Editorial: Why Are Children Hurting Themselves and What Can We Do?

Alarmingly, suicide is now a leading cause of death for preadolescent youth (ie, less than 13 years of age), and among community samples, 2.56% report lifetime suicide attempts with 15.08% experiencing suicidal ideation.¹ Predictable but preventable factors have conspired to propel us toward this public health crisis. Chief among them is that approximately 45% of individuals in the United States reside in communities with shortages of mental health professionals,² a problem that is disproportionately affecting youth of color. The reduced access to psychiatric care means that treatment for many preadolescent youth, particularly during non-acute periods when many interventions are most effective, is delayed given limited clinician availability. Furthermore, the increased acuity of the modal case may be contributing to clinician burnout, further diminishing an already beleaguered workforce. Moreover, societal cracks present prior to the COVID-19 pandemic were further exacerbated, including increased loneliness and isolation³ as well as educational inequities,⁴ which have led to more pronounced social disconnectedness and greater stress exposure (eg, academic challenges)-factors directly implicated in suicidal thoughts and behaviors (STB).⁵ Although substantial efforts are underway to improve the short-term prediction of adolescent and adult STB, limited research has focused on clarifying which preadolescent youth are at risk and when that risk is greatest.