Kids and Suicide
The COVID-19 pandemic has exacerbated mental health issues for all ages, but mental health practitioners are particularly concerned with youth, and increasing rates of suicidal ideation.
Across the country, suicide rates among those 14 and younger are rising. In Vermont, according to statistics from the Department of Health, youth suicide rates have stayed level – but young people are showing up at Emergency Rooms and elsewhere in crisis more often.
“Just the deaths by suicide doesn’t capture the story. It’s all the children coming into the emergency room, and youth with suicidal ideation needing a high-level of support for that reason,” says Haley McGowan, DO, a pediatric psychiatrist who serves as the Co-Director of the Child and Adolescent Psychiatry and Psychology Consult program at The University of Vermont Medical Center and Children's Medical Director for the Vermont Department of Mental Health.
“There are a lot of kids, teens, who are presenting to primary care, emergency departments, schools, with suicide thinking and attempts, and I think that’s where the increase is of most concern,” says Andrew Rosenfeld, MD, a child psychiatrist at UVM Medical Center.
Northern New York is facing the same thing, says Bethany Sousis, BSN, RN, the director of the Child and Adolescent Inpatient Psychiatry unit at UVM Health Network – Champlain Valley Physicians Hospital. She says children of all ages are coming to the emergency room in distress, and other areas are looking to send youth to the hospital’s unit.
Both Rosenfeld and McGowan note that children experiencing mental health challenges, or suicidal ideation, have lately been expressing issues stemming from the pandemic. Among the many challenges youth are facing is social isolation, and difficulty adjusting to changes in school environments.
“It’s never just one thing. There’s never just one issue,” says Dr. McGowan.
According to the Vermont Department of Health, suicide rates in 2022 for those 14 and younger are at 1.1 per 100,000 people – up from the 0.7 three-year average. But rates of self-harm are significantly higher at 112.7 per 100,000 people.
Meanwhile, the rates of emergency department visits for suicidal ideation are higher for youth who are black, indigenous or people of color at 335.1 per 10,000 visits, compared to 226.9 for white non-Hispanic youth. Additionally, LGBTQIA+ students are more likely to feel sad or hopeless, make a suicide plan or attempt suicide, according to the Vermont Department of Health.
In addition to the pandemic, Dr. McGowan says students are facing pressures that previous generations may not have experienced.
“There’s a lot of visibility of all that’s challenging in the world. It’s more than the pre-teen brain should have to manage, and they can absorb it all on their phone,” she says.
Many youth are also finding that the places they turn to for support, such as parents and caregivers, are also feeling higher rates of mental distress. “There are fewer places to turn to even if one recognizes the need and gets over the stigma of getting mental health treatment,” Dr. Rosenfeld says. “There’s less of a mental health care workforce across the state. We’re struggling to recruit and retain people.”
Maintaining enough providers is an issue in New York, too.
"We're having to bring in (temporary) psychiatrists. It's helping the fact that we're able to see patients, but on a cost note, it's quite expensive,” Sousis says. “The fact of the matter is, what we're faced with is the numbers of practitioners being available. They're just not there. It's not that they're available and just don't want to come to us.”
Both Drs. McGowan and Rosenfeld say the focus is helping youth regain a sense of hope, and clear the hurdles to seeking mental health treatment, such as the stigma that many feel. The most important factor in ensuring youth seek and receive the help they need is having a trusted person to speak with. School mentoring programs and programs like Big Brothers, Big Sisters can often provide kids with that person and can also be a way that adults looking to help can channel their energy.
“It does not have to be mental health-trained folks. Often the people who make the most powerful difference are not a therapist or psychiatrist," Dr. Rosenfeld says. "But it is important to have the input or guidance of a therapist or psychiatrist when the risk of suicide is high or even increasing.”
Providers across the UVM Health Network are now trying to screen high-risk youth for mental health distress, even if they are being seen for another reason. Primary Care physicians can also access telephone consultations with mental health providers anywhere in the state to help better serve youth in need.
If you or someone you know is in crisis, help is available. The national suicide hotline is available by calling 988, and offers support 24 hours a day. The Crisis Text Line also serves anyone, in any type of crisis, and provides access to free, 24/7 support and information by texting "VT" to 741741.