Suicide ideation and attempts in a pediatric emergency department before and during COVID-19

Objectives. Recent studies have identified elevated rates of mental health concerns during the COVID-19 pandemic. This study sought to evaluate whether youth reported greater frequency of suicide-related behaviors during the 2020 COVID-19 pandemic, as compared with data from 2019. We hypothesized that rates of suicide-related behaviors would be elevated between the months of March and July 2020, as compared with 2019, corresponding to the onset of the COVID-19 pandemic.

Method. Routine suicide risk screening was completed with youth ages 11-21 in a pediatric Emergency Department. Electronic health records data for suicide risk screens completed between January-July 2019 and January-July 2020 were evaluated. A total of 9,092 completed screens were examined (mean age 14.72 years, 47.7% Hispanic/Latinx, 26.7% non-Hispanic White, 18.7% non-Hispanic Black).

Results. Analyses compared rates of positive suicide risk screens for January-July 2020 with corresponding rates from January-July 2019. Results indicated a significantly higher rate of suicide ideation in March and July 2020 and higher rates of suicide attempts in February, March, April, and July 2020, as compared with the same months in 2019. Demographic characteristics (sex, race/ethnicity) were not associated with increased rates  of suicide-related behaviors during this period.

Conclusions. 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. 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.