We’ve seen disturbing news stories on tragic spikes in youth suicide across the months of the COVID-19 pandemic. Clearly, coronavirus and its aftermath have been more difficult on even the strongest among us than most anticipated. So of course, it would not be surprising to find it affecting our young people in such dramatic ways.
At the dawn of the COVID-19 outbreak, a physician from the Icahn School of Medicine at Mount Sinai hospital in New York City, writing in “QJM: An International Journal of Medicine,” reasonably posited:
There is a high probability that suicide rates will increase in many countries of the world. This problem may be especially difficult in the US. Suicide rates have been steadily growing in the USA over the last two decades.
Some professionals anticipated we could see suicide increases as high as 145 percent. But if we move beyond the disturbing headlines, anecdotes, and assumptions and look at the larger research, has there actually been a parallel COVID pandemic of youth suicide? As one group of scholars studying the topic correctly reminds us, “Supposition…is no replacement for evidence.”
We must ask what research-based, big-picture evidence indicates? There appears to be some good news on this question so far, as well as some interesting protective dynamics happening among our youth during this very trying year.
British scholars examining this question with an international scope explained late last year, that even in developed countries, “It is still too early to say what the ultimate effect of the pandemic will be on suicide rates.” Still, they add, “Data so far provide some reassurance, but the overall picture is complex.”
So, what do we know? First, we must note that we simply do not know for sure at this point whether suicide rates increased over the last year. National U.S. data on youth suicides for 2020 simply have not been compiled yet, so cumulative numbers do not exist. We do know that a Centers for Disease Control (CDC) study published in November 2020 finds that emergency room visits related to mental-health emergencies, such as attempted suicides, among children ages 5-17 increased by at least 24 percent starting in April 2020 through the rest of the year, as compared to the same period in 2019.
Dr. Greta Massetti, the senior scientist who studies teen health and violence at the CDC confesses that in normal times, reasons for suicide are almost impossible to fully understand — they are not rational actions but impulsive, fickle acts, and exceedingly difficult to ascribe to specific causes. Massetti also adds that the pandemic has created social and inter-personal conditions unlike anything mental health professionals have seen before, making possible causation that much more difficult to determine.
“[It] makes conceptual sense,” Massetti believes, that increases in cluster suicides among young people would follow the kind of social isolation that lockdowns have brought. Massetti confirms school districts have anecdotally been reporting increases in clusters of suicide. Some school districts have refused to open for in-person school until a student commits suicide due to isolation. But we simply do not have a conclusive national scope for 2020 to date.
Is Suicide Related to COVID-19 on the Rise?
Even though we do not have final national data, there are reliable and research-based secondary indications that the suicide rate in 2020 may not have been markedly different than in previous years. If true, this is certainly good news coming out of a year with much bad news.
The December 2020 issue of the medical journal Pediatrics reports, “Results indicated that rates of suicide ideation and attempts were higher during some months of 2020, as compared with 2019, but were not universally higher across this period” of the COVID-19 pandemic. This study examined emergency room admissions of youth aged 11-21 from suicide attempts through the COVID months of 2020, contrasting them with the same months in 2019.
These scholars explained, “Months with significantly higher rates of suicide-related behaviors appear to correspond to times when COVID-related stressors and community responses were heightened, indicating that youth experienced elevated distress during these periods” relative to the concern of the adults around them, as well as increased lock-down actions taken by community leaders. But all in all, “Rates of positive suicide risk screens were not uniformly higher after the outbreak of the COVID-19 pandemic in the United States in March 2020” than in recent years.
A November editorial published in the British Medical Journal confirmed this appears consistent across other developed nations. Admitting that the literature on suicide deaths, attempts, and ideation “should be interpreted with caution,” early indications are “a reasonably consistent picture is beginning to emerge” that rates have neither climbed nor declined overall, although that may not be true of specific states or regions. Spikes have indeed occurred in various countries.
But the rise and falls are very dynamic, as in Japan where there was a 20 percent decrease in their national suicide rate early in the pandemic. But in August a 7.7 percent national rise was reported. They conclude the overall trend has remained generally steady with previous years in most nations, including the United States.
A peer-reviewed literature analysis on the topic conducted by 15 scholars and published in September (updated January 2021) at the open-source online journal F1000Research concluded, “There is thus far no clear evidence of an increase in suicide, self-harm, suicidal behavior, or suicidal thoughts associated with the pandemic” across major countries where data is available. These scholars admit, “However, suicide data are challenging to collect in real-time…”
A study reported in the journal Psychiatric Research did find a relationship between increased suicidal thoughts, but not behavior, in communities with more severe lock-down and shelter-at-home orders across the United States. The authors explained, “By June, the percentage of individuals reporting any suicidal ideation was 1.8 times greater among those under stay-at-home restrictions compared to those who were not.”
Youth Suicide Rates Have Climbed the Last Few Years
If it is indeed true that rates in youth suicide have not increased notably in 2020, that good news is only relative. It simply means our nation’s already growing suicide rates have not gotten worse during COVID-19 on average.
The Centers for Disease Control and Prevention’s most recent Youth Risk Behavior Survey 2009-2019 reports that all measures of suicide and suicidal ideation have been increasing markedly over the last decade, rising through the years just before COVID-19. And suicidal ideation and attempts are significantly more prevalent for girls than boys.
Youth self-reporting experiencing “persistent feelings of sadness or hopelessness” have climbed dramatically since 2015 in the United States. The British Medical Journal reported recently, “In 2019, suicide rates among men in England and Wales were the highest since 2000, and although suicide in young people is relatively rare, rates have been rising in 10 to 24-year-olds since 2010.”
What Explains This Early Data on Suicide?
Dr. Jean M. Twenge, a research professor of psychology at San Diego State University and one of the leading scholars in the nation studying the personal lives and psychology of young people, conducted a national research project this summer for the Institute for Family Studies on how the COVID-19 pandemic and lockdowns have affected American youth’s mental health and family life. She concludes, “To our surprise, we found that teens fared relatively well during quarantine. Depression and loneliness were actually lower among teens in 2020 than in 2018, and unhappiness and dissatisfaction with life were only slightly higher.”
This data shows that COVID-19 has indeed been a significant disruption in young people’s lives and routines, leading to greater unhappiness and dissatisfaction with life. That is to be expected. But youth reporting lowered levels of both depression and loneliness in this COVID-19 year is truly surprising and encouraging. The reasons for this lowered depression and loneliness appears to be related to this next finding.
These scholars also found that the mental health of youth was significantly related to family form. Kids living with their mother and father showed better coping skills overall as they had double the number of comforting adults as well as a diversity in approaches toward coping. Given this, Twenge’s team isolated two primary reasons why they believe these kids with stronger family support were coping better with COVID-19 stresses.
First, the kids were shown to be getting better sleep during quarantine, a major factor in stress reduction and coping. Second, they were spending more time with their parents and siblings, and youth who spent more time with their families during the pandemic were much less likely to report feeling depressed and anxious.
Specifically, it was revealed that during the COVID-19 months:
- 56 percent of youth said they were spending more time talking to their parents than pre-pandemic.
- 54 percent said their families ate dinner together more often during the pandemic.
- 46 percent reported spending more time with their brothers and sisters during the pandemic.
- 68 percent of teens said their families had become closer during the pandemic.
These factors serve as important stress reducers and emotional comforts. So, while kids have been physically isolated from their friends and their regular school routine has been interrupted, the pandemic has meant more time with those in their household. These scholars indicate this has had a positive effect on many young people, especially those with strong families.
Twenge and her team state the unanticipated reduction in depression and loneliness in American teens in the COVID-19 months could be well be related to the increased family time teens reported during the lockdown. They explain, “given associations between positive family relationships and mental health, more family time may have mitigated the negative effects of the pandemic.”
The research Twenge and her team referenced on the connection between family time and improved mental health is a uniquely sophisticated longitudinal investigation into how family intimacy and togetherness boost emotional well-being and prevents depression in children and adolescents. This 2019 data, published in JAMA Pediatrics by scholars at the University of North Carolina-Chapel Hill, explains:
Family cohesion and the absence of parent-child conflict were associated with a lower risk of depression, not only in the short-term during adolescence but also throughout young adulthood and into midlife.
Increased family intimacy, as is happening during the COVID-19 lockdown, is indeed associated with the development of numerous skills:
…[family closesness helps with] coping with changing and cumulative stressors, promoting mental health throughout the life course from early adolescence to midlife, and helping to prevent negative outcomes and premature deaths due to suicide, alcohol, or drugs in middle age.
The Power of Families
God created humans as social creatures. As we have all seen during the COVID-19 outbreak, isolation can be extremely hard on us. It can even bring death.
But as some of this early university-based research shows, young people’s increased time with family and parents during the long months of shelter-at-home could have served as a balm and buffer from these difficulties for many young people. Leading scholars believe these two things are related.
It very well could be that increased time with parents and siblings is helping mitigate the struggles, sense of loneliness, anxiety, and depressive feelings we would expect young people to experience under such trying situations. It also shows that, all other things being equal, children from married, two-parent homes are doing better than those in other familial situations because of the emotional stability such homes can provide over less stable, alternative family forms.