ITASCA, IL – Rates of attempted suicide and suicidal thoughts among youth have risen in recent years, and suicide is the second leading cause of death among people ages 10-24 in the United States. This trend has been exacerbated by stressors related to the COVID-19 pandemic. The devastating – and preventable – losses in life reveal real-time gaps in the nation’s mental health services and disparities in access to treatment.
To address these needs, the American Academy of Pediatrics (AAP) and American Foundation for Suicide Prevention (AFSP), in collaboration with experts from the National Institute of Mental Health (NIMH), have created a Blueprint for Youth Suicide Prevention. This comprehensive document aims to support pediatric health clinicians in identifying strategies and partnerships to support children and teens at risk for suicide.
“The pandemic’s toll on our children and families’ mental health is becoming clear, and for some, it has been life-threatening,” said Moira Szilagyi, MD, PhD, FAAP, president of the American Academy of Pediatrics. “When children lose hope, when our emergency departments are filled with young people on the edge of mental breakdown, we know that we need to do more. This blueprint offers tangible recommendations for working with patients, partnering with schools and other community groups, and advocating for legislative action and funding. We cannot afford to look the other way as our children and young people suffer.”
The proportion of mental health–related emergency department visits for suicide attempts in early 2021 among teens ages 12–17 increased 31% compared with the same period in 2019, according to the Centers for Disease Control and Prevention.
The blueprint represents the first major interdisciplinary effort to infuse suicide risk reducing strategies into pediatric care and youth community settings.
“As the leading expert suicide prevention organization, we at AFSP are immensely proud and grateful to work with AAP in collaboration with NIMH experts to provide the pediatric health community with this new set of tools,” said Christine Yu Moutier, MD, chief medical officer of the American Foundation for Suicide Prevention. “We hope to partner with health systems, school districts and many others to achieve maximal implementation in order to change the culture and access to support for youth across the U.S.”
“Pediatric health settings – and primary care in general – are ideally suited not only as trusted resources for families and patients, but for playing a pivotal frontline role in identifying youth who are struggling and engaging them in supportive, effective care,” Dr. Moutier said.
“The suicide research field has been providing new tools and interventions that reduce suicide risk, yet most of these have yet to be implemented in a way that is accessible for families,” Dr. Moutier said. “This means we are missing opportunities to identify youth who are becoming at risk for suicide and to connect them to potentially life-saving care.”
A key takeaway was that health equity is critical to suicide prevention. There are significant disparities in suicide rates, risk, and care for youth across cultures and communities. Yet there is little research that explores the suicidal thoughts, behaviors, and risk factors among Black youth, Indigenous youth, Latino youth, Asian American youth, and youth from other communities of color.
Broader recommendations within the blueprint call for national leaders to:
Build the evidence base to address disparities in youth suicide prevention;
Increase payment and insurance coverage for mental/behavioral health and suicide prevention services;
Increase access to affordable, effective mental health care for all youth;
Address lethal means access to reduce suicide risk among youth, such as the presence of firearms in a home;
Build the mental and behavioral health workforce;
Foster healthy mental development in children and adolescents;
Address disparities in suicide risk via education and policy change;
Support children and adolescents in crisis;
Build clinical-community partnerships to better identify youth at risk for suicide and provide the supports they need.
Pediatricians are well-poised to speak out against stigma, raise awareness, and educate patients and families about mental health and suicide prevention. Within their practices, they are encouraged to screen all patients ages 12 and older for mental health concerns and suicide risk. Most young people keep suicidal thoughts to themselves and do not bring up the topic on their own. Screening can help open the door for an honest conversation about suicide risk.
The blueprint covers risk factors that play a role in suicide, and also protective factors that are known to help in prevention, such as coping and problem-solving skills and supportive relationships with family, friends and caregivers.
“We all strive to build relationships with our patients that are compassionate and without judgment, and to offer support to families who are struggling,” Dr. Szilagyi said. “Suicide is tragic and complex. It truly takes a community to help keep our children safe, healthy and supported in all ways.”
Blueprint for Youth Suicide Prevention: www.aap.org/suicideprevention
AAP Additional Suicide Prevention Resources: https://www.aap.org/en/patient-care/blueprint-for-youth-suicide-prevention/additional-resources-for-suicide-prevention/
AFSP Additional Suicide Prevention Resources: afsp.org
National Suicide Prevention Lifeline 1-800-273-8255 (TALK) Crisis Text Line text “talk” to 741 741