In 2021, 22% of high school students reported seriously considering suicide, 18% made a plan to commit suicide, and 10% attempted suicide one or more times during the past year. Female students were roughly twice as likely to consider, plan, or attempt suicide than male students. Similarly, LGBQ+ students were significantly more likely to consider, plan, or attempt suicide than heterosexual students. 

"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."

Separately, a  study  recently published in CDC's  Morbidity  and Mortality Weekly Report   found that the rate of suspected suicide attempts by self-poisoning among children ages 10-19 increased by 30% between 2019 and 2021.

This rise was particularly prominent among younger children, with those ages 10 to 12 seeing a 73% increase. Adolescents ages 13 to 15 also saw a 48.8% increase. Compared to young boys, who saw a 5.6% increase, young girls had a 36.8% increase in suspected suicides by self-poisoning. 

The substances most often involved in these suspected suicide attempts include acetaminophen, ibuprofen, sertraline, fluoxetine, and diphenhydramine (Benadryl). Compared to 2019, overdoses involving acetaminophen increased by 71% in 2021 and 58% in 2022 while diphenhydramine overdoses increased by 24.2% in 2021 and 35.8% in 2022.

"As someone who takes care of these children, it's concerning to see some of the over-the-counter products that are utilized," said Christopher Holstege, one of the study's authors and a professor of emergency medicine and pediatrics at the  University of Virginia School of Medicine. He also noted that it is challenging to control access to products that "have some pretty significant toxicity" that youth can easily purchase at drug stores.

How to address the youth mental health crisis

In its 2021 Youth Risk Behavior Survey, CDC outlined several steps for schools and partners to take to help address mental health issues among American youth, including:

• Ensuring students feel connected to others through youth development programs or inclusivity efforts
• Connecting families and students with community resources
• Providing 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," said Debra Houry, CDC's CMO. "Proven school prevention programs can offer teens a vital lifeline in these growing waves of trauma."

Holstege and his co-authors also made similar recommendations in their own study, emphasizing a need for effective partnerships with families, teachers, mental health professionals, and more.

"It is imperative to mitigate this increase with suicide prevention measures that focus on children and adolescents and involve partnerships between key partners in the communities, such as families, school teachers, mental health professionals, and public health leadership," the authors wrote.

"Suicide prevention resources and tools are available to help communities prevent suicide," they added. "These strategies include identifying and supporting youth at risk for suicide, creating protective environments through reduction of access to lethal means, improving access to mental healthcare, and teaching coping and problem-solving skills." (Henderson, MedPage Today, 4/20; Castillo, STAT, 4/20; Payne/Mahr, Politico Pro [subscription required], 4/28; Farah et al., Morbidity and Mortality Weekly Report, 4/21; CDC 2021 Youth Risk Behavior Survey, accessed 4/28)

Crisis response services are often patients’ first entry point for behavioral health care.  A more equitable system would provide the most marginalized and at-risk patients with more accessible, affordable options prior to escalation. Download our cheat sheet to learn more.