ER Visits Among Suicidal Teens Increased: How to Talk to Your Child

A new study reveals that emergency room visits among adolescents with suicides are increasing. Therefore, parents need to be able to talk openly with their children who may be thinking of taking their own life.

The study published in the peer-reviewed journal Pediatrics analyzed Illinois hospital administrative data for emergency department (ED) visits coded for suicide (SI) at 205 hospitals across the state from January 2016 to June 2021 for teenagers aged 5 to 19 years.

Of 81,051 emergency department visits coded for suicide, one in four (24.6%) resulted in hospitalization. Research also found that ED SI visits increased by 59% from 2016 through 2017 to 2019 through 2021.

“This study documents child ED SI visits in Illinois spiked in 2019, with an additional surge in hospitalizations during the pandemic. Rapidly rising hospital use may reflect worsening mental illness and continued difficulty in accessing low-cost, high-quality outpatient mental health services,” the study authors concluded.

Dr. John Crimmins, a consultant psychotherapist based in Ireland with over 25 years of clinical experience, says that the isolation due to the COVID-19 pandemic is one of the major contributing factors to the increasing number of ED visits among teenagers with suicidal thoughts.

A survey from 2021 revealed that nearly four in ten (37%) US high school students reported that their mental health was not good most or all of the time during the pandemic. In the survey, “poor mental health” included stress, anxiety, and depression.

The extensive usage of social media, which induces peer pressure, and makes teenagers more self-conscious and concerned about self-image, is another factor, Dr. Crimmins says. However, he explains that technology, such as virtual reality therapies or online counseling, may help to improve mental health.

Another research published in the JAMA Pediatrics this week linked the increased rate of suicides by youth aged 5-19 years to shortages of mental healthcare workers at a county level.

Is my child suicidal?

According to Dr. Crimmins, signs that a teenager may be suicidal include the following:

• Talking about suicide or death
• Seeking access to lethal things such as guns, knives, razors, etc.
• Being moody, sad, and withdrawn from people they are normally close to
• Getting very anxious or agitated
• Engaging in self-destructive, risky behavior
• Using alcohol or drugs

Dr. Crimmins highlights the importance of parents starting the conversation about suicide and being very direct but not “in a judgmental or threatening way.”

“There is no evidence that asking someone if they are thinking about suicide is dangerous,” he told Healthnews.

How to talk about suicide?

To start the conversation, Dr. Crimmins recommends using the following phrases:

• Are you having thoughts of suicide?
• Are you thinking of killing yourself?
• Are you thinking of taking your own life?
• I understand that it is difficult for you to hear it from me, but I am very concerned about you.

Crimmins says it is important not to minimize your child’s problems.

“When they say, for example, that their life is terrible, acknowledge it, use phrases like ‘I appreciate that this time of your life feels very down, but there is something we can do about it,’” he says.

As teenagers spend a lot of time texting, it may be easier to make your child talk about suicide by phone, so they would find it less intimidating.

According to Dr. Crimmins, research has shown that planning suicide increases the risk of taking your life. Therefore, parents need to carefully ask what the plans are. The following phrases may come in handy:

• Have you thought about how you would kill yourself?
• Have you thought about when you would kill yourself?
• Have you taken any steps to get the things you need to commit suicide?

“All the research shows that the more teenagers talk about it, the more it reduces the actual risk of suicide. So rather than brushing it under the carpet, bring it up, be very direct, emphatic, and very sensitive to what’s going on,” Dr. Crimmins says.

For suicidal teenagers whose parents do not want to talk about it, Dr. Crimmins recommends reaching out to school staff, such as teachers, support workers, or guidance counselors.

The 988 Lifeline provides 24/7, free, and confidential support for people in distress.