children may show different warning signs

Dr. Drummond notes that it's important to recognize that mental illness (a risk factor for suicide), may appear different in younger children than in adolescents.

A 2016 study published in Pediatrics looked at 699 suicides in elementary-aged children. It found that, among those children who had been diagnosed with a mental health problem, the younger children who died by suicide were more likely to have a diagnosis of attention-deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD). Older children, on the other hand, were more likely to be diagnosed with depression.

"The rate of completed suicide among the younger age group has a high correlation with ADD," Drummond points out. "ADD can manifest as an increase in activity or appetite or as behavioral problems." He notes that impulsivity - a hallmark of ADD - may contribute to suicide in younger children because it can result in acting on suicidal thoughts.

Other warning signs in younger children are often subtler than those seen in adolescents and teens. "I always try to alert people for a change in a child's behavior that involves some sort of withdrawal or a change in attitude about other people," Drummond says. Crying spells, becoming less verbal and displaying a lack of interest in familiar activities are also signals.

"These signs should be noted," he says, "and there should be an intervention at that point."

What to do if you see signs


Drummond says the first thing to do if you detect warning signs of suicide is to talk directly to your child about it. "Be open and try to make it non-threatening," he says.

If you continue to suspect a risk for suicide, Drummond says it would be appropriate to reach out to a family therapist or counselor who focuses on children, or a child psychiatrist.

Communication and staying engaged with your child is key. "The way that families manage feelings and the more support that families provide can definitely help manage some of these stressors," Drummond says. "Isolation of the individual is one of the big risk factors for a completed suicide."


Teachers have a role to play, too. "Kids can present a different face at school than they do at home," Drummond says, "and teachers can help identify acute behavioral changes."

For example, teachers may be able to discern changes in a child's interaction with peers or self-isolating behavior, which may be more obvious at school than at home. "Changes in academic or sports performance - when something suddenly becomes difficult for a child or when a child suddenly loses interest - are other signs that teachers should tune into," Drummond says.

If a teacher detects signs like these, he or she can refer a student to a school counselor. "That will trigger a child psychiatrist visit or a mental health intervention," he says.

When children display suicidal behavior - that is, an attempt in the moment to inflict self-harm - they should be kept under close watch in a safe environment without the means to hurt themselves. They should then be promptly referred to a mental health professional or taken to an emergency room for evaluation and treatment.

This content originally appeared on Sharecare.com.