Six year-olds have told Dr. Anne Glowinski that they don’t want to live anymore.
It’s her job to figure out what they mean by that, and how to best help them.
Glowinski is a professor of child and adolescent psychiatry at the Washington University School of Medicine, and specializes in treating depression and suicidal behaviors. She is also working on ways to empower front-line providers, such as pediatricians, to deal with the alarming findings from recent research on American youth and suicide.
Researchers reported this month in the Journal of the American Medical Association that the youth suicide rate is the highest it has been in nearly two decades. There’s been a sharp rise among older teen boys and an increase in girls aged 10 to 14. Between 2009 and 2017, rates of depression among kids ages 14 to 17 increased by more than 60%, another study found. The number of children sent to hospital emergency departments for suicide attempts and suicidal ideation doubled over a nine-year period ending in 2016, according to a study published in the Journal of American Medicine-Pediatrics.
Clearly, there is a crisis in mental health among America’s children and teens. And no one is exactly sure what is fueling it.
So, what can be done about it?
Glowinski shared some ideas: All pediatricians should screen patients for depression. And they need to be more comfortable prescribing medication and treatment for children who need it. As the rates of depression have risen, the rate of treatment has not, she said.
Next, doctors should ask about lethal means of suicide in the home. More young people in America die of suicide by guns than homicide by guns. If there is a gun in the home, the risk of suicide increases. This is a public health issue, not a political one. It also makes sense that adding more therapists in schools is likely to save far more lives than arming teachers with guns.
Lastly, when doctors see a depressed or anxious child, they should also screen for parental psychopathology.
“You will do a world of good for the child by treating the parent,” Glowinski said.
Unfortunately, she says, there can be several barriers, both external and internal, standing between a child and treatment. External barriers can include whether there is an available provider nearby, whether the child has health care coverage and a supportive parent who can afford it.
Internal barriers involve the persistent stigma in seeking medical treatment. Too many people are still afraid of using medicines to treat depression, anxiety and other disorders.
“When it comes to depression, it can be a very isolating illness,” she said. Children will manifest symptoms in different ways. Some act out. Others suffer in silence.
Jessie Vance, supervisor of Provident Crisis Services in St. Louis, says alienation, isolation, bullying and feeling unsupported by an adult can all increase suicide risk. Vance says parents shouldn’t be afraid to ask a child about any changes in mood and behavior that they notice.
In the case of a young child, parents can ask questions like:
Have you been having thoughts of going to sleep and not waking up?
Have you been wishing you weren’t here anymore, or wishing that you could disappear?
Vance said that Provident’s crisis hotline has received calls from children as young as 10 years old. The hotline also handles a number of calls from parents worried about their children and not sure what to do.
The idea of young children wanting to kill themselves is shocking to adults, because it goes against our very notion of childhood. But we have to be willing to face the reality of the challenges facing children today.
“It you have major depression, if you are 8 or 38, your risk for having suicide ideation is the same,” Glowinski said.
The National Suicide Prevention Lifeline: 800-273-8255