Study: Suicidal behavior in youths higher during COVID-19 closures than in 2019

Rates of suicidal ideation and suicide attempts were higher in some months in 2020 compared to 2019, according to a study of 11- to 21-year-olds in a major metropolitan area of Texas.

Significantly higher rates of suicide-related behaviors appear to have corresponded with times when COVID-19 stressors and community responses (e.g., stay-at-home orders and school closures) were heightened, indicating that youth experienced elevated distress during these periods, according to “Suicide Ideation and Attempts in a Pediatric Emergency Department Before and During COVID-19” (Hill RM, et al. Pediatrics. Dec. 16, 2020).

Researchers analyzed electronic health record data from 18,247 youths presenting for any complaint to a large pediatric emergency department (ED). Of the 12,827 youths who completed a suicide risk screening, 59% were female and the mean age was 14.5 years. About 48% were Hispanic/Latinx, 26.8% non-Hispanic White and 19.1% non-Hispanic Black or African American. A chief complaint of suicidal thoughts or behaviors was reported by 3.5% of patients.

Patients completed the seven-item screening version of the Columbia-Suicide Severity Rating Scale. Two items assessed passive and active suicidal ideation in the prior month. If active ideation was present, three additional items assessed severity. All youths responded to an item about lifetime suicide attempt history, and if positive, were asked if an attempt occurred within the previous three months.

Positive suicide risk screens for January through July 2020 were compared with positive screens from the same months in 2019.

Results showed recent suicidal ideation was 1.60 and 1.45 times higher in March and July 2020, respectively, than in March and July 2019. Odds of recent suicide attempt were 1.58, 2.34, 1.75 and 1.77 times higher in February, March, April and July 2020 than the same months in 2019, respectively.

Sex and racial/ethnic group did not raise the likelihood of recent suicidal ideation from 2019 to 2020.

The authors said comparison of rates across years should be made with caution because the number of ED visits was substantially lower during the pandemic.

The authors importantly noted that “additional research is needed to evaluate unique risk and protective factors that may be associated with suicide risk in the context of a global pandemic.”