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Citation
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Yard E, Radhakrishnan L, Ballesteros MF, Sheppard M, Gates A, Stein Z, Hartnett K, Kite-Powell A, Rodgers L, Adjemian J, Ehlman DC, Holland K, Idaikkadar N, Ivey-Stephenson A, Martinez P, Law R, Stone DM. MMWR Morb. Mortal. Wkly. Rep. 2021; ePub(ePub): ePub. |
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Abstract
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What is already known about this topic?
During 2020, the proportion of mental health-related emergency department (ED) visits among adolescents aged 12-17 years increased 31% compared with that during 2019.
What is added by this report?
In May 2020, during the COVID-19 pandemic, ED visits for suspected suicide attempts began to increase among adolescents aged 12-17 years, especially girls. During February 21-March 20, 2021, suspected suicide attempt ED visits were 50.6% higher among girls aged 12-17 years than during the same period in 2019; among boys aged 12-17 years, suspected suicide attempt ED visits increased 3.7%.
What are the implications for public health practice?
Suicide prevention requires a comprehensive approach that is adapted during times of infrastructure disruption, involves multisectoral partnerships and implements evidence-based strategies to address the range of factors influencing suicide risk.
This report expands upon previous work highlighting increases in ED visits for suspected suicide attempts earlier in the pandemic among all persons (5) and suggests that these trends persisted among young persons as the pandemic progressed. Compared with the corresponding period in 2019, persons aged 12-25 years made fewer ED visits for suspected suicide attempts during March 29-April 25, 2020, the period that followed the declaration of the COVID-19 pandemic as a national emergency and a concurrent 42% decrease in the total number of U.S. ED visits (6). However, ED visits for suspected suicide attempts increased among adolescent girls aged 12-17 years during summer 2020 and remained elevated throughout the remaining study period; the mean weekly number of these visits was 26.2% higher during summer 2020 and 50.6% higher during winter 2021 compared with the corresponding periods in 2019. The number of ED visits for suspected suicide attempts remained stable among adolescent boys aged 12-17 years and among all adults aged 18-25 years compared with the corresponding periods in 2019, although rates of ED visits for suspected suicide attempts increased.
The difference in suspected suicide attempts by sex and the increase in suspected suicide attempts among young persons, especially adolescent females, is consistent with past research: self-reported suicide attempts are consistently higher among adolescent females than among males (7), and research before the COVID-19 pandemic indicated that young females had both higher and increasing rates of ED visits for suicide attempts compared with males (8). However, the findings from this study suggest more severe distress among young females than has been identified in previous reports during the pandemic (1,2), reinforcing the need for increased attention to, and prevention for, this population. Importantly, although this report found increases in ED visits for suspected suicide attempts among adolescent females during 2020 and early 2021, this does not mean that suicide deaths have increased. Provisional mortality data found an overall decrease in the age-adjusted suicide rate from quarter 3 (July-September) of 2019 to quarter 3 of 2020. The suicide rate among young persons aged 15-24 years during this same period saw no significant change (9). Future analyses should further examine these provisional rates by age, sex, race, ethnicity, and geographic setting.
Language: en |