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. 2022 Feb 1;149(2):e2021053486.
doi: 10.1542/peds.2021-053486.

Suicide Risk in Adolescents During the COVID-19 Pandemic

John D Lantos  1 , Hung-Wen Yeh  2 , Fajar Raza  1 , Mark Connelly  3 , Kathy Goggin  2   4 , Shayla A Sullivant  5
Affiliations

Suicide Risk in Adolescents During the COVID-19 Pandemic

John D Lantos et al. Pediatrics. .

Erratum in

  • Statement of Correction.
    [No authors listed] [No authors listed] Pediatrics. 2022 Jun 1;149(6):e2022057224. doi: 10.1542/peds.2022-057224. Pediatrics. 2022. PMID: 35634878 Free PMC article. No abstract available.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic created high levels of psychological distress and may have increased suicide risk.

Methods: We used the 4-item Ask Suicide-Screening Questions (ASQ) to assess suicide risk among all patients 12 to 24 years of age at a children's hospital. We compared demographics, encounter type (telehealth or face-to-face [F2F]), and screening results from April to June 2020 (T2) to those from April to June 2019 (T1).

Results: Fewer patients were seen at T2 than T1 (17 986 vs 24 863). A greater proportion of visits at T2 were by telehealth (0% vs 43%). The rate of positive suicide screens was higher in T2 than in T1 (12.2% vs 11.1%, adjusted odds ration [aOR], 1.24; 95% confidence interval [CI], 1.15-1.35). The odds of a positive screen were greater for older patients (aOR of 1.12 for age in years; 95% CI, 1.10-1.14), female patients (aOR, 2.23; 95% CI, 2.00-2.48), patients with public versus private insurance (aOR, 1.88; 95% CI, 1.72-2.07), and lower for Black versus White patients (aOR, 0.85; 95% CI, 0.77-0.95). Rates of positive screens were highest among inpatients (20.0%), intermediate for emergency department patients (14.4%), and lowest in outpatient clinics (9.9%) (P < .05).

Conclusions: Rates of positive suicide risk screens among adolescents rose in the pandemic's early months with differences related to sociodemographics and visit type. Changes in health care delivery highlight the complexities of assessing and responding to mental health needs of adolescents. Additional research might determine the effects of screening methods and patient populations on screening results.

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Conflict of interest statement

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Study population and key variables. Percentage based on the N from 1 level above (eg, among the 2020 visits, telemedicine was 6359 of 14 635 [43.5%] and the screen rate was 19 261 of 22 887 [84.2%] among the 2019 face-to-face visits).
FIGURE 2
FIGURE 2
Effects of clinical, temporal, and sociodemographic variables on suicide risk. The adjusted odds ratios for the effect of different factors (encounter type, month, patient age, race, sex, and insurance type) on positive screen results. Odds ratios are along the x-axis. Adjusted odds ratios are estimated with contrasts of interest in year (red) and in year-by-encounter-type (black). Solid and hollow circles indicate P < .05 and P > .05, respectively. 2020.F2F, positive screen for suicide risk in face-to-face visits during 2020; 2019.F2F, positive screen for suicide risk in face-to-face visits during 2019; 2020.TELE, positive screen for suicide risk in telemedicine visits during 2020.
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References

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