Suicidality-Related Emergency Department Visits Among US Children and Adolescents, 2016-2022

To examine national trends in suicidality-related (intentional self-harm, self-inflicted injury, and suicide attempt) emergency department (ED) visits among US children and adolescents between 2016 and 2022 and describe demographic and psychiatric correlates across age groups.

Data were obtained from the 2016 to 2022 Nationwide Emergency Department Sample (NEDS) for patients aged 5 to 19 years with suicidality-related ICD-10-CM codes. Weighted national estimates, demographics, and psychiatric comorbidities were compared across age groups (5-9, 10-14, and 15-19 years). Temporal trends were evaluated using Daniel's test for trend, with p < .05 considered significant.

There were an estimated 1,100,785 suicidality-related ED visits (intentional self-harm 61%, self-inflicted injury 39%, suicide attempt 9%). The number of visits increased significantly among age group 10 to 14 for all diagnoses (p ≤ .01) and among age group 15 to 19 for suicide attempts only (p = .003). Female patients (74.7%) accounted for most visits. Depression (45.3%) and anxiety (21.6%) were the most common comorbidities.

Suicidality-related ED visits among US youth remain alarmingly high, especially among young adolescents. The predominance of depression, anxiety, and female patient representation underscores the need for early, community-based mental health interventions and post-ED follow-up care.

• Screen earlier and repeatedly. Incorporate routine suicide risk screening beginning in late elementary school (ages 9-10), especially during well-child visits, school physicals, and emergency department encounters, even when presenting complaints are nonpsychiatric.• Treat self-harm as a high-risk signal. Any self-inflicted injury-regardless of stated intent-should trigger a structured suicide risk assessment, safety planning, and close follow-up, as self-harm often precedes suicide attempts.• Address comorbid depression, anxiety, and trauma aggressively. Early identification and evidence-based treatment (eg, cognitive behavioral therapy, dialectical behavior therapy-informed skills, trauma-focused care) should be prioritized, with coordinated family involvement when developmentally appropriate.• Strengthen transitions of care after emergency department visits. Ensure rapid outpatient follow-up (within 7 days), clear communication with caregivers, and linkage to school- and community-based supports, particularly for preteens and adolescents from low-income households.

One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.