Suicide Ideation and Attempts in a Pediatric Emergency Department Before and During COVID-19

Elevated rates of mental health concerns have been identified during the coronavirus disease 2019 (COVID-19) pandemic. In this study, we sought to evaluate whether youth reported a greater frequency of suicide-related behaviors during the 2020 COVID-19 pandemic as compared with 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.

Routine suicide-risk screening was completed with youth aged 11 to 21 in a pediatric emergency department. Electronic health records data for suicide-risk screens completed between January and July 2019 and January and July 2020 were evaluated. A total of 9092 completed screens were examined (mean age 14.72 years, 47.7% Hispanic and/or Latinx, 26.7% non-Hispanic white, 18.7% non-Hispanic Black).

Rates of positive suicide-risk screen results from January to July 2020 were compared with corresponding rates from January to 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.

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-19-related stressors and community responses were heightened, indicating that youth experienced elevated distress during these periods.