Youth suicide attempts, ideation rose globally during pandemic, new Calgary study finds

A new study led by the University of Calgary found that emergency department visits for suicide attempts among youth under 18 increased by 22 per cent during the pandemic.

Visits from young people experiencing suicidal ideation also rose globally by eight per cent.

The study analyzed more than 11 million pediatric emergency department visits across 18 countries. Researchers in Calgary, Toronto, Ottawa and Dublin compared pre-pandemic visits to visits during the pandemic, up to July 2021.

Lead author Sheri Madigan, a professor of clinical psychology at the University of Calgary, says before the pandemic, an average pediatric emergency department would see about 102 visits per month for suicide attempts by youth. During the pandemic, that increased to an average of 125 visits.

"As a researcher and as a parent, these findings were really distressing," said Madigan.

She says it's important to recognize that despite an overall decrease in pediatric emergency room visits for physical ailments — likely due to fear of catching COVID-19 — hospitals still saw an increase in visits from suicide attempts.

Of those children and teens, the study found that girls were considerably more likely than boys to end up in the emergency department for severe mental distress.

As kids were pulled out of school and their social circles during the pandemic, physical activity decreased and screen times increased, contributing to worsening mental health, Madigan said. But she also points to greater family violence and increased anxiety and depression among parents.

"Without the provision of supports or intervention to help them through this difficult time, it tends to create greater distress amongst kids and sadly, potentially some kids then engage in some suicidal behaviour."

Warned about youth mental health crisis in 2019

While distressing, the results came as no surprise to Madigan.

In 2019, she co-authored a study about mental health and warned the public that youth were experiencing double the depression and anxiety that they did pre-pandemic.

"One of the things we discussed about 18 months ago … is that if we don't start to implement prevention strategies and bolster intervention strategies and supports, we might see that kids tend to get worse over time than get better," she said.

"Sadly, I think this is an example of that sort of caution — we're seeing that this increase in suicide attempts is happening at a rate that is quite concerning."

In 2021, physicians in Calgary also reported an "unprecedented" number of kids showing up in the emergency room at Alberta Children's Hospital grappling with serious mental health concerns, including anxiety, depression, eating disorders, self-harm and suicidal ideation.

At the Alberta Children's Hospital, pediatric emergency medicine physician Dr. Stephen Freedman calls it an acute problem on top of a growing chronic problem.

He says visits from kids with mental health concerns were "very low" at the start of the pandemic — but then dramatically increased as the pandemic went on.

And today?

"We continue to see a very large number of children seeking emergency department care with acute mental health concerns," said Freedman. 

"We have challenges finding sufficient resources for these beds in the emergency as well as in the hospital and it continues to be a major concern."

Overall suicide rates down

At the Centre for Suicide Prevention in Calgary, research librarian Robert Olson has spent the last decade helping to compile suicide-related reports to create the largest library on suicide prevention research in the world — at least to his knowledge.

Based on the data available from the early pandemic, Olson says overall suicide rates are down across the globe, "but not instances of suicidal behaviour in general." 

According to the organization, suicide deaths in Alberta decreased to 580 in 2021, from 615 in 2020 and 604 in 2019. But Olson emphasizes that it's tough to accurately measure suicide statistics because they're only classified as suicides if it's unequivocally seen as such.

He points to renewed closeness felt by many families over the pandemic that could contribute to resilience. The Globe and Mail covered a study earlier this week that shows that COVID-19 didn't have a big impact on the mental health of the general population.

But with less experience managing stress, and as kids were isolated from their peers, it's possible that didn't translate as strongly with kids and teens, he says.

"Adolescents in particular — if they're susceptible to mental health issues already, a lockdown kind of situation where you're cut off from your peers, your normal activities, it would make someone who's already vulnerable even more so."

Olson says the real impact of the pandemic, related to suicide, likely won't be seen for another couple of years.

Preventing numbers from rising further

Back at the Alberta Children's Hospital, Freedman says to prevent numbers from continuing to rise, it's critical that families have access to social supports before children start experiencing mental health problems — as well as mental health resources for those who need it.

In a five-part series about the state of youth mental health resources in Calgary, CBC also reported last year that fewer children and teens would end up in the emergency room for mental health concerns if there were more robust psychological services in schools.

Madigan says the study demonstrates the need to make kids' mental health a priority.

"It's really important for parents out there to sit down and either talk about the results of this study or talk to their kids about how they're feeling and really try to open those conversations and have them more frequently,"

On Monday, the Alberta government promised $92 million in funding for youth mental health in budget 2023 to fund two new inpatient CASA House sites in Alberta, expanding youth day treatment programs and rolling out new mental health classrooms in the province.

If you or someone you know is struggling, here's where to get help:

• Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (text between 4 p.m. and midnight ET).

• Kids Help Phone: 1-800-668-6868 (phone), live chat counselling on the website.

• Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.

• This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you're worried about.