When children want to die – why suicide screenings are on the rise in CMS
North Carolina children and teens are killing themselves nearly twice as often as they did just a decade ago, state data shows, with Mecklenburg County’s number the highest in the state by a wide margin in recent years.
Suicide is now the state’s second-leading cause of death for children 10 to 17 years, trailing only motor vehicle accidents. Forty-four children and teens took their lives in 2017, compared to 22 in 2008, according to data reported by the N.C. State Center for Health Statistics.
Mecklenburg had five child and teen suicides in 2017, matching Guilford County. The county’s 24 deaths between 2013 and 2017 were nine more incidents than any other county. Wake County had 14 youth suicides in 2013-2017 and four in 2017.
The North Carolina Institute of Medicine, an independent agency chartered by the state legislature, and the Raleigh-based advocacy group NC Child highlighted the suicide data in an annual report that was released last month.
Suicidal thoughts most commonly occur in children with anxiety, depression or other mental health issues, the report said. Lack of impulse control, access to firearms and prescription drugs and risk factors such as bullying, family violence and social isolation may also play roles, it said.
Sexual orientation and race can also influence suicide risks, the report said.
Quoting a Centers for Disease Control and Prevention-designed survey that is conducted at schools, it said gay, lesbian or bisexual high school students in North Carolina were three times more likely to report seriously considering suicide in 2017 than heterosexual students. African-American high schoolers were twice as likely as white students to have attempted suicide in the previous 12 months, it said.
How deaths are reported may account for part of the rising suicide rate, said Victor Armstrong, vice president of behavioral health services at Atrium Health in Charlotte. Deaths that had been labeled accidental, such as in drug overdoses, might now be called suicide.
But it’s also becoming clear that children and teens low on the socio-economic scale — those who live under the stress of unsafe living conditions and traumatic disruptions — are more likely to have signs of mental disorders and to attempt suicide, Armstrong said. In 2015, national statistics showed for the first time that the suicide rate among African-American youth surpassed that of whites.
Bullying is also a factor, especially when it’s spread across social media, which can be as isolating as it connective.
Atrium Health offers free training sessions in “mental health first aid” that focus on identifying warning signs of suicide, mental disorders and substance abuse and how to react to them. A bill that calls for study of mental health screenings in public schools is before North Carolina’s Senate after passing the House.
“I’m of the belief that if we’re going to put a dent in suicide, it’s going to take a community effort,” Armstrong said. “Suicide is a public health issue and it needs a public health response.”
NC Child says reducing barriers to mental health treatment, limiting access to guns and prescription drugs, and training caregivers and school staff in how to detect suicide risks would help.
“The reality is that many kids have to cope with tremendous stressors and don’t have the supports they need to navigate them,” NC Child executive director Michelle Hughes said in releasing the report. “Dealing with things like discrimination because of their race or sexual identity, or experiencing abuse and neglect, all contribute to a child’s likelihood of attempting suicide. These are all things that we can address with better public policy choices.”
The number of students Charlotte-Mecklenburg Schools screened for suicide risk tripled in five years, to more than 2,100 in 2017, The Observer reported in a year ago. Hundreds of children show risk signs each year, CMS said, with most falling between grades three and eight.
The district cautioned that those numbers don’t necessarily mean more students are suicidal, but that CMS was reacting to signs of potential trouble.
In the CDC’s Youth Risk Behavior Survey, 17 percent of CMS high school students reported seriously considering suicide in 2017, up slightly from 14 percent in 2009. Actual suicide attempts declined to 10 percent in 2017 from 14 percent in 2009.
Dr. Crystal Bullard, a child and adolescent psychiatrist at Atrium Health, said the patients she’s interviewed usually attempt suicide after an acute stress such as an argument with friends or parents or the breakup of a relationship. Those children also most have mental health issues such as anxiety or depression that may be compounded by feelings of low self-esteem, problems at school or use of drugs or alcohol.
Exposure to suicide, such as in pop culture, also plays a role. “Children aren’t just born with the concept of suicide,” Bullard said.
The popular Netflix show “13 Reasons Why,” in which a fictional high school student leaves tapes explaining why she took her life, might also influence young viewers to attempt suicide, a University of Michigan study found, Newsweek reported in November.
Bullard advises parents to talk with children they suspect of having suicidal thoughts, and to keep that conversation going if self-harm such as cutting is suspected. Parents should stay aware of their kids’ friends, social media use, what they watch on TV and possible drug use, she added: “Supervise, supervise, supervise.”
Free crisis support is available around the clock at these numbers:
- Atrium Health Behavioral Health Help Line: 704-444-2400.
- National Crisis text line: Text HOME to 741741.
- National Suicide Prevention Lifeline: 800-273-8255