ARI SHAPIRO, HOST:
A year into this pandemic, it's clear that the disease has led to more than a physical health crisis and an economic crisis. It's also led to a mental health crisis, especially for young people. A recent CDC report shows that hospital emergency departments are seeing a greater proportion of children and adolescents with mental health problems. And educators and child psychiatrists are concerned that more kids in emotional crises are considering suicide. NPR's Rhitu Chatterjee reports.
RHITU CHATTERJEE, BYLINE: To understand why educators are concerned, consider Nevada's Clark County School District. It's had 19 students die from suicide since last March. One of those students was a senior at Shadow Ridge High School on the outskirts of Las Vegas. Colleen Neely was his counselor.
COLLEEN NEELY: He had a huge smile that would just light up his whole face, and he flashed that almost daily. And it just made my day.
CHATTERJEE: She says he was shy but smart and polite, and he'd stop by her office every day to check in. Neely says he'd gone through a period of homelessness, but he'd been doing really well lately.
NEELY: He was passing all of his classes, going to earn the highest-level diploma that we offer at our school. So he was in a really good place, you know, and this was leading right up to us being shut down.
CHATTERJEE: Then a couple of months after they switched to online classes, her boss called her to give her the news. Neely was devastated.
NEELY: I had just sent him an email telling him how proud I was of him and that he was almost there and that the next phase of his life was going to start.
CHATTERJEE: It's hard to know what drove him and the other students to end their lives, but the deaths have school officials wondering if the pandemic played a role. Now, there's no nationwide data yet for suicide deaths or attempts, but...
SUSAN DUFFY: Across the country, we're hearing that there are increased numbers of serious suicidal attempts and suicidal deaths.
CHATTERJEE: Dr. Susan Duffy is a professor of pediatrics and emergency medicine at Brown University. She says in recent months, many of the seriously suicidal children and teens are showing up at emergency departments. In her own hospital...
DUFFY: We are seeing an increased number with plans and thoughts.
CHATTERJEE: I spoke with providers in hospitals in seven states, and they all reported a similar trend. Dr. Vera Feuer directs pediatric emergency psychiatry at the Children's Medical Center of Northwell Health in New York.
VERA FEUER: The kids that we are seeing now in the emergency department are really at the stage of maybe even having tried or attempted or have a detailed plan, looked up online how one hurts themselves.
CHATTERJEE: She says while there's been a slight increase in 10- and 11-year-olds attempting, the majority of kids she sees are teenagers. Feuer and her colleagues around the country are collecting data to get a better picture of this disturbing trend. In the meantime, their patients are providing a window into how the pandemic created a perfect storm, increasing their risk for suicide. Feuer says children who are most at risk are those with physical or mental health problems. They've been cut off from crucial in-person services at school and in their communities and are really struggling to cope.
FEUER: Because they have difficulties with their mood or learning or socialization or medical issues. And now you have other layers of difficulties on top of that. Those are the kids that we see in real hopeless moments.
CHATTERJEE: Like the 14-year-old she saw last fall who has a health problem that hasn't been properly diagnosed because of pandemic-related delays in his care. Then the pandemic also took away his access to sports.
FEUER: Which was his world and life and - you know, can't do that. School's not going very well because can't focus. And then he looks at you and says, like, what's the point? Like, what do I have to look forward to? Like, you tell me - what do I have to be hopeful about?
CHATTERJEE: One child psychiatrist told me about a teenage girl with an anxiety disorder, feeling overwhelmed with worries about a close family member who's a health care worker. Another psychiatrist told me about a 9-year-old boy who wanted to die after his father passed away from COVID-19. Many kids feeling suicidal right now are from families and communities hit hardest by the pandemic.
Dr. Richard Martini is a child and adolescent psychiatrist at the University of Utah.
RICHARD MARTINI: Families who have lost family members, parents who have lost jobs, kids who have lost contact with people who are close to them, children who have experienced some significant challenges at school - all of these experiences are fairly traumatic.
CHATTERJEE: And it's harder to cope with all of this when kids are cut off from their supports at school - mental health services, social workers, teachers, counselors, friends.
MARTINI: The vast majority of my patients want to go back to school, miss the social contacts, miss the life that they have. I mean, these kids really do have a separate life in school that's important to them, valuable to them.
CHATTERJEE: It's among the reasons why the American Academy of Pediatrics is encouraging school districts to aim to bring students back into classrooms when it's safe to do so.
MARTINI: There's a level of social isolation for these kids - particularly for adolescents, but I think for all children - that they have not experienced before.
CHATTERJEE: Social isolation is a major risk factor for suicide, especially for young people already struggling with difficult life circumstances.
MARTINI: They may begin to feel like they're in a situation that they can't sort out. They may also be in a position where they feel they can't talk to anybody, even their parents, because their parents are going to be quite upset. And as the number of solutions for that situation dwindle, they can begin to think about, you know, I'd rather be dead than sort through this.
CHATTERJEE: Especially with all the uncertainty about when the pandemic will end. Dr. Nasuh Malas is a psychiatrist and pediatrician at the University of Michigan.
NASUH MALAS: I think it's the coupling of those things - is pretty daunting for a lot of our youth, who are still trying to figure out who they are, right? I mean, these are kids who are developing and growing.
CHATTERJEE: And still in need of guidance from adults, especially to cope during difficult times. Colleen Neely, the school counselor in Las Vegas, doesn't know the exact circumstances that led her student to suicide, but she wonders if someone could have prevented it if the pandemic hadn't upended everything.
NEELY: It's very hard because part of me will always question, you know, if we had been in the building and if he had been able to just see another adult, see his friends, possibly talk to me, if things would have been different.
CHATTERJEE: Rhitu Chatterjee, NPR News.
SHAPIRO: And if you're concerned that your child or someone you know is struggling to cope and thinking about suicide, we have tips on how to spot the warning signs and how to help prevent suicide at npr.org. You can also text or call the National Suicide Prevention Lifeline at 1-800-273-8255.
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