As rates of suicidal youth increase, doctors look at influence of school, internet

Lara Korte

 

Dr. Dan Nelson, a physician at Cincinnati Children's Hospital, said most pediatric or adolescent hospitalizations have to do with suicidal behavior.

 

 

Previous reporting:  Video: Footage shows incident with 8-year-old two days before suicide Student beat him, others kicked him while he lay unconscious. Later, he killed himself at 8 years old Youth suicides rising in Hamilton County

An increasingly stressful environment and unfiltered access to information could be dramatically boosting the number of teens and children hospitalized for suicidal thoughts or actions.

A recent study found that children’s hospital admissions of patients 5 to 17 years old for such thoughts or actions more than doubled from 2008-2015. The study looked at 32 hospitals using data from the Pediatric Health Information System (PHIS), which includes Cincinnati Children’s Hospital Medical Center.
 
Dr. Dan Nelson is the medical director in the child psychiatry unit at Cincinnati Children’s. When patients are hospitalized, doctors look at factors such as family history, worldview, and social environments. School systems, in particular, are becoming “more and more challenging,” Nelson said, and pointed to concerns about weapons and bullying.
 
The news about increased hospitalizations of youths for suicidal thoughts or actions comes amid an ongoing outbreak of youth suicide in Hamilton County.

In 2014, the county saw four suicides of people 18 and under. In 2015, there were five. In 2016, there were 13. So far this year, seven.

The most shocking was the January death of 8-year-old Gabriel Taye killed himself two days after other students knocked him unconscious in a Carson Elementary School. A security camera video shows other students touched and kicked Gabriel until an administrator at the East Price Hill school arrived and roused him. Upon reviewing video footage of the incident, a Cincinnati homicide detective described it as bullying that bordered on criminal assault. 

In addition, the study on hospitalizations, made by researchers at Vanderbilt University, comes in the wake of a national Centers for Disease Control and Prevention report from November. The CDC found the suicide rate for children age 10 to 14 doubled from 2007 to 2014. The report showed suicide had overtaken motor vehicle accidents as a cause of death in that age group.
 
As the numbers increase, researchers are learning more about what these suicidal cases look like and when they occur. The Vanderbilt study found that children’s hospitals saw higher rates of suicidal patients during the fall and the spring, but not during the summer.
 
“There is a seasonality to suicide,” said Dr. Gregory Plemmons, the lead author on the study. “If you look at adult data, most adults tend to commit suicide in summer and the spring, we noticed that our biggest time (for children) was in the fall.” 
 
Plemmons, who is an associate professor at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, said he’s seen the increase of young suicidal patients first-hand. 
 
“We’re definitely seeing it in our hospital,” he said. “We’ve actually had to hire extra people to support this population.”
 
In addition to a rise in kids having suicidal thoughts, Plemmons has seen young people engaging in “more dramatic ways” of harming themselves.
 
“Hanging and suffocation seem to be around in a way they weren’t before,” he said.
 
Nelson at Cincinnati Children’s said when treating suicidal patients, he’s amazed at how much information youth has access to, some of which can be traumatizing. He said in addition to things like cyberbullying, kids can now easily access information about how to hurt themselves. 
 
“The media that children are exposed to gets more and more sophisticated and more and more graphic and so kids get exposed to more and more things,” he said.
 
Hamilton County Prosecutor Joe Deters has said his office wants to examine a computer that Gabriel owned for any clues to his suicide. 
 
Although the CDC says that the majority of young people report little to no involvement in electronic aggression, it is still an emerging public health problem
 
Any form of bullying, whether it be face-to-face or online, is known to be connected to depression and suicidal behaviors in young people. The CDC reports youth who have only observed, but not participated in, bullying behavior report they feel more helpless and less connected to parents and schools than those who have not witnessed bullying.
 
On May 12, Cincinnati Public Schools released the video footage of the incident along with a timeline of events. The statement on CPS’s website said staffers were not aware that Gabriel had been knocked down until a student notified them that “a boy is laying on the ground outside of the bathroom.” Gabriel's mother said school officials initially told her that her son had fainted.
 
CPS said they are now reviewing procedures regarding adult supervision in the restrooms with faculty and staff.
 
“We are committed to student safety and ensuring that all CPS schools foster a positive, learning environment,” the statement said. 
 
When a young patient is hospitalized for suicidal thoughts or behaviors, physicians at Cincinnati Children’s will work on developing coping skills and a safety plan. That means working with parents and schools to ensure the child gets the help they need after they leave the hospital. Suicidal thoughts can be difficult to detect in children, but spreading awareness is critical.
 
“Education is really important,” Vanderbilt's Plemmons said. “Schools play a role, parents play a role.” 

Warning signs of suicide

People who are wrestling with thoughts of suicide give off indicators. Here are a few things to watch for, and if you see them, ask if help is needed immediately.

  • Talking to others or posting on social media about suicide, about wanting to die or about feeling hopeless or trapped or a burden to others.
  • Looking for ways to die by suicide -- gathering medication, sharp objects, firearms, or looking online for methods.
  • Expressing unbearable emotional pain.
  • Visiting or calling people to "say good-bye."
  • Giving away prized possessions.
  • Suddenly becoming calm or cheerful after a long period of depression

Resources for youth and adolescent mental health care

  • Talbert House's 24-hour hotline line: 513-281-2273
  • Talbert House's 24-hour text line: Send the phrase 4hope to 839863
  • The state of Ohio has a 24-hour text line: Send the phrase 4hope to 741741
  • Mental Health Association of Northern Kentucky and Southwest Ohio: 859-431-1077
  • Mental Health Access Point mobile crisis line: 513-558-8888
  • Mindpeace, at Cincinnati Children's Hospital Medical Center, 513-803-0844.
  • SEAS the Day, dania@seasthedayfoundation.org, 513-212-6631
  • Mental Health Recovery Services of Warren and Clinton counties: 877-695-6333