March 15, 2022 – Suicide attempts spurring calls to poison control centers more than quadrupled among U.S. children aged 10–12 years from 2000–2020, according to research published in JAMA Pediatrics.

The reasons for the increase in suicide attempts isn’t clear from the new study, but the researchers note that popular social media networks launched during the 20-year period, and other studies have linked spending time on social media with depression in adolescence. The COVID-19 pandemic, which began in the last year the researchers looked at, also disrupted normal life and routines for children.

For all children older than age 9, the proportion of incidents in which kids ate or drank something harmful that were deemed suicide attempts increased, while those classified as misuse or abuse of potentially poisonous substances declined. Children aged 6-9 did not have an increase in suicide attempts, the study found.

"It's a huge problem we're seeing in [ERs]. It's exponentially blowing up numbers across the nation," says David Sheridan, MD, an ER pediatric doctor at the Oregon Health and Science University, in Portland, who led the study.

Adolescents or preteens who have attempted suicide can sit in ERs "for days or weeks" as they wait to be moved elsewhere in the hospital or to an outpatient facility for treatment, Sheridan says. The delays not only are unpleasant for the children, he says, but they also strain hospitals by leaving less space available for other patients coming to the ER.

"It's really tough on the entire health care system, and most importantly, it's really rough on the families who are going through a crisis," Sheridan says. He noted that young people often attempt suicide by taking excessive quantities of common over-the-counter products found in many medicine cabinets — acetaminophen, ibuprofen, diphenhydramine — not items marked "poison."

Twenty-Year Trend

The researchers examined phone calls to poison control centers about kids age 6 and up taking in potentially harmful substances from 2000–2020 recorded in the National Poison Data System, which is maintained by the American Association of Poison Control Centers.

Of more than 1.2 million total calls, 854,000 involved girls. A poison control data analyst determined if the call involved attempted suicide or deliberate misuse or abuse of a potentially poisonous substance.

The researchers identified 1005 deaths. About 70% of the total cases had either no effect or a minor effect on the child’s health.

Over the 20-year period, more than 90% of the calls involved children aged at least 13 years, with approximately 72,000 (5.7%) about children aged 10–12. Most calls for children 13 and older were for suicide attempts.

Suspected suicide attempts accounted for about 50% of the total calls to poison control centers among children aged 10–12 in 2000 ― a figure that ballooned to 80% in 2020, the researchers found.

Both the number of calls and the proportion related to suicide attempts increased among children aged 10–12, Sheridan says. By 2020, the researchers found, poison control centers were fielding 4.5 times as many suicide-related calls among kids of this age group as they had in 2000. This jump was the largest such increase for any age group in the study, he says.

The reasons for such a large increase of suicide-related calls among preadolescents are unclear, the researchers note.

The increase became apparent around 2013, at the time many popular social media networks launched. Sheridan and his colleagues cite studies showing an association between spending more time on social media or watching television and depression in adolescence, but said further research is needed to understand the root causes of this increase.

The latest study did not look specifically at the effect of the COVID-19 pandemic on suicide among young people. The Centers for Disease Control and Prevention earlier reported a sharp rise in suicide attempts among youth during the early months of the pandemic, especially among girls aged 12–17 years. By February 2021, suicide attempts within this group had climbed by 50% compared to 2 years earlier.

Although suicide attempts are concerning enough, deaths by suicide are even more worrisome, experts said.

The researchers’ findings are consistent with overall recent trends in youth suicide deaths, says Jeff Bridge, PhD, an epidemiologist at Nationwide Children's Hospital in Columbus, Ohio. From 2010 to 2020, suicide rates increased by 50% among 13- to 18-year-olds, Bridge said, and more than doubled in children aged 10–12.

The latest study captured only calls to poison control centers, and so did not count suicide attempts that did not result in a call for help. Another limitation of the study is that poison control data are not categorized by race or ethnicity, prompting Bridge to urge researchers to look specifically at the effect of race and ethnicity on these trends.

"This study supports screening for suicide risk as young as 10 years old," Bridge says.

Sheridan agrees that prevention is essential: "The ER is where kids come when they're in crisis. Trying to be more preventative by diagnosing or picking up on this earlier, I think, is really important."

Show Sources

JAMA Pediatrics: “Changes in Suicidal Ingestion Among Preadolescent Children From 2000 to 2020.”
David Sheridan, MD, ER pediatric doctor at the Oregon Health and Science University, Portland

Morbidity and Mortality Weekly Report: “Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12–25 Years Before and During the COVID-19 Pandemic.”

Jeff Bridge, PhD, epidemiologist at Nationwide Children's Hospital, Columbus, Ohio

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