A new study from Nationwide Children’s Hospital and the Central Ohio Poison Center found rates of suicide attempts by self-poisoning among adolescents have more than doubled in the last decade in the U.S., and more than tripled for girls and young women.
The study, published online today in the Journal of Pediatrics, evaluated the incidence and outcomes from intentional suspected-suicide self-poisoning in children and young adults ages 10 to 24 years old from 2000-18.
In the 19-year time period of the study, there were more than 1.6 million intentional suspected-suicide self-poisoning cases in youth and young adults reported to U.S. poison centers.
More than 71% (1.1 million) of those were female.
“The severity of outcomes in adolescents has also increased, especially in 10- to 15-year-olds,” said Henry Spiller, MS, D.ABAT, director of the Central Ohio Poison Center at Nationwide Children’s Hospital, and co-author of the study.
“In youth overall, from 2010-2018 there was a 141% increase in attempts by self-poisoning reported to U.S. poison centers, which is concerning.”
Previous research has shown that suicide is the second leading cause of death among young people aged 10 to 24 years, and that while males die by suicide more frequently than females, females attempt suicide more than males.
Self-poisoning is the most common way that someone attempts suicide and third most common method of suicide in adolescents, with higher rates in females.
“Suicide in children under 12 years of age is still rare, but suicidal thoughts and attempts in this younger age group do occur, as these data show,” said John Ackerman, PhD, clinical psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children’s Hospital, and co-author of the study.
“While certainly unsettling, it’s important that parents and individuals who care for youth don’t panic at these findings, but rather equip themselves with the tools to start important conversations and engage in prevention strategies, such as safe storage of medications and reducing access to lethal means.
There are many resources and crisis supports available around the clock to aid in the prevention of suicide, and suicide prevention needs to start early.”
What causes suicide?
Research shows that approximately 90% of people who have died by suicide were suffering from a mental illness at the time.
The most common mental illness reported was depression.
Impulsivity and substance use, including alcohol and drugs, also warning signs for elevated suicide risk.
It is important to remember that suicidal thoughts and behaviors are not the natural consequence of serious life stresses.
People who experience a stressful life event may feel intense sadness or loss, anxiety, anger, or hopelessness, and may occasionally have the thought that they would be better off dead.
In most people, however, experiences of stressful life events do not trigger recurring thoughts of death, creation of a suicide plan, or intent to die.
If any of these are present, it suggests that the person is suffering from depression or another psychiatric disorder and should seek professional treatment.
Who is affected by suicide?
Unfortunately, suicide crosses all age, racial, and socioeconomic groups in the US and around the world.
In the US, suicide is the 2nd leading cause of death among children and adolescents ages 10-24, and the 3rd leading cause of death among 12 year olds.
Nearly one of every eight children between the ages 6 and 12 has suicidal thoughts.
The suicide rate is approximately 4 times higher among males than among females, but females attempt suicide 3 times as often as males.
When a suicide occurs, everyone is affected, including the people who are left behind.
What are the symptoms of suicide?
The primary symptom of suicide is talking about suicide or doing something to try to harm oneself.
If your child expresses suicidal thoughts or exhibits self-harming behaviors, seek professional help.
There are many warning signs and risk factors for suicide.
The list below is not exhaustive, but is intended to provide insight into what factors might elevate a child or adolescent’s level of suicide risk.
This does not mean that if your child or adolescent has some of these risk factors, then s/he will automatically take his/her own life.
Suicide risk takes into account many factors and needs to be continuously monitored by a mental health professional.
Remember that many factors combine to lead to a suicidal crisis and may include some of those that are listed below.
Risk Factors:
- Mental illness/psychiatric diagnosis
- Family history of suicide and/or exposure to suicide Family history of mental illness
- Physical/sexual abuse
- Losses
- Aggressive behavior/impulsivity
- Lack of social support/social isolation
- Poor coping skills
- Access to ways of harming oneself, like guns, knives, etc.
- Difficulties in dealing with sexual orientation
- Physical illness
- Family disruptions (divorce or problems with the law)
- Traumatic event
Warning Signs:
- Preoccupation with death (e.g., recurring themes of death or self-destruction in artwork or written assignments
- Intense sadness and/or hopelessness
- Not caring about activities that used to matter
- Social withdrawal from family, friends, sports, social activities
- Substance abuse
- Sleep disturbance (either not sleeping or staying awake all night)
- Giving away possessions
- Risky behavior
- Lack of energy
- Inability to think clearly/concentration problems
- Declining school performance/increased absences from school
- Increased irritability
- Changes in appetite

Previous research has shown that suicide is the second leading cause of death among young people aged 10 to 24 years, and that while males die by suicide more frequently than females, females attempt suicide more than males.
Self-poisoning is the most common way that someone attempts suicide and third most common method of suicide in adolescents, with higher rates in females. The image is in the public domain.
According to the Big Lots Behavioral Health experts at Nationwide Children’s, parents should check in regularly with their children, ask them directly how they are doing and if they have ever had thoughts about ending their life.
These direct questions are even more critical if warning signs of suicide are observed.
“There is no need to wait until there is a major crisis to talk about a plan to manage emotional distress.
Actually, a good time to talk directly about suicide or mental health is when things are going well,” said Ackerman, whose suicide prevention team provides comprehensive programming to more than 120 central and southeast Ohio schools and delivers suicide prevention training to community organizations that serve youth.
“A helpful starting point for any parent to increase the dialogue is OnOurSleeves.org, which has resources about beginning this important conversation as a family.
The American Association of Suicidology and American Foundation for Suicide Prevention also have many resources.”
Data for this study were collected by the National Poison Data System (NPDS) from January 2000 to November 2018.
If you or your child need immediate help due to having suicidal thoughts, go to your local emergency room immediately, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or you can reach the Crisis Text Line by texting “START” to 741-741. If you believe an overdose has occurred, call the national Poison Help hotline 1-800-222-1222.
Source:
Nationwide Children’s Hospital
Media Contacts:
Katelyn Hanzel – Nationwide Children’s Hospital
Image Source:
The image is in the public domain.
Original Research: Open access
“Sex- and Age-specific Increases in Suicide Attempts by Self-Poisoning in the United States among Youth and Young Adults from 2000 to 2018”. Henry A. Spiller, John P. Ackerman, Natalie E. Spiller, Marcel J. Casavant. The Journal of Pediatrics doi:10.1016/j.jpeds.2019.02.045