Wednesday, May 16, 2018

Visits for Suicide Ideation, Attempts More Than Doubled at U.S. Children’s Hospitals Since 2008

Surveillance studies have reported that the number of suicide ideation and suicide attempts have been increasing among children in the United States over the last decade. A study published in Pediatrics now shows that from 2008 to 2015 emergency department (ED) visits and hospitalizations for suicide ideation/attempts more than doubled at U.S. children’s hospitals and accounted for an increasing percentage of all children’s hospital encounters.

“Our findings that ED and inpatient children’s hospital encounters for SI [suicide ideation] or SA [suicide attempts] have increased over the past decade underscore the increasing impact of mental health disorders in youth on children’s hospital services,” wrote Gregory Plemmons, M.D., of Monroe Carell Jr. Children’s Hospital at Vanderbilt and colleagues. “Recognition of this increasing burden on children’s hospitals is paramount in helping to inform future strategies for suicide prevention and treatment and to ensure that interventions to reverse this concerning trend continue to reach the individuals at highest risk.”

Plemmons and colleagues used the Pediatric Health Information System database—which contains clinical and billing data from 49 children’s hospitals in the United States—to collect information on ED visits and hospitalizations for suicide ideation/attempts by children and adolescents aged 5 to 17 between 2008 and 2015.

During the study period, the investigators identified 115,856 encounters for suicide ideation and suicide attempts at 31 hospitals (the other 18 had incomplete data during the study timeframe and were excluded), representing 1.21% of total hospital encounters. Half of the patients were aged 15 to 17, 37% were aged 12 to 14, and 13% were aged 5 to 11; 64% of the patients were girls.

The yearly rate of hospital visits for suicide ideation/attempts more than doubled over the study period, increasing from 0.66% of all visits in 2008 to 1.82% of all visits in 2015. The researchers also observed seasonal trends in visits for suicide ideation/attempts throughout the study period, with the lowest percentage of visits occurring during summer months (June to August) and the highest percentage occurring during spring and fall—during the academic year.

“[O]ur findings … underscore the need for future work to explore the relationship between school and suicidal ideation, recognizing that the role of academics is a complex one, and there may also be other additional influences at play regarding seasonality,” Plemmons and colleagues wrote.

To read more on this topic, see the Psychiatric News article “Impulsivity May Be Strong Contributor to Childhood Suicides” and the Psychiatric Services article “Utilization Patterns at a Specialized Children's Comprehensive Psychiatric Emergency Program.”

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