Here are some numbers we need to reckon with: the number of suicide deaths in people ages 15 to 24, over 36 years in the United States.
As you can see in this chart, after a steep drop in the late 1990s, the number of suicide deaths among young people (as measured in deaths per 100,000 people) began climbing around 2008 before reaching a new high in 2017, according to the Centers for Disease Control and Prevention.
Suicide rates lately have been increasing in all age groups in America, in almost every state. But the epidemic of youth suicide is particularly stymying, even for experts who study it.
There are plenty of hypotheses about what’s driving it floating around. They include the changing way teens interact with each other in digital spaces, economic stress and fallout from the 2008 recession, increasing social isolation, suicide contagion, and the fact that teens can more easily look up suicide methods online.
Two other enormous public health issues of our time are at play too. Children of opioid users appear to be more at risk for suicide. Same goes for young people who live in a house with a gun.
But the bottom line is that no one really knows why. That doesn’t mean more suicides can’t be prevented, however.
For a leading cause of death (suicide is second among youth, 10th overall), the research on suicide prevention policies isn’t as robust and well-funded as one might hope. Out of 295 disease research areas the National Institutes of Health funds, suicide prevention ranked 206th in 2018. Research on West Nile virus, which kills around 137 people a year, is ranked higher.
But I’ve been talking with several mental health researchers, and they all say we don’t need to know the exact causes of the teen suicide trends to be able to help.
These solutions aren’t easy: Some require political momentum that the country may not be able to muster. But I found that there are many concrete ways parents, mental health clinicians, and schools can help. Importantly, there are also policy solutions that can potentially contribute.
But first, I think it’s useful to go through the scope of what’s happening.
Suicide deaths are just the tip of the iceberg
Suicide is a hard topic to write about.
And it’s not just because of the pain and sadness that comes with contemplating so much loss. It’s because if we’re not careful in writing about it, we can potentially make the problem worse. (Indeed, you might have seen a recent example: There’s some not entirely conclusive research that the Netflix show 13 Reasons Why led more kids to suicide by, presumably, glamorizing and normalizing it.)
So that’s why it’s important to state outright: While suicide rates are on the rise, that does not mean suicide is normal or common. (Learning that suicide is “normal” could make someone feel more comfortable with doing it themselves.) It’s still rare. In 2017, 6,241 suicide deaths occurred in people ages 15 to 24. Most were male, but an increasing number of young women are dying this way too.
Overall, around 16 percent of adolescents, the CDC reports, consider suicide in a given year. “That’s an epidemic,” says Mitch Prinstein, the director of clinical psychology at the University of North Carolina Chapel Hill. And the deaths are just the tip of a sorrowful iceberg. Beneath it is a rising tide of pain in young people.
For instance, the number of teens diagnosed with clinical depression grew 37 percent between 2005 and 2014. And suicide attempts — which are not always fatal — are on the rise as well. Here’s an unsettling example of that. A recent paper in the Journal of Pediatrics estimated that in 2018, close to 60,000 girls ages 10 to 18 tried to poison themselves. In 2008, that figure was closer to 30,000. Very few of these poisonings were fatal, but they represent an enormous amount of emotional trauma.
“We’re seeing in the schools a lot more kids having mental health difficulties, whether that’s anxiety, trauma, depression, eating disorders, emotional difficulties, a lot more,” says James Mazza, a University of Washington youth suicide researcher. “Only a few of those are going to result in a death due to suicide. … Our schools need to be focusing much more on mental wellness or providing kids and youth with skills to deal with the emotion disregulation they’ll experience during adolescence.”
So, how to act?
I’ll be clear: The following solutions are not an exhaustive list. Instead, they were the most commonly mentioned in my conversations and the broadest in scope, and seem to have the most robust research in support of their effectiveness.
Restricting access to weapons and drugs can clearly prevent suicide
The simplest, bluntest, most wide-reaching policy tool to reduce suicide deaths is also the one that’s the most rarely used: simply reducing access to lethal means. If people can’t access tools like firearms and drugs to harm themselves, there will be fewer deaths.
In the United States, that means gun control.
We hear a lot in the news about how guns cause incidents of mass murder or homicide. But guns are implicated in more suicides than homicides every year. “Youth who live in a home with access to a firearm are significantly more likely to die by suicide,” says Jonathan Singer, the president of the American Association of Suicidology and a sociology professor at Loyola University Chicago.
There’s good evidence that stricter gun control would save lives in regard to suicides.
After New Zealand passed strict gun control laws in 1992, “firearm-related suicides significantly decreased, particularly among youth,” a 2006 study found. The rates dropped among those ages 15 to 24 from four in 100,000 in the late 1980s to around one in 100,000 in the early 2000s. (And overall, research finds that when gun suicides drop, those deaths are not offset by suicides by other lethal means.)
“As a population level intervention, reducing access to firearms is one of the best solutions,” Singer says. “Does the country want to do that? No.”
Another, simpler option is something called “lethal means restriction counseling” for families who have a child who may be at risk for suicide. That counseling, which usually takes place in a hospital setting after a psychiatric emergency, involves discussing with parents how much access their kids have to firearms or poison, and then suggesting ways to make their homes safer.
Yet many kids (perhaps more than half, according to one study) are discharged from the hospital without their families receiving such counseling. And