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Key takeaways:
- There was an unexpected decrease in youth suicidality during school closures for COVID-19.
- Data strongly support the idea that suicidality may be associated with the school calendar.
Youth suicidality unexpectedly declined in the United States during school closures for COVID-19, according to a study published in JAMA Network Open¸ which found a potential association between suicidality and the school calendar.
The investigation is the latest in a series of studies that have explored ways the pandemic has affected the nation’s children, adolescents and young adults.
“Suicidality and youth suicidality are of interest to us,” Scott D Lane, PhD, a professor of psychiatry and behavioral sciences at McGovern Medical School in the Texas Medical Center in Houston, told Healio. “It’s an ongoing issue at our at our psychiatric hospital, and it’s always of critical importance, particularly to parents and caregivers.”
According to Lane, the researchers hypothesized, based on previous research, that there are stressors and other factors associated with being in school that contribute to the seasonality patterns of suicide.
“That includes peer influence, negative parental influence, school pressures, disruptive or lack of sleep that most adolescents are getting because of the school schedules … We decided to look at trends and suicidality over the 5-year period for which we had complete data,” he said.
Lane and colleagues studied national data on 73,123 emergency department visits and hospitalizations for suicidality among children aged 10 to 12 and adolescents aged 13 to 18 years who were commercially insured from Jan. 1, 2016, to Dec. 31, 2021.
The mean annual incidence of ED visits and hospitalizations for suicidality was 964 per 100,000 children and adolescents, which increased from 760 per 100,000 in 2016 to 942 per 100,000 in 2020 and a final peak of 1,160 per 100,000 in 2021.
“We’re interested in seasonality, so we looked at month-to-month trends and then we looked at whether or not any of those trends changed, notably, during the COVID period,” Lane said. “Part of our working with this larger national data set was to examine mental health phenomenon that might be related to the COVID pandemic.”
Seasonal peaks usually occurred in April and dipped in July, but the pattern was disrupted in the spring of 2020, when schools were closed for COVID-19, with the lowest rates occurring in April and May.
“There are a couple of known issues related to suicidality, one of which is that there are definite seasonal trends, and these trends are actually prevalent across the whole lifespan,” Lane said. “They’re not particular to children and adolescents. These seasonality patterns are evident with adults as well. However, they’re unique here.”
The authors concluded that there was an unexpected decrease in suicidality among children and adolescents after COVID-19-related school closures in March 2020, which suggests a potential association between suicidality and the school calendar.
“We were surprised, because the other work that we had done related to COVID was that most of the effects of COVID on mental health were viewed as negative,” Lane said. “The fact that [suicide declined] raised eyebrows. But then we started thinking more carefully about it, and the school stressors may well have been a contributing factor.”
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