New study shows increased rates of hospitalization for suicide among youths

The number of school-age children and adolescents hospitalized for suicidal thoughts or attempts has more than doubled since 2008, according to a new Vanderbilt-led study published today in Pediatrics.

The study, "Hospitalization for Suicide Ideation or Attempt," looked at trends in emergency room and inpatient encounters for suicide ideation and attempts in children ages 5-17 years at U.S. children's hospitals from 2008 to 2015. Preliminary information from the study was initially presented last spring at the annual meeting of the Pediatric Academic Societies.

During the study period, researchers identified 115,856 encounters for suicide ideation and attempts in emergency departments at 31 children's hospitals. Nearly two-thirds of those encounters were girls. While increases were seen across all age groups, they were highest among teens ages 15-17, followed by ages 12-14.

Just over half of the encounters were children ages 15-17; another 37 percent were children ages 12-14; and 12.8 percent were children ages 5-11. Seasonal variation was also seen consistently across the period, with October accounting for nearly twice as many encounters as reported in July.

Using data from the Pediatric Health Information System (PHIS), the researchers used billing codes to identify emergency department encounters, observation stays and inpatient hospitalizations tied to suicide ideation and attempts. In addition to looking at overall suicide ideation and attempt rates in school-age children and adolescents, the researchers analyzed the data month-by-month and found seasonal trends in the encounters. Peaks for encounters among the groups were highest in the fall and spring, and lowest in the summer.

"To our knowledge, this is one of only a few studies to report higher rates of hospitalization for suicide during the academic school year," said study lead author Greg Plemmons, MD, associate professor of Clinical Pediatrics at Monroe Carell Jr. Children's Hospital at Vanderbilt. Rates were lowest in summer, a season which has historically seen the highest numbers in adults, suggesting that youth may face increased stress and mental health challenges when school is in session.

Suicide is the third leading cause of death among adolescents in the United States, preceded only by accidents and homicides, according to the U.S. Centers for Disease Control and Prevention.

"The growing impact of mental health issues in pediatrics on hospitals and clinics can longer be ignored," said Plemmons, "particularly in a time when mental health resources for children appear to be static, and woefully scarce across the U.S."