In recent years, suicide rates among U.S. children and adolescents have steadily increased. Researchers examined changes over time in the rates of suicidal ideation and suicide attempts seen in EDs and on inpatient units at children's hospitals, as well as the demographic and clinical characteristics of these children. They used a pediatric database that contains clinical and billing data from 49 U.S. children's hospitals to identify ED visits, or encounters; "observation stays"; and inpatient hospitalizations in children and adolescents ages five to 17 years over a seven-year period.

During the study period, nearly 116,000 encounters for suicidal ideation and attempts were identified. More than half of these resulted in inpatient hospitalization at a children's hospital, and about 13% required intensive care. The annual percentage of all visits for suicidal ideation and suicide attempts nearly tripled, increasing from 0.66% in 2008 to 1.82% in 2015. Significant increases were seen in all age groups but were higher in adolescents 15 to 17 years of age and 12 to 14 years of age than in those five to 11 years of age. Significant increases occurred among both girls and boys, but were higher among girls. Seasonal patterns were also observed, with peaks in the fall and spring, suggesting that youths may face increased stress during the academic year.

The findings indicate that mental health disorders in youths have an increasing impact on children's hospital services, and the authors conclude that these findings must be considered in developing strategies for managing children's behavioral health issues.-KR

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