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In the United States, the number of children and adolescents who have gone to emergency rooms to commit suicide and to attempt suicide has doubled between 2007 and 2015, according to a new report. analysis.
The researchers used public data from the Ambulatory Medical Care Survey conducted in national hospitals, administered annually by the US Centers for Disease Control and Prevention. The researchers analyzed each year the number of children aged 5 to 18 years diagnosed with suicidal ideation or suicide attempts, among the 300 emergency rooms sampled.
Diagnoses of one or the other condition went from 580,000 in 2007 to 1.12 million in 2015, according to the study published Monday in JAMA Pediatrics. The average age of a child at the time of assessment was 13 years and 43% of visits involved children aged 5 to 11 years.
"The numbers are very alarming," said Dr. Brett Burstein, lead author of the study and pediatric emergency physician at the Montreal Children's Hospital of the McGill University Health Center. "This also represents a larger percentage of all pediatric emergency visits. Where the suicidal behavior of the pediatric population represented only 2% of all visits, it now stands at 3.5%. "
The results are not a surprise for child psychiatrists.
"We know that the number of suicides and depressions has increased dramatically," said Dr. Gene Beresin, executive director of the Clay Center for Healthy Minds at Massachusetts General Hospital and professor of psychiatry at Harvard Medical School, who did not participate in the study.
Depression and previous suicide attempt are the two most important risk factors for suicide. And with an increasing suicide rate, it makes sense that risk factors also increase, he explained.
The reason? It's complicated
One of the reasons for the increase in depression and suicidal behavior could be more stress and pressure on children, said Beresin.
"Children are feeling more pressure to succeed, more pressure at school and more worried about making a living than in previous years," he said.
Parents and caregivers are also more stressed, Beresin added, adding that suicide rates have increased in all age groups over the past 20 years and that stress is being passed on to children and adolescents.
Another reason could be the rise of social media and the rising rates of cyberbullying that followed, Beresin said.
According to the CDC, about 15% of American high school students reported being bullied online in the last year.
A survey by the Pew Research Center revealed that this number could be even higher: 59%.
"Cyberbullying can be particularly difficult for children," said Dr. Neha Chaudhary, psychiatrist for children and adolescents at Massachusetts General Hospital and Harvard Medical School and co-founder of Brainstorm: Stanford Lab for Innovation brain health and entrepreneurship. "Unlike what happens in environments like schools, it can fly under the radar without anyone knowing it and without the same impact for bullies."
In isolation, none of these factors has resulted in increased suicidal behavior and ultimately suicide, but taken together, a trend is beginning to emerge, Beresin said.
And the country may not be adequately equipped to deal with the problem.
Families left waiting
According to data from the American Academy of Child and Youth Psychiatry, the majority of the United States faces a severe shortage of psychiatrists for children and adolescents, with fewer than 17 providers available per 100,000 children.
This means that many families face long waiting times, which can worsen the underlying mental health condition of a child and possibly require more treatment sessions than if the problem had been addressed in its early days, said Jennifer Mautone, psychologist in the department. Psychiatry and behavioral science of the child and teenager at the Children 's Hospital of Philadelphia.
Available skilled service providers face another challenge: communicating with other childcare systems.
Many systems are aimed at child care, including education, health, juvenile justice and child protection systems, said Dr. Barbara Robles-Ramamurthy, psychiatrist for children and adolescents from the Long School of Medicine of UT Health San Antonio. involved in the study.
"All these systems that are supposed to take care of children are not often talking to each other," she said. "Very often, children are left behind and families do not get the appropriate help they need."
According to a study published in JAMA Pediatrics in February in the United States, half of children with mental disorders such as depression and anxiety are not treated.
Rising rates of mental health problems among young people, coupled with difficulties in accessing care and long waiting lists, is a bad combination, Beresin said.
Burstein, who regularly sees emergency services for suicidal children and adolescents, fears that rates will continue to rise.
"We are seeing an acceleration of this problem and I am afraid the peak has not yet been reached," he said.
If you or someone you know needs help call the National Suicide Prevention Line at 1-800-273-TALK (8255).
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