There is no easy way to say this: in the past decade, there has been a dramatic increase in the number of teenagers trying to kill themselves with poison.
The data appear Wednesday in The Journal of Pediatricsand come from venom control centers. Overall, the study found that the rate of poisoning attempts more than doubled among boys and girls.
Girls, however, account for most of the increase. The study found that attempts at poisoning by girls aged 10 to 12 years increased 268% from 2010 to 2017, for example. For girls aged 13 to 15, the poisoning rate increased by 143%.
Overall, it is estimated that by 2018, about 60,000 girls between the ages of 10 and 18 attempted to poison themselves. In 2008, that number was close to 30,000.
The current study does not describe the poisons used (this analysis is forthcoming), but anything from many gummy vitamins to a high dose of opioids can be considered a poison if the intent is self-destructive.
The following is one of the most moving charts I've seen in an academic paper. In red, the number (and rate) of girls becoming poisoned in suicide attempts since the year 2000.
The first shows boys and girls between the ages of 10 and 12; the second shows boys and girls 13-15.
Another graphic in the paper shows that 29,000 girls between the ages of 16 and 18 got poisoned last year – and it's a significantly higher rate compared to 2011.
The report also reveals problems in women ages 19 to 24.
In general, attempts at poisoning are only fatal in less than 5% of the time. In this study, which analyzed all suspected self-poisoning from 2000 to 2018 in people aged 10 to 24 years, there were 1,627,825 intoxications and 1,404 deaths.
The results are a wake-up call to the disturbing scenario of the teen suicide crisis in the United States. Deaths, says John Ackerman, a co-author of the study and coordinator of suicide prevention at Nationwide Children's Hospital, "are just the tip of the iceberg" of pain. Underneath this, "you have attempts, and millions of children are entertaining the idea that life could be better if they were not alive."
Although the researchers do not have a clear explanation for this sudden increase, they are convinced that this should be solved. Because, as this last data shows, the trends do not show recent signs of reduction. It must be a wake-up call.
Teenage suicide is still rare in America. But it is increasing.
About 16 percent of teens, the CDC reports, consider suicide in a given year. "This is an epidemic," says Mitch Prinstein, director of clinical psychology at the University of North Carolina, Chapel Hill, who was not involved in this research.
But it's definitely hard to talk about. And if we talk about it carelessly, we can make the problem worse. Just this week, a study found the television program 13 reasons why – which showed a girl taking her own life in retaliation for bullying at school – could have led to a small increase in suicide deaths.
One thing that can put a person at risk for suicide, the researchers warn, is exposure to the idea that suicide is an effective way to deal with their problems. It can be dangerous to expose young people to "how to get hurt," says Ackerman, or the notion that suicide is common.
The problem is large enough for policymakers to take this much more seriously.
Between 2009 and 2017, the number of high school students who contemplated suicide increased by 25 percent. Teen suicide deaths increased by 33 percent in that time period as well. Suicide is now the second leading cause of death among teenagers after accidents (trafficking, poisoning, drowning, etc.). It is important to note that suicide deaths among adolescents are still rare. Only 10 out of 100,000 teenagers ages 15 to 19 die that way. But even one death is too much. And all the attempts, anguish, and depression that can lead them need to be resolved as well.
While teens tend to poison themselves more often in suicide attempts than adolescent boys, boys tend to use more lethal means, such as firearms. The result is that while girls try to take their lives more often, boys die in larger numbers.
Experts are unsure of the exact cause of these disturbing trends: hypotheses include stressful consequences of the recession, changing the way teens interact in digital spaces, increasing social isolation, stressful opioid crises that plague children, contagion suicidal, the fact that teens can more easily seek out how to kill themselves online, and others. But there does not seem to be a single cause.
"The reason we do not know why children are doing this is because suicide is not a single diagnosis, it's a result that many, many paths can lead," says Prinstein.
Access to lethal means also plays a role. Children are more likely to die of suicide when a gun is accessible. The increased availability of opioids could also play a role.
We do not need to know the cause of increased suicide and poisoning to help
We may not know the exact cause of recent suicide trends. But we know ways to help teens at risk. Therapists can help and science-supported therapies that help (see the sidebar above for resources). Schools and teachers can help. Parents can help. Friends can help. Anguish is not inevitable.
But, as we are seeing, it is not enough. "Based on absolute numbers, you do not have psychologists, social workers, counselors and other therapists enough to physically address the need that's clearly out there," says Ackerman. "Even if you had everyone in the mental health workforce dealing with suicide and life-threatening behavior, you would not be able to fully address the need."
So as a society, we can do more to work toward possible policy solutions.
"If you replaced depression or suicide with the flu, you would see a flu shot warning you in every corner, insisting it's a public health crisis," Prinstein says. "We should be making projections, we should be doing education programs in every school. All parents should talk to their children about suicide. It's time for less conversations and more action. "
He says that teachers and schools need to be better trained to identify children at risk, and parents need to feel free to ask their children directly if they are suicidal.
"There is a long time ago a myth that simply asking a child if she is suicidal can put an idea in your head and increase the risk," he says. "And we know now that this is not true."
Kathryn Gordon, a clinical psychologist and researcher who recently left her academic job for a private practice, says parents can learn to "listen in a non-critical way." Listening, she says, can be a first step.
"As a parent," she says, it's easy to want to come in and solve the problem immediately. "But children often see it as disregard or discomfort," she says. "If you're open and listen, often kids and teens can start solving on their own, or they'll ask for help."
Taking care of adults can make a difference in saving lives, a new study shows. But it will take more than just parents and professional therapists to help.
States can work with schools to track more children in search of suicide and depression. And there needs to be more funding for research.
In 2017, the National Institutes of Health spent $ 37 million on research grants for suicide prevention. That's trivial when you compare it to the $ 6.6 billion spent on cancer research. Of the 295 disease research areas, the NIH funds suicide prevention in 2018 in 206. Research on the West Nile virus – which kills about 137 a year – comes first. By 2017, the Centers for Disease Control and Prevention reported that there were 2,877 suicide deaths between the ages of 13 and 19 nationwide.
Interventions "have to start early – even elementary school," says Ackerman. "And certainly in high school, you need to understand what to look for to respond."