The Centers for Disease Control and Prevention (CDC) released new data indicating that the rate of suicide in the United States increased in 2021. After rising 35% from 1999 to 2018, followed by a modest decrease through 2020, the latest increase of 4% overall indicates the continuance of a long-term trend. Pertinently, the rate increased 7% for young people between the ages of 15 and 24 (primarily due to the 8% increase among males in that age group). Suicide remains the second-leading cause of death among 10- to 34-year-olds in the U.S.
As a nation, and as a society, we need to do better. And we can.
As the leading nonprofit addressing youth mental health and suicide prevention, The Jed Foundation (JED) knows that suicide is a complex problem–but there are ways to prevent it.
In light of the new data from CDC, JED urges a proactive response, at a national scale, in order to protect youth mental health and save lives. That involves understanding some of the factors that are impacting youth wellbeing and that might have contributed to the latest rate increase and, with an informed and interdisciplinary lens, further establishing the supports that have been proven to reduce risks for suicide.
Factors that may have contributed to this uptick include:
- Pandemic stressors: Many people experienced mental health burdens during the pandemic, whether or not they directly experienced COVID-19. Young people were hit especially hard by school closures, social isolation, loss of family members, and overall uncertainty during a time in life when people are already coping with big emotions. In particular, the pandemic removed essential supports, like community gatherings and school networks. It should be noted that 61% of individuals ages 18 to 25 state that the pandemic remains a “daily stressor.”
- Financial challenges: Following steep inflation across the country and across commerce sectors, young people ages 18-25 reported money, the economy, and housing to be top sources of stress. Money stress levels are at the highest recorded level for all adults since 2015, according to the poll.
- Workforce instability: Similar to the effects of school closures, young professionals experienced a sense of uncertainty and isolation as their workplaces converted to virtual or hybrid settings and issued furloughs or layoffs. This led to feelings of impermanence and widespread burnout. Many young people considered changing jobs or career paths in light of the shifting labor landscape.
- Racial and social injustice: In 2020, there was a national reckoning in terms of racial inequality and social injustice, spurred by the murder of George Floyd; by 2021, however, there was a growing sense of fatigue and a lingering sense that there was a lot of work left to be done. One study from this period shows that young people are especially sensitive to social and racial injustice. Research has also found that young adults who frequently experience discrimination based on race, sex, or physical appearance are at greater risk of mental health issues than those who don’t. In pursuit of care, people of color can be further harmed by institutionalized racism. During the pandemic, the nation also saw immigrant families unfairly detained, separated, and deported, as well as numerous reports of hate toward individuals within the Asian American-Pacific Islander community.
- Climate change: Young people have grown up hearing only dismal news about the likely outcomes for our planet, if not experiencing the ramifications of climate change. They may feel helpless to do anything about it or like the burden to save the world is entirely on them, leading to anxiety, depression, and other mental health challenges.
- Barriers to care: Teenagers and young adults may not feel comfortable asking for help, whether due to the stigma surrounding mental illness or fear of a caregiver reacting negatively. Those who do ask for help may not be able to find it, as the high cost of therapy and varied insurance coverage for mental health care are often prohibitive. With mental health treatment in high demand and a shortage of behavioral healthcare providers, it’s becoming even harder to find a provider with availability. Even if individuals can afford therapy, they might still have difficulty finding a provider who is culturally competent.
Rates of suicide tend to respond to economic cycles and natural disasters. The CDC report correlates with those previously observed trends, which show that rates often don’t rise immediately during the peak of the crisis, but during its ebb.
Unfortunately, the rate of suicide in our country was on the rise for two decades preceding the pandemic. We know that this surge is especially affecting teens and young adults. And we know that suicide continues to disproportionately affect American Indian/Alaska Native youth, those in rural areas, and those who identify as LGBTQ. Suicide rates for Black youth are also rapidly worsening. We do not need to sit back and wait for another annual report to confirm this; we can start doing more to change the numbers on future reports right now.
The only way to change this trajectory is if the nation, collectively and with support at the federal and state levels, makes mental health a top priority. The Biden administration has already taken steps to prioritize youth mental health by issuing an advisory, allocating funds, and modeling a framework upon which we need to build. Now, we must address this national crisis on all fronts: urgently, cooperatively, and holistically. Health care experts, policymakers, corporate, education and community leaders, and those who have been directly affected by suicidal ideation or the loss of a loved one to suicide must come together with those in areas like technology, finance, environmentalism, journalism, sociology, and education to pursue proactive, enactable solutions.
Those solutions must include:
- Strategic planning: The first step must always be for community and organizational leaders to seek to implement a comprehensive approach to mental health promotion and suicide prevention, with guidance and support from experts like JED. The unique structures, problems, needs, and resources of each community or organization l needs to be examined and thoughtful decisions should be made around prioritizing and choosing specific tactics. Strategic planning–which the CDC also recommends–must take place at every level of society, including the state and community levels, and within companies, schools, and community-based organizations.
- Creating connectedness and community: Research has shown that loneliness and isolation are significant risk factors for mental health problems and/or suicidal behavior. Supportive social relationships and feeling connected to school communities, family, and friends are protective factors that can help lower risk of suicide in young people.
- Means safety: Promoting means safety is a proven way to reduce the rate of suicides; in a moment of acute distress, removing a path to suicide can often create enough distance from the immediate impulse as to quell it altogether, and often for good. Youth firearm suicides are the highest they’ve been in 20 years, and firearms are the leading method of suicide in the United States. With better practices in place and improved firearm safety measures (better screening and storage, for example), we can save lives. Other examples of means safety include putting barriers on bridges, disposing of expired medications, and putting locks on upper-story windows. Means safety can be practiced in all settings, including at the community level, within institutions and employers, and at home.
- Access to care: It is currently difficult to find, and pay for, adequate providers, services, and medications. We must work to reform the health care system so that mental health is as much of a priority as physical health. This would include increasing the numbers of behavioral healthcare providers who are in insurance networks, in addition to implementing mental and physical health benefits with parity. To further ensure that treatment is accessible, we must pursue innovative approaches to leveraging our current mental health capacity such as collaborative care, recruitment, training, and retention of providers, as well as new ways to connect individuals with the resources they need. The Path Forward is an example of a coalition working to address these issues.
- Reducing stigma: The first step to destigmatization is encouraging people to talk openly about mental health challenges (including peer-to-peer help-giving behavior) and have conversations about suicide. It also entails giving the media the correct tools and guidelines to report on suicide deaths and mental illness. Today, we know that 1 in 5 adults live with a mental illness, and 1 in 3 young adults ages 18 to 25 experienced a mental, behavioral, or emotional health issue as of 2020. These experiences should be normalized, discussed, and fully addressed.
- Supporting essential needs: It’s essential for community engagement to be paired with a strengthening of basic, essential supports like stable housing, food security, childcare, and other social determinants of mental health.
While a collective approach at the highest level is pivotal, youth suicide prevention is something that can and should be addressed within communities, employers, schools, and households. Community and organizational leaders should work to implement a comprehensive plan. Parents and caregivers can learn about how they can support the mental health of the young people in their lives, including knowing how to identify signs that a youth may need help. Caring communities have been shown to cultivate a sense of well-being and positivity in young people and correlate with a decreased incidence of high-risk behavior.
There is no shortage of research to show that risks for suicide can be reduced. But there are still actions that need to be taken in order to achieve this goal. First, we must make suicide prevention a national priority; then, our approach must draw on expertise from diverse knowledge areas to address the complex sources feeding into this crisis. With commitment and diligence, it is possible to reverse this upward trend. At JED, we know that it is possible to prevent the loss of young lives to suicide, but we know that it will require commitment and substantial reforms: We implore the nation to take action, together, now.