Children's Hospital Colorado

Suicide Prevention In The Pandemic

Addressing the unique needs of every child so they can be their unique selves.

The rate of suicide among youth ages 10 to 24 increased nearly 60% between 2007 and 2018, and the COVID-19 pandemic has exacerbated that trend. A national poll found 1 in 3 teen girls and 1 in 5 teen boys experienced new or worsening anxiety since March 2020. Among adolescents ages 12 to 17, the average number of weekly ED visits for suspected suicide attempts was 22.3% higher during summer 2020 and 39.1% higher during winter 2021 compared to corresponding periods in 2019, a recent CDC report found. Notably, these numbers showed stark differences when broken down by sex, with the increases in attempts being disproportionately represented by females, who experienced a 50.6% increase compared to a 3.5% increase for males.

These increases in mental health problems and suicide attempts are likely a result of a combination of factors, including increased stressors due to changes in schooling formats, plus decreased access to resiliency-building activities such as social interactions and increased time at home with caregivers. Given this alarming trend, it’s essential to prioritize mental health and suicide screening in both health and education settings to identify youth at risk and connect them with services for stabilization and safety.

Screening for suicide

There are several free validated measures for assessing suicide risk available to professionals who work with youth. These include the Columbia Suicide Severity Rating Scale (C-SSRS) and the Ask Suicide Screening Questions (ASQ). Both measures effectively identify at-risk youth and can be administered to youth within five minutes. Both are also available in a variety of different languages.

Reviewing means restriction

Because the majority of mental health crises are short in duration, it’s vital to educate families whose child screens positive or at-risk for suicidal ideation on means restriction. Limiting or eliminating access to lethal methods has been shown by numerous studies to reduce deaths by suicide.

Ask what lethal means are potentially available to the youth and provide information on how to restrict access.

Medications

  • Advise families to keep both prescription and over-the-counter medications locked in a safe place.
  • Encourage families to safely dispose of medications that are no longer needed in the home.
  • If youth are taking medication, have a parent distribute it to ensure the patient is not taking more than prescribed.

Firearms

  • Store firearms and ammunition in separate locations. Make sure both are locked and that youth do not have access to bypass the lock feature.
  • Ask a family or friend to store the firearms until the youth is no longer in a mental health crisis.
  • Police stations also often have temporary firearm storage options.

Sharp objects

  • Store sharp objects (such as knives and razors) in a lockbox that the youth cannot access.
  • Supervise activities where sharp objects are needed, such as cooking and shaving.

When talking with families about restricting access to means, emphasize that these are temporary measures that can relax when the youth feels better. The important thing is that these efforts will help reduce risk of death by suicide for their child.

Resources

The Suicide Prevention Resource Center offers training to help educate providers who wish to learn more about means restriction counseling. CALM: Counseling on Access to Lethal Means is a free online course designed to help professionals identify people who will benefit from lethal means counseling, ask families about access to lethal means, and work with them to reduce access.