Youth Suicide Attempts by Self-Poisoning Rose 30% in 2021, Poison Center Data Show

In 2020, suicide was the second leading cause of death among people aged 10–14 in the United States and the third among those aged 15–24. After the World Health Organization declared COVID-19 a pandemic on March 11, 2020, there was concern that quarantine and social distancing were harming young people's mental and physical health. Researchers used the National Poison Data System — the data warehouse for all 55 U.S. poison control centers — to see what happened to suspected suicide attempts by self-poisoning among people aged 10–19 from January 2016 through September 2022.

Key findings

Compared with 2019, the last year before the pandemic:

• The overall rate rose 30.0% in 2021 — from 209.2 to 272.0 per 100,000 young people (88,535 to 114,664 cases).
• The biggest increases were among children 10–12 (73.0%), adolescents 13–15 (48.8%) and females (36.8%).
• The rise continued into 2022: through September, the rate was still 18.6% above 2019.
• Admissions to psychiatric facilities after such attempts rose 29.3% in 2021.
• It wasn't simply more calls: total calls to poison centers about human exposures fell 3.1% from 2019 to 2021, from 2,148,141 to 2,080,917, and the population aged 10–19 shrank 0.4%.

By group

2022 covers January–September, annualized.

Substances involved

The five substances most often involved in 2021 and 2022 were acetaminophen, ibuprofen, sertraline, fluoxetine and diphenhydramine — three over-the-counter medicines and two antidepressants.

In 2020, acetaminophen overtook ibuprofen, which had led in earlier years, and it kept rising through September 2022.

Suspected suicide attempts by self-poisoning among people aged 10–19 reported to U.S. poison control centers, by substance, 2016–2022. From CDC's MMWR.

Timing

• When the pandemic and stay-at-home orders began in March 2020, reported attempts first dipped, then rose from July 2020 — a pattern often seen after disasters and wars and sometimes called the "honeymoon effect."
• Attempts climb during the school year, with a sharp jump in September, and drop in June, July and December. This seasonal pattern reappeared from September 2020.

Monthly suspected suicide attempts among people aged 10–19 reported to U.S. poison control centers, 2019–2022. From CDC's MMWR.

Why it matters

The findings suggest the pandemic affected children's and teens' mental health, with possible long-term consequences: a previous suicide attempt is the strongest predictor of later death by suicide. They match other reports of more emergency department visits for suspected suicide attempts among 12- to 17-year-olds, especially girls, from mid-2020.

Limits: poison center data can't show the risk factors behind the rise; they depend on voluntary, complete reporting and accurate coding, so they don't capture every case; and when several substances are reported in one call, it's impossible to tell which caused the effects.

What can help

The authors call for suicide prevention aimed at children and adolescents, built on partnerships among families, teachers, mental health professionals and public health leaders:

• identify and support young people at risk;
• create protective environments by reducing access to lethal means, including safe storage of medicines — over-the-counter ones too;
• improve access to mental health care;
• teach coping and problem-solving skills.

The 988 Suicide & Crisis Lifeline, available nationwide since July 2022, is a network of more than 200 crisis centers, supported by local and state sources and the federal Substance Abuse and Mental Health Services Administration. It helps people in mental health distress and those worried about someone in crisis.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline in the United States.

Sources

Based on Farah R, Rege SV, Cole RJ, Holstege CP, "Suspected Suicide Attempts by Self-Poisoning Among Persons Aged 10–19 Years During the COVID-19 Pandemic — United States, 2020–2022," Morbidity and Mortality Weekly Report 72(16), CDC; a work of the United States government in the public domain.