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Abstract
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In 2021, the US Surgeon General and influential organizations like the American Academy of Pediatrics (AAP), the American Association of Child and Adolescent Psychiatry, and the Children's Hospital Association declared a national youth mental health crisis. As the second leading cause of death, suicide is responsible for approximately 20% of deaths in the US each year among youths aged 10 to 24 years, and rates have increased more than 50% over the prior 2 decades. The fact that the US lost 71 820 young lives to suicide between 2010 and 2021 is a call to action.
The retrospective, cross-sectional study published by Chaudhary and colleagues1 used the National Violent Death Reporting System Restricted Access Database to examine characteristics of 40 618 US youths aged 10 to 24 years who died by suicide between 2010 and 2021. Based on source records collected from coroners, medical examiners, law enforcement, and families, the study's primary outcome finding was that approximately 60% of youths who died by suicide had no documented mental health diagnosis.1 This finding is in sharp contrast with carefully conducted psychological autopsy studies of youth suicide decedents, where the vast majority received a diagnosis of a mental disorder,2 yet still consistent with investigations using data such as medical claims that identified a mental disorder in less than one-half of youths who died by suicide.3
These study findings1 are a reminder that early identification of youths with mental disorders and at risk for suicide is more the exception than the rule in the US. Approximately one-quarter of youths with a history of suicide attempt and nearly one-half of youths with depressed mood had no documented mental health diagnosis.1 Strikingly, approximately one-quarter of suicide decedents, 8948 young people, disclosed suicidal intent, yet 4430 (18.3%) had no diagnosed mental health disorder.1 These findings suggest that a large proportion of youth suicide decedents had unmet mental health needs that were not detected prior to death. The importance of improving recognition in health care settings is also supported by previous research demonstrating that most people who die by suicide have visited a health care clinician in the months and even weeks beforehand. If not asked directly, "Are you thinking of killing yourself?" they are unlikely to raise the issue.
Nearly one-half of youth suicide deaths were from firearms,1 a common method with an inordinately high incidence unique to the US. Youths who died by firearm were less likely to have a documented mental health...
Language: en |