As young children commit suicide in increasing numbers, better monitoring and prevention are sought

Jason Lance thought January 21, 2010 was just another day until the call came.

He had dropped off his 9-year-old son Montana at Stewart’s Creek Elementary School in The Colony, Texas, that morning.

“There was no problem at home. He was smart. He had a good heart and he talked and talked and talked,” Lance said. It was “the same old, same old normal day. There were kisses and goodbyes and he said, ‘I love you, Dad.'”

Hours later, school officials called to say Montana had killed himself while locked in the nurse’s bathroom.

“I knew he was having trouble at school, but I never saw it coming,” Lance said. Her shock and grief were complicated by the realization that there may have been other signs that her son was struggling.

As children across the country take a step return to school routines this fall, it is important to pay attention to their mental health as well as their academics. Suicide is the seventh or eighth leading cause of death among children ages 5 to 11, according to the Centers for Disease Control and Prevention and recent studies. And the numbers show that rates among young children appear to have increased over the past decade, particularly among black boys.

More and more research shows that “historically we thought suicide was a problem among adolescents and adults, but that younger children express similar thoughts that might have been overlooked previously,” said Paul Lipkin, a pediatrician at the Kennedy Krieger Institute in Baltimore and a specialist in developmental disorders such as autism.

This leads many experts to call for lowering the screening age for suicidal thoughts in children and strive to develop early detection of suicide risk and more effective targeted prevention strategies. The broad approach includes pediatricians, teachers and parents working with young children to build their resilience and identify and manage their stress.

Studies have shown that young children gain an understanding of death and suicide through television or other media, discussions with other children, or exposure to death due to family or community loss .

“Pediatric suicide was not on our radar several decades ago and may have been underestimated,” said Holly Wilcox, president of the International Academy for Suicide Research and professor at the School of Health. public Johns Hopkins Bloomberg in Baltimore. “The truth is we can now do something.”

It is very likely that the 136 suicides reported between 2001 and 2021 among children aged 5 to 9 are underestimated.

“Counts are often incomplete and causes of death may be awaiting investigation, leading to an undercount compared to final counts,” said Margaret Warner, senior epidemiologist at the CDC.

The problems with these numbers are important because, Warner said, “if we miss deaths or don’t have all the information leading up to them, we can’t properly develop programs to prevent future deaths.”

That’s why coroners and medical examiners also have ongoing national efforts to improve the quality and consistency of child death investigations.

Suicide prevention leaders hope this increased focus on pediatric suicide will also help curb the increase in suicide rates among people ages 10 to 24 in the United States since suicide is the second leading cause of death in this age group, according to the CDC.

Some of the increase in mental health problems among children has been attributed to isolation and lack of school structure. during the pandemic. Starting in April 2020, pediatric emergency room visits for children ages 5 to 11 increased by about 24%, according to a November 2020 CDC report.

Other factors, such as being neurodivergent or having a psychiatric disorder, can make a child more vulnerable to suicide.

A study published in February in Frontiers in Public Health also found that being a victim or perpetrator of bullying is a risk factor for suicide, even when researchers control for other risk factors.

Montana Lance was diagnosed with attention-deficit/hyperactivity disorder, as well as dyslexia, and was often the target of bullying at school.

Lewisville Independent School District officials declined to comment on Montana’s death. Her parents filed a lawsuit against the school district, but it was dismissed and the district was found not responsible for her death.

Suicide is complex, but recent studies have shown that there are things parents, teachers, pediatricians and caregivers can do to help protect children.

Lisa Horowitz, a pediatric psychologist and scientist at the National Institute of Mental Health, said, “It’s never too early to start a conversation with children about recognizing mental distress and what we can do to help them have better adaptation strategies and promote their development. resilience.”

Building resilience in children can help protect them during times of stress, according to a 2022 study published in Frontiers of Psychiatry.

“I don’t want people to panic, but I just want them to be vigilant about their children,” Horowitz said.

Sometimes this vigilance can be “tricky” because depression can appear different in young children. They may act out, be more irritable and not manifest their symptoms in the same way as adolescents and adults, Wilcox said.

“We don’t have enough studies on how best to identify preteens and children at risk for suicide. Often you just have to trust your instincts with these things,” she said.

If a child is upset, parents should ask them questions about what they are experiencing, said Tami D. Benton, psychiatrist-in-chief, executive director and chair of the Department of Child Psychiatry and Behavioral Sciences. the teen at Children’s Hospital of Philadelphia.

“Parents should not discourage their children from talking about their feelings, give them examples of when this has happened to them, or minimize their feelings. This demeans them,” she said.

Parents and children should develop a plan together, but also teach their children that they can control these situations, Benton said.

When parents are unsure of what to do in difficult situations, they should consult their child’s pediatrician.

In March, the American Academy of Pediatrics recommended universal suicide risk screening for all children ages 12 and older and when clinically indicated for children ages 8 to 11. There are no screening tools validated for use in children younger than 8 years. But Horowitz said younger children can still be evaluated and evaluated for suicide risk.

Schools can also play an important role in suicide prevention.

Meghan Feby, a school counselor for the Colonial School District in New Castle, Delaware, said, “I am the only school counselor in my building. It’s a daunting task. This is why there are supporters who have eyes wherever I can. » I don’t have eyes… on the school computers. Using software strategies like GoGuardian Beacon can really help fill gaps and supports.

The software captures keywords and phrases that could indicate a child is thinking about suicide and has previously been used to intervene when children using the district’s computers displayed behavior related to their behavior. It monitors activity on school computers used by more than 6.7 million public school students, grades K-12.

Some schools have reported difficulty implementing software like this because some parents find it intrusive.

Many schools use the Good Behavior Game, a decades-old behavior management intervention for children in first and second grade, and it has been used in higher grades. The team-based curriculum uses peer pressure to motivate students to be attentive, engaged and work together. Researchers such as Wilcox have studied mass participation of thousands of students and found that it reduced suicidal thoughts and behaviors.

Children who played this game were half as likely as young adults to report suicidal thoughts and about a third less likely to report a suicide attempt.

Lance said the day Montana killed himself changed his life forever.

“You’re not supposed to bury your children. They’re supposed to bury you,” he said. “All this attention to children’s mental health these days won’t bring my child back, but it may stop another family from suffering.”

KFF Health Newsformerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism on health issues and is one of the major operating programs of KFF — the independent source for health policy research, polling and journalism.