When a child under 10 committed suicide in central Ohio a few years ago, Jeff Bridge found himself answering a reporter's question about how often young children take their own lives.
Bridge, director of the Center for Suicide Prevention and Research at Nationwide Children's Hospital in Columbus, Ohio, discussed the question with his colleagues and discovered that suicide rates in elementary-age children hadn't been carefully analyzed. He set out to correct that.
In a new study appearing in October's Pediatrics journal, lead author Bridge and six co-authors found that suicide among young children is extremely rare, but it affects some communities disproportionately and merits serious attention.
By analyzing National Violent Death Reporting System data for 17 states, researchers found 693 children ages 5-14 died by suicide from 2003 to 2012. Of those 693 deaths, 87 were children ages 5-11.
Close to 37 percent of children ages 5-11 who died by suicide were black, the study found. That's a startling percentage, given that African-Americans account for about 12 percent of the U.S. population, according to the U.S. Census Bureau.
"Suicide rates have increased among black children and decreased among white children in the United States," Bridge told me recently. "If you look at the overall suicide rate among children, there was no change over a 20-year period. It's only when you look at the analytics by race that a pattern emerges."
Bridge's study attempts to determine why.
"Black youth may experience disproportionate exposure to violence or traumatic stressors, both of which have been associated with suicidal behavior," the study states. "Also, research has shown that black youth are less likely to receive services for depression, suicidal ideation and other mental health problems compared with nonblack youth."
To be sure, suicide affects all races. And this study should be a wake-up call about just how early we ought to address that reality.
One third of all children 5-14 who died by suicide were diagnosed with a mental health problem - frequently attention deficit disorder. Children under 11 were less likely to be diagnosed with depression than children 12-14, but Bridge said that could be because young children aren't screened for depression as frequently as early adolescents.
Perhaps they should be.
"I would like to see more of an upstream approach to suicide prevention in young people," Bridge said. "Let's begin the conversation about mental health earlier. Let's not wait until the teen years to have these conversations, because even though it's extremely rare, suicide and suicidal behaviors can and do sometimes occur in children."
Outdated thinking suggested that talking about suicide with a child could increase that child's risk of committing suicide. Bridge said that's categorically not the case.
"Talking about suicide will not put the thought in a child's head," he said. "If anything, it offers hope for children who may be at risk."
Parents should talk to their child's pediatrician if they're concerned their child might harm himself or herself, Bridge said. And parents should talk directly to their children as well.
"It opens up the conversation," he said. "It allows children to know that if they're struggling, they can go to their parents and talk to them and that there's a support system for them."
Thirty percent of all suicide deaths in children and early adolescents occur after an earlier disclosure of suicide intention, Bridge said.
"Part of why we want to educate adults - parents, teachers, health care providers - is because there is time for intervention," he said. "These conversations can potentially save lives."
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