The pandemic has had a significant impact on Americans' mental health, with two new CDC reports showing an increase in overall suicide rates in 2021 and record levels of sadness and hopelessness among teenagers.

Suicide rates are increasing once again

According to a new CDC report, suicide rates in the United States increased in 2021 after two years of declines in 2020 and 2019.

In 2021, there were 48,183 suicides deaths in the United States, almost matching the record high number of deaths in 2018. In comparison, there were 45,979 suicide deaths in 2020 and 47,511 in 2019.

After adjusting for age, American Indian/Alaska Native people had the highest suicide rates across all racial and ethnic groups at 28.1 suicide deaths per 100,000 people. This group also saw the largest percentage increase in suicide deaths between 2018 and 2021 at 26%.

During the same time, Black Americans saw their suicide rates increase by 19%. However, suicide rates among young Black Americans ages 10 to 24 increased by roughly 36%, which CDC noted was a "particular concern."

Among Hispanic people, suicide rates increased by 6.8% between 2018 and 2021. Non-Hispanic white people were the only group to see a decrease in suicide rates at almost 4%. There was also a 12.4% decline in suicide rates among Americans ages 45 to 64.

According to CDC, several factors may have contributed to the increased suicide rates in 2021, including personal, professional, or financial issues, as well as the ongoing COVID-19 pandemic.

"Suicide is a complex problem related to multiple risk factors such as relationship, job or school, and financial problems, as well as mental illness, substance use, social isolation, historical trauma, barriers to health care, and easy access to lethal means of suicide among persons at risk," CDC said.

"As the nation continues to respond to the short- and long-term impacts of the COVID-19 pandemic, remaining vigilant in prevention efforts is critical, especially among disproportionately affected populations where longer-term impacts might compound preexisting inequities in suicide risk," the agency added.

The growing mental health crisis among American youth

In a separate report, CDC found that there is a growing mental health crisis among American youth, with rates of sadness and hopelessness among teenagers reaching their highest point in a decade.

In the latest national Youth Risk Behavior Survey, which was conducted in fall 2021 and the first iteration to take the pandemic into account, 42% of teenagers reported experiencing "persistent feelings of sadness or hopelessness" in the last year, 29% said they had poor mental health in the past month, and 22% said they had "seriously considered attempting suicide" in the past year.

"I think there's really no question what this data is telling us," said Kathleen Ethier, head of CDC's adolescent and school health program. "Young people are telling us that they are in crisis."

The survey also found that there were significant differences based on gender, sexual orientation, and racial/ethnic identity.

Compared to teenage boys, teenage girls were significantly more likely to report feelings of sadness, hopelessness, violence, and suicidal ideation. Overall, 57% of teenage girls said they felt sad or hopeless in 2021 — almost double the rate among boys (29%) and a significant increase from the 36% of teenage girls who reported the same in 2011.

In addition, 30% of teenage girls reported seriously considering attempting suicide, and almost 25% said they made suicide plans. In comparison, 14% of teenage boys said they seriously considered attempting suicide, and 12% made a plan.

There were also record high levels of violence against teenage girls, with 18% saying they had experienced sexual violence over the last year and 14% saying that they had been forced to have sex. According to CDC, these are the first significant increases to these measures since the agency first began tracking them.

"These data show a distressing picture," said Debra Houry, CDC's CMO. "America's teen girls are engulfed in a growing wave of sadness, violence, and trauma."

LGBQ+ teenagers also reported high levels of mental distress, with nearly 70% reporting that they had felt persistently sad or hopeless and 52% saying they had poor mental health in the past month. Forty-five percent of LGBQ+ teenagers also seriously considered attempting suicide, and 37% said they had made plans.

Although there were less consistent disparities among different racial/ethnic groups, the researchers did find that Hispanic and multiracial teenagers were more likely to report feelings of sadness and hopeless than their Asian, Black, and white peers. However, Black teenagers were the most likely to attempt suicide compared to their peers.

To address mental health issues among American youth, the report outlined several steps for schools and partners, including ensuring students feel connected to others through youth development programs or inclusivity efforts. The report also suggested schools connect families and students with community resources and provide more education on mental, physical, and sexual health.

"High school should be a time for trailblazing, not trauma. These data show our kids need far more support to cope, hope, and thrive," Houry said. "Proven school prevention programs can offer teens a vital lifeline in these growing waves of trauma." (Sforza, The Hill, 2/13; Joseph, STAT, 2/13; Firth, MedPage Today, 2/14; Saric, Axios, 2/13; Ghorayshi/Rabin, New York Times, 2/13; Hou, The Hill, 2/13; Raman, Roll Call, 2/13)