Creating a Safety Net to Prevent Youth Suicide

by Christine Yu-Moutier, M.D., AFSP Chief Medical Officer

Suicide and suicidal behavior – among young adults, teens, and in recent years, younger children – are a major public health crisis. During the past two years, concerns about the impact of the pandemic on youth mental health have added to pre-pandemic levels of concern. Youth and young adults had been experiencing rises in depression, anxiety and self-harm over the past decade and a half and many of us had already been concerned about many aspects of their experiences and the culture surrounding young people. The pandemic then led to new and urgent concerns about uncertainty, social isolation and potential disruptions in their psychological development. Many known protective factors such as social support, community cohesion, and practicing coping strategies could have been disrupted by the pandemic, while concerning risk factors – such as worsening in mental health, family stress, increased substance use, experiencing isolation and loneliness or bullying – could have been increased for many during the pandemic.

The US Surgeon General, Sound the Alarm for Kids, and other groups recently declared a state of emergency related to youth mental health. Suicide is the second leading cause of death among youth 10-24 years of age in the United States (and around the world), with significant disparities by race, ethnicity, gender, and sexual identity. Our children should grow, thrive and live long, healthy lives. Yet over a quarter of youth deaths in the U.S. are from suicide, which could potentially be prevented. Developing a “safety net” that could reduce rates of youth suicide is a critical and feasible goal, but adults working with youth in clinical and community settings haven’t necessarily been trained on how to respond and need a blueprint to guide actions that can reduce risk of youth suicide.

Just before the pandemic began, I had the opportunity to meet the American Academy of Pediatrics (AAP) leadership team at their 2019 Annual AAP Conference in New Orleans after giving an invited talk on youth suicide prevention. In the several years prior, AAP had been increasingly interested in youth mental health and suicide prevention. They were listening to their members – pediatricians and family members – who were voicing growing concerns about youth mental health and suicide. As the premier public health organization focused on issues affecting youth, they had developed a keen interest in suicide prevention.

While AFSP has suicide prevention expertise, we absolutely need partners who can implement suicide prevention in their field. (See Project 2025, AFSP’s nationwide initiative to reduce the annual rate of suicide in the U.S. 20% by the year 2025.) In order to implement strategies to reduce youth suicide risk, we found that partner in AAP to bring suicide prevention to pediatric primary care, to schools and community groups where pediatricians serve as trusted resources. We formed a partnership, and during a three-day Youth Suicide Prevention Summit, convened experts – from suicide experts, pediatricians, and researchers, to youth with lived experience, parents who experienced suicide loss of a child, and many other youth focused organizations – to come together and bring the key life-saving strategies into one place for pediatricians and families to use.

The Blueprint for Youth Suicide Prevention signifies a major priority within the field of pediatrics being placed on suicide prevention. And its true significance lies in how we hope it will come to life through the implementation of the potentially lifesaving steps outlined in the document.

Aligned with the public health framework for preventing suicide, there are three main sections in the Blueprint:

  1. Clinical: The Blueprint can serve as a practical guide for pediatricians to inform their clinical care of patients.
  2. Community: There is guidance on community-based suicide prevention in schools, athletics, youth organizations, child welfare and justice systems, and faith communities.
  3. Policy: Public policy has its own focus, outlining timely policy actions at federal and state levels that can reduce youth suicide. We hope this guidance will impact policy makers and the voice of the people to transform passion and public interest into lifesaving action.

By working together – AFSP, AAP, and any interested health systems, government agencies, school districts, and more – the Blueprint is meant to stimulate implementation of suicide prevention through initiatives in a variety of settings – clinical settings as well as community-based – e.g., schools, youth clubs, athletics, faith-based organizations, child welfare, and juvenile justice, to name just a few examples. A strong public health approach includes educating the entire population and using more targeted approaches and interventions guided by what research shows is most effective.

The great news is that we have a growing set of tools; stigma around mental health has diminished tremendously; and families and youth are ready to engage. Pediatricians, mental health professionals, parents, educators and policy makers – we all have a role to play, and together, we can and we will make progress to save lives.

Read more about AFSP’s role in creating the Blueprint here.

View The Blueprint for Youth Suicide Prevention here.