I know so many survivors of suicide in their families who have told me they saw no signs that would lead them to believe this horrible outcome was possible.  In addition, I know there are families out there who have said “this could never happen in my family.” Sadly, the facts on the ground prove otherwise.

• Suicide is the 11thleading cause of death in the US;
• In 2022, 49,476 Americans died by suicide;
• In 2022, there were an estimated 1.6M suicide attempts;
• Suicide rates increased 37% between 2000-2018 and decreased 5% between 2018-2020. However, rates returned to their peak in 2022.
• About 1/4 of children and teens experience some type of mental disorder in any given year, 1/3 at some time in their lives.  The most common kind of mental disorders are anxiety disorders, like overanxious disorder of childhood or separation anxiety disorder.  Other common types of mental illnesses in childhood include behavior disorders like attention deficit hyperactivity disorder.
• Depression occurs at a rate of about 2% during childhood and from 4%-7% during adolescence, affecting up to about 20% of adolescents by the time they reach adulthood.
• The prevalence of adolescent depression is high, it is significantly underdiagnosed and undertreated. Because of the lack of mental health care professionals, family physicians are often responsible for detecting and treating childhood and adolescent depression, however, they are often not trained properly to do so.
• As is the case with most mental-health disorders at any age, such disorders in children do not have one single definitive cause. Rather, people with these illnesses tend to have a number of biological, psychological, and environmental risk factors that contribute to their development. Biologically, mental illnesses tend to be associated with abnormal levels of neurotransmitters, like serotonin or dopamine in the brain, a decrease in the size of some areas of the brain, as well as increased activity in other areas of the brain. Girls are more likely to be diagnosed with mood disorders like depression.
• Children and adolescents with a mentally ill parent are up to 4 times more likely to develop such an illness themselves.  This must be acknowledged by the parents of a young child and accepted.  Only then will you recognize the warnings signs and be in a position to help.

• Social anxiety disorder is a persistent fear of embarrassment, ridicule, or humiliation in social settings. Typically, affected children avoid situations that might provoke social scrutiny (e.g., school).  Affected children are terrified that they will humiliate themselves in front of their peers by giving the wrong answer, saying something inappropriate, becoming embarrassed, or even vomiting.  In some cases, social anxiety disorder emerges after an unfortunate and embarrassing incident. In severe cases, children may refuse to talk on the telephone or even refuse to leave the house.
• Nonsuicidal self-injurious behaviors can include superficial scratching, cutting, or burning the skin (using cigarettes or curling irons), as well as stabbing, hitting, and repeated rubbing the skin. In many adolescents, these behaviors do not indicate suicidality but instead are self-punishing actions that they may feel they deserve; these behaviors are used to gain the attention of parents and/or significant others, express anger, or identify with a peer group. However, these adolescents, especially those who have used multiple methods of self-harm, have an increased risk of suicide.
• Suicides take the lives of 11% of children from 12-19 years old per year from 1999 to 2006, which amounts to 1,801 deaths per year during that period.  Unaccounted for in this number is deaths by overdose or “accident” not categorized as suicide.
• Because mood disorders such as depression substantially increase the risk of suicide, suicidal behavior is a matter of serious concern. The incidence of suicide attempts reaches a peak during the mid-adolescent years, and mortality from suicide, which increases steadily through the teens, is the third leading cause of death at that age.
• There is good evidence that over 90 percent of children and adolescents who commit suicide have a mental disorder before their death. The most common disorders that predispose to suicide are some form of mood disorder, with or without alcoholism or other substance abuse problem, and/or certain forms of anxiety disorder.
• Treatment options are few or many, depending how you look at them. Treatment of childhood and adolescent depression consists of psychotherapy, pharmacotherapy, or a combination of these.   Stay involved in your child’s treatment.  Moreover, provide your child’s psychiatrist with a HIPAA form authorizing you to speak with the physician concerning your child’s care and have access to all medical records, even when your child turns 18.   Urge your child’s psychiatrist to work as a team with his/her psychotherapist to come up with the best treatment plan for your child.