Demographic, Social, and Incident Characteristics of Suicide Deaths Among Youth Ages 10–17 in the United States, 2020–2021, by COVID-19 Impact
| Characteristic . | COVID-19–Impacted, N = 144 . | No Documented COVID-19 Impact, N = 408 . | P . |
|---|---|---|---|
| Child demographics | |||
| Age, y, n (%) | .90 | ||
| 10–12a | 16 (11) | 48 (12) | |
| 13 | 19 (13) | 49 (12) | |
| 14 | 15 (10) | 48 (12) | |
| 15 | 28 (19) | 71 (17) | |
| 16 | 33 (23) | 92 (23) | |
| 17 | 33 (23) | 100 (24) | |
| Mean (SD) | 14.9 (1.86) | 14.9 (1.82) | .79 |
| Sex, n (%) | .90 | ||
| Male | 99 (69) | 285 (70) | |
| Female | 44 (31) | 123 (30) | |
| Missing (n = 1) | |||
| Race, n (%) | .59 | ||
| American Indian/Alaska Native | — | 12 (3) | |
| Asian American | 8 (6) | 19 (5) | |
| Black | 20 (14) | 49 (13) | |
| Native Hawaiian/Pacific Islander | — | — | |
| White | 104 (74) | 292 (77) | |
| Multiracial | — | 6 (2) | |
| Missing (n = 31) | |||
| Hispanic ethnicity, n (%) | .48 | ||
| Yes | 34 (24) | 78 (21) | |
| No | 109 (76) | 295 (79) | |
| Missing (n = 36) | |||
| Incident, n (%) | |||
| Year of death | <.01 | ||
| 2020 | 107 (74) | 251 (62) | |
| 2021 | 37 (26) | 157 (38) | |
| Incident area, n (%) | .04 | ||
| Urban | 32 (23) | 95 (26) | |
| Suburban | 80 (57) | 165 (45) | |
| Rural | 29 (21) | 108 (29) | |
| Missing (n = 43) | |||
| Mechanism of injury, n (%) | <.00 | ||
| Asphyxia/hanging | 71 (51) | 158 (40) | |
| GSW/firearm | 46 (33) | 192 (49) | |
| Poisoning/overdose | 18 (13) | 21 (5) | |
| Other | — | 22 (6) | |
| Missing (n = 19) | |||
| Child maltreatment, school problems, mental health history | |||
| History of child maltreatment, n (%) | .49 | ||
| Yes | 34 (26) | 92 (29) | |
| No | 99 (74) | 228 (71) | |
| Missing (n = 99) | |||
| Open CPS record at death, n (%) | .55 | ||
| Yes | — | 14 (4) | |
| No | 136 (97) | 338 (96) | |
| Missing (n = 60) | |||
| Child abuse or neglect cause or contribute to death, n (%) | .22 | ||
| Yes | 37 (26) | 115 (32) | |
| No | 103 (74) | 244 (68) | |
| Missing (n = 53) | |||
| Had problems in school, n (%) | .02 | ||
| Yes | 64 (56) | 113 (43) | |
| No | 51 (44) | 153 (56) | |
| Missing (n = 171) | |||
| History of drug abuse, n (%) | .63 | ||
| Yes | 38 (31) | 88 (28) | |
| No | 86 (69) | 223 (72) | |
| Missing (n = 117) | |||
| Received previous mental health services, n (%) | .03 | ||
| Yes | 83 (63) | 160 (52) | |
| No | 49 (37) | 150 (48) | |
| Missing (n = 110) | |||
| Currently receiving mental health services, n (%) | .54 | ||
| Yes | 54 (40) | 115 (37) | |
| No | 82 (60) | 199 (63) | |
| Missing (n = 102) | |||
| Taking mental health medications, n (%) | .03 | ||
| Yes | 50 (38) | 83 (27) | |
| No | 83 (62) | 222 (73) | |
| Missing (n = 114) | |||
| ED visit for mental health in previous year, n (%) | .40 | ||
| Yes | 19 (15) | 35 (12) | |
| No | 104 (85) | 248 (88) | |
| Missing (n = 146) | |||
| Hospitalized for mental health in previous year, n (%) | .30 | ||
| Yes | 20 (16) | 37 (12) | |
| No | 106 (84) | 267 (88) | |
| Missing (n = 122) | |||
| Diagnosis anxiety, n (%) | <.00 | ||
| Yes | 33 (23) | 47 (12) | |
| Not specified | 111 (77) | 361 (88) | |
| Diagnosis depression, n (%) | <.00 | ||
| Yes | 62 (43) | 98 (24) | |
| Not specified | 82 (57) | 310 (76) | |
| History of suicide attempt, n (%) | .72 | ||
| Yes | 33 (32) | 80 (30) | |
| No | 71 (68) | 188 (70) | |
| Missing (n = 180) | |||
| Suicide warning signs, n (%) | |||
| Talked about suicide | 42 (29) | 95 (23) | .16 |
| Talked about suicide not specified | 102 (71) | 313 (77) | |
| Expressed hopelessness | 23 (15) | 57 (14) | .56 |
| Expressed hopelessness not specified | 121 (84) | 351 (86) | |
| Displayed severe emotional pain/distress | 43 (30) | 78 (19) | .01 |
| Severe emotional pain/distress not specified | 101 (70) | 330 (81) | |
| Expressed perceived burden on others | 15 (10) | 30 (7) | .25 |
| Expressed perceived burden not specified | 129 (90) | 378 (93) | |
| Showed marked behavior changes | 45 (31) | 88 (22) | .02 |
| Marked behavior changes not specified | 99 (69) | 320 (78) | |
| Disruptions/changes in the 12 mo before death, n (%) | |||
| School disruption/change | 113 (78) | 101 (25) | <.00 |
| School disruption/change not specified | 31 (22) | 307 (75) | |
| Living environment disruption/change | 20 (14) | 18 (4) | <.00 |
| Living environment disruption not specified | 124 (86) | 390 (96) | |
| Medical care disruption/change | 9 (6) | — | <.00 |
| Medical care disruption not specified | 135 (94) | 407 (100) | |
| Mental health care disruption/change | 35 (24) | 18 (4) | <.00 |
| Mental health care disruption not specified | 109 (76) | 390 (96) | |
| Stay-at-home order in place, n (%) | |||
| In the 12 mo before death | <.00 | ||
| Yes | 117 (89) | 176 (57) | |
| No | 15 (11) | 135 (43) | |
| Missing (n = 109) | |||
| At the time of death | <.00 | ||
| Yes | 51 (46) | 39 (24) | |
| No | 59 (54) | 123 (76) | |
| Missing (n = 21) |
| Characteristic . | COVID-19–Impacted, N = 144 . | No Documented COVID-19 Impact, N = 408 . | P . |
|---|---|---|---|
| Child demographics | |||
| Age, y, n (%) | .90 | ||
| 10–12a | 16 (11) | 48 (12) | |
| 13 | 19 (13) | 49 (12) | |
| 14 | 15 (10) | 48 (12) | |
| 15 | 28 (19) | 71 (17) | |
| 16 | 33 (23) | 92 (23) | |
| 17 | 33 (23) | 100 (24) | |
| Mean (SD) | 14.9 (1.86) | 14.9 (1.82) | .79 |
| Sex, n (%) | .90 | ||
| Male | 99 (69) | 285 (70) | |
| Female | 44 (31) | 123 (30) | |
| Missing (n = 1) | |||
| Race, n (%) | .59 | ||
| American Indian/Alaska Native | — | 12 (3) | |
| Asian American | 8 (6) | 19 (5) | |
| Black | 20 (14) | 49 (13) | |
| Native Hawaiian/Pacific Islander | — | — | |
| White | 104 (74) | 292 (77) | |
| Multiracial | — | 6 (2) | |
| Missing (n = 31) | |||
| Hispanic ethnicity, n (%) | .48 | ||
| Yes | 34 (24) | 78 (21) | |
| No | 109 (76) | 295 (79) | |
| Missing (n = 36) | |||
| Incident, n (%) | |||
| Year of death | <.01 | ||
| 2020 | 107 (74) | 251 (62) | |
| 2021 | 37 (26) | 157 (38) | |
| Incident area, n (%) | .04 | ||
| Urban | 32 (23) | 95 (26) | |
| Suburban | 80 (57) | 165 (45) | |
| Rural | 29 (21) | 108 (29) | |
| Missing (n = 43) | |||
| Mechanism of injury, n (%) | <.00 | ||
| Asphyxia/hanging | 71 (51) | 158 (40) | |
| GSW/firearm | 46 (33) | 192 (49) | |
| Poisoning/overdose | 18 (13) | 21 (5) | |
| Other | — | 22 (6) | |
| Missing (n = 19) | |||
| Child maltreatment, school problems, mental health history | |||
| History of child maltreatment, n (%) | .49 | ||
| Yes | 34 (26) | 92 (29) | |
| No | 99 (74) | 228 (71) | |
| Missing (n = 99) | |||
| Open CPS record at death, n (%) | .55 | ||
| Yes | — | 14 (4) | |
| No | 136 (97) | 338 (96) | |
| Missing (n = 60) | |||
| Child abuse or neglect cause or contribute to death, n (%) | .22 | ||
| Yes | 37 (26) | 115 (32) | |
| No | 103 (74) | 244 (68) | |
| Missing (n = 53) | |||
| Had problems in school, n (%) | .02 | ||
| Yes | 64 (56) | 113 (43) | |
| No | 51 (44) | 153 (56) | |
| Missing (n = 171) | |||
| History of drug abuse, n (%) | .63 | ||
| Yes | 38 (31) | 88 (28) | |
| No | 86 (69) | 223 (72) | |
| Missing (n = 117) | |||
| Received previous mental health services, n (%) | .03 | ||
| Yes | 83 (63) | 160 (52) | |
| No | 49 (37) | 150 (48) | |
| Missing (n = 110) | |||
| Currently receiving mental health services, n (%) | .54 | ||
| Yes | 54 (40) | 115 (37) | |
| No | 82 (60) | 199 (63) | |
| Missing (n = 102) | |||
| Taking mental health medications, n (%) | .03 | ||
| Yes | 50 (38) | 83 (27) | |
| No | 83 (62) | 222 (73) | |
| Missing (n = 114) | |||
| ED visit for mental health in previous year, n (%) | .40 | ||
| Yes | 19 (15) | 35 (12) | |
| No | 104 (85) | 248 (88) | |
| Missing (n = 146) | |||
| Hospitalized for mental health in previous year, n (%) | .30 | ||
| Yes | 20 (16) | 37 (12) | |
| No | 106 (84) | 267 (88) | |
| Missing (n = 122) | |||
| Diagnosis anxiety, n (%) | <.00 | ||
| Yes | 33 (23) | 47 (12) | |
| Not specified | 111 (77) | 361 (88) | |
| Diagnosis depression, n (%) | <.00 | ||
| Yes | 62 (43) | 98 (24) | |
| Not specified | 82 (57) | 310 (76) | |
| History of suicide attempt, n (%) | .72 | ||
| Yes | 33 (32) | 80 (30) | |
| No | 71 (68) | 188 (70) | |
| Missing (n = 180) | |||
| Suicide warning signs, n (%) | |||
| Talked about suicide | 42 (29) | 95 (23) | .16 |
| Talked about suicide not specified | 102 (71) | 313 (77) | |
| Expressed hopelessness | 23 (15) | 57 (14) | .56 |
| Expressed hopelessness not specified | 121 (84) | 351 (86) | |
| Displayed severe emotional pain/distress | 43 (30) | 78 (19) | .01 |
| Severe emotional pain/distress not specified | 101 (70) | 330 (81) | |
| Expressed perceived burden on others | 15 (10) | 30 (7) | .25 |
| Expressed perceived burden not specified | 129 (90) | 378 (93) | |
| Showed marked behavior changes | 45 (31) | 88 (22) | .02 |
| Marked behavior changes not specified | 99 (69) | 320 (78) | |
| Disruptions/changes in the 12 mo before death, n (%) | |||
| School disruption/change | 113 (78) | 101 (25) | <.00 |
| School disruption/change not specified | 31 (22) | 307 (75) | |
| Living environment disruption/change | 20 (14) | 18 (4) | <.00 |
| Living environment disruption not specified | 124 (86) | 390 (96) | |
| Medical care disruption/change | 9 (6) | — | <.00 |
| Medical care disruption not specified | 135 (94) | 407 (100) | |
| Mental health care disruption/change | 35 (24) | 18 (4) | <.00 |
| Mental health care disruption not specified | 109 (76) | 390 (96) | |
| Stay-at-home order in place, n (%) | |||
| In the 12 mo before death | <.00 | ||
| Yes | 117 (89) | 176 (57) | |
| No | 15 (11) | 135 (43) | |
| Missing (n = 109) | |||
| At the time of death | <.00 | ||
| Yes | 51 (46) | 39 (24) | |
| No | 59 (54) | 123 (76) | |
| Missing (n = 21) |
CPS, Child Protective Services; GSW, gun shot wound;. —, indicates frequency suppressed due to small cell size.
Ages 10 to 12 years grouped because small cell sizes would require suppression if individual ages reported.