Suicides soar among teenagers, Harvard study says
Growing numbers of young Americans are taking their own lives, with particularly steep increases in the past few years, according to an analysis published Tuesday that provides a detailed portrait of a troubling phenomenon.
The study by Harvard Medical School researchers shows that from 2000 to 2017, the suicide rate rose by 47 percent among teens age 15 to 19 and 36 percent among those 20 to 24. That’s well above the 30 percent increase seen across all age groups.
Although the trend of soaring youth suicides is well known, the report provides the first breakdown of this group by age and sex over several years. And it reveals a recent, abrupt spike.
“People may assume the suicide increase is this very constant thing that just gradually goes up,” said Oren Miron, a research associate in biomedical informatics at Harvard Medical School and lead author of the study, published in the Journal of the American Medical Association.
But Miron’s numbers show that the rise in suicides among people age 15 to 24 has followed an uneven trajectory, with a very recent acceleration, especially for males. “There might be something new we need to worry about,” he said.
For example, among males age 15 to 19, the suicide rate dipped slightly from 2000 to 2007, rose just 3.1 percent per year from 2007 to 2014, and then jumped a startling 14.2 percent annually from 2015 to 2017.
All told, 6,241 suicides occurred among people age 15 to 24 in 2017. Eighty percent of the victims were male.
Suicide experts, asked to comment on Miron’s study, did not find the data surprising.
Dr. David A. Brent, a University of Pittsburgh School of Medicine psychiatry professor who has studied adolescent suicide, said the research provides “a more detailed snapshot of a trend that we know is very worrisome.”
“It raised my anxiety a little bit more,” he said. “When you look at the trends, it’s pretty heart-rending.”
But the 14 percent yearly spikes in deaths among older male teens involved too short a time period to draw conclusions, he said.
Brent speculated that the more recent numbers might have been affected by “13 Reasons Why,” a Netflix series about a teenage girl who took her own life, which aired in March 2017. Suicides increased 28.9 percent among Americans age 10 to 17 in the month afterward, and remained higher than usual throughout the year, with boys much more likely to be victims.
Kimberly O’Brien, a research scientist who studies adolescent suicide at Boston Children’s Hospital, said the Harvard report “reiterates the sobering truth about suicide among young people.”
“This is indicative of a society that is just hurting,” O’Brien said. “This is not mental illness. This is a societal problem. . . . We’re not taking care of people who are struggling.”
Youth suicides seem to track closely with the increase in opioid-related deaths seen around the country, and Miron said he hopes to examine, in future studies, how the two phenomena intertwine.
The opioid crisis may be contributing to suicides. People who have lost loved ones, especially parents or siblings, might be more likely to fall into a depression, he said.
A study published last month found that children whose parents have prescriptions for opioids are more likely to attempt suicide.
Miron acknowledges that unintended overdoses may have been mislabeled as suicides, artificially inflating the numbers.
But O’Brien thinks the opposite may be true.
“Researchers estimate that about a third of all opioid deaths are actually suicides,” she said. “We could have more suicides by opioids than we know. If you’re addicted to opioids you can feel helpless and hopeless.”
The study looked at nationwide data and did not break down suicides by state. But other research looking at all groups combined found that Massachusetts has seen one of the biggest increases in suicide — up 35 percent from 1999 to 2016. Even so, that state still has one of the lowest suicide rates in the nation, ranking 48th.
Kelley Cunningham, director of the state Suicide Prevention Program, said Massachusetts has seen suicide rates among teens and young adults increase steadily since 2003, with a particularly notable increase among women age 20 to 24. In that group, suicide deaths doubled from seven in 2005 to 14 in 2016.
Miron said his interest in suicide is personal as well as academic: a high school friend took his own life after being bullied. Miron feels the loss of a brilliant young man who could have contributed so much if he’d waited to finish high school and escaped the daily bullying.
That inability to see a better future is a feature of teenagers’ brains that makes them vulnerable to suicide, said O’Brien, of Boston Children’s.
“They’re in a crisis. They feel like, ‘I can’t get through this.’ They really cannot see through to the other side,” she said. “And if they have access to a gun, if they have one bad moment, that gun could end their lives forever.”
Today’s teenagers cope with anxiety, depression, and pressure to succeed, circumstances exacerbated by easy access to guns and poor access to mental health care, O’Brien said.
Brent, the University of Pittsburgh researcher, said there is no clear data on why youth suicide is increasing. But social media are suspected of playing a role, by promoting social comparison, enabling cyber-bullying, and disrupting sleep.
“There is a very strong relationship between not getting enough sleep and depression and suicidal behavior,” he said.
But while the causes might be obscure, Brent said, the solutions are well-known.
Programs that deliver mental health care in collaboration with primary care providers, certain school-based prevention efforts, and reducing access to firearms have been shown to make a difference. The Henry Ford Health System in Michigan reduced suicides among its patients by 80 percent by making a series of evidence-based improvements, such as drop-in group visits, same-day psychiatrist appointments, and working with families to remove firearms.
“It’s really a matter of having the will to do it,” Brent said. “We have the methods. There are interventions out there that work, but people aren’t getting them.”
Massachusetts is trying to bring such interventions to hard-hit areas, said Cunningham, of the state’s Suicide Prevention Program. The state has a federal grant to partner with two health care systems in Western Massachusetts to adopt the “Zero Suicide” initiative. The program trains mental health professionals in treating people at risk of suicide and develops services to build resiliency in younger people before suicidal thoughts take root.
Cunningham expects these efforts to make a difference, though not right away.
“We’re going to be moving slowly for a while before we really start to make an impact,” she said.
If you or someone you know is thinking about suicide, call the National Suicide Prevention Lifeline, (800) 273-TALK (8255).