Suicide Rates Keep Rising

❝ Those of us who work in pediatric intensive care have frequent encounters with the problem of suicide and attempted suicide. It has seemed to me for some years that the numbers are increasing, and this has been shown to be the case. After years of declining, the suicide rate in our country has been increasing, now at about 125 percent of the rate of several decades ago.

This increase accelerated after 2006. Although all age groups showed an increase, the rate among women, particularly adolescent girls, took a notable jump. In 2012 suicide was the second leading cause of death in adolescents aged 12 to 19 years, accounting for more deaths in this age group than cancer, heart disease, influenza, pneumonia, diabetes mellitus, human immunodeficiency virus, and stroke combined…

❝ Actual suicide is just the tip of the iceberg, since, at least among adolescent girls who attempt it typically with drug overdose, there are as many as 90 attempts for every death. Since a large number of these attempts end up in the PICU, I’m not surprised we are seeing more and more of them come through our doors. A few other points are worth noting here. The success statistics for adolescent boys are unfortunately much higher because boys tend to use more violent means than girls, such as hanging, firearms, or automobiles.

However, although rates for boys are up slightly, they really haven’t changed much. It’s also important to realize suicide attempts are a spectrum — some are more serious than others. Many girls take an overdose and then immediately tell somebody about it. These are often called suicide gestures and can be quite impulsive. Some use the term “cry for help” to describe them. More ominous are children who carefully plan, such as by hoarding powerful drugs in secret and taking them in a setting where they won’t be found. They may leave a suicide note. I couldn’t find any data about whether these different categories are discordant in the rate increase, but I assume the two are tracking together. Finally, a child may not know which drugs are truly dangerous. I have seen very serious suicide attempts by children who take overdoses of what we know to be innocuous medications but the child does not.

❝ Regardless of what category the attempt is, of course, the child needs mental health services subsequently. These days we find a child’s text messages to be very helpful. So why the increase in adolescent girls?

I’ll give you the spoiler. Dr. Johnson doesn’t know the answer. He’s in early stages of his examination as are many others. We also happen to live in a society so screwed-up that suicide is increasing for most age groups.

You still should RTFA. He has suggestions. He has hopes. He has other scientists to help him.

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