EDITOR’S NOTE: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide & Crisis Lifeline by dialing 988 to connect with a trained counselor, or visit the 988 Lifeline website. For exposures to medication or a drug, you can call the National Poison Helpline at 1-800-222-1222 or visit www.poison.org.
Children ages 6 to 12 are experiencing a dramatic increase in instances of self-harm –– and they are using common items available around the house, according to a new study.
The rate of instances reported to poison control centers of children being exposed to substances has risen by more than 50% since 2000, said study coauthor Dr. Hannah Hays, chief of toxicology at Nationwide Children’s Hospital and medical director of the Central Ohio Poison Center.
But the number of those cases with suspected suicide or self-harm intent increased up to fourfold, she added.
“These cases were far more likely to result in serious medical outcomes or hospitalization for these children,” Hays said.
Hays said she noticed seeing more and younger kids experiencing self-harm and suicidality, and she wanted to understand whether there was a real trend borne out in the data. To investigate, researchers analyzed more than 1.5 million reports of substance exposures to US poison control centers across the country.
Reports to poison control with suspected self-harm intent among 11-year-olds increased by 398% since 2000. The increase was 343% in 12-year-olds, according to the study published Monday by Pediatrics, a journal of the American Academy of Pediatrics.
The substances in the reports included common household products such as pain relievers, antihistamines, cold medicines and vitamins, the study said.
Researchers have analyzed data about toddlers accidentally ingesting medications and teenagers taking them for harm or recreational purposes, but this study offers important data on the ages in between, said Dr. Jennifer Hoffmann, assistant professor of pediatrics at Northwestern University and attending physician in pediatric emergency medicine at Ann and Robert H. Lurie Children’s Hospital of Chicago. She was not involved in the study.
And although the data is stronger because of the large number of reports researchers analyzed, instances of ingestion are likely underreported to poison control centers — because families have to think to make the report after something bad happens, Hays said. That means the rates are likely even higher.
The increases of ingestions with harmful intent are concerning, but they make sense given the rise in reports of suicidal feelings in younger kids, said psychologist Dr. Christopher Willard, a lecturer in psychiatry at Harvard Medical School. He was not involved in the study.
“With younger kids, it’s always hard to know if they fully understand the consequences of their behaviors, and what their true intentions are,” he said in an email.
The other problem is that many homes have more poisonous substances easily available than in the past, Willard said. Those include medication, cleaning products, supplements and recreational marijuana products.
One of the most important lessons to come out of the data is that families should lock away over-the-counter and prescription medications and dispose of old products safely, Hoffmann said.
“With increased access comes increased exposures to all things,” Hays said.
The decision-making and planning part of the brain doesn’t develop until a person is in their mid-20s, so if kids can access potentially harmful medications, they may make an impulsive choice without fully thinking it through, she added.
Policymakers can have an impact on access by limiting package sizes for high-risk drugs and expanding the use of blister packages that require a person to pop out each pill individually, Hays said.
“Just those few minutes to pop the pills out of the blister pack can be enough to make a child think about what they’re doing, stop, and it can therefore save their life,” she added.
Health care providers can also make a difference by screening for suicide risk and doing routine mental health checks, Hoffmann said.
And families need to know what to look for, Hays said.
“Children don’t always look at you and say, ‘I’m feeling depressed. I’m feeling like I want to harm myself,’” she said. “Parents can look for changes in their children.”
Signs that something is wrong can include changes in mood, like increased irritability, hopelessness or tearfulness. Changes in behavior such as refusing to go to school and body cues like headaches, sleep or appetite changes can also be a signal to investigate, Hays said.
“If your gut says something’s off, the next best step would be to ask kids directly,” she said. “Then go from there by looping in your safety nets, your school, your counselors, your pediatrician, to make safety plans and get concrete directions on next best steps.”
Suicide in children is often an impulsive act precipitated by a stressful event, yet many reports show cases of children without a known mental health condition, Hoffmann said. That means there needs to be more universal prevention efforts, she added.
If you or a loved one has been exposed to a medication or drug, you can call the National Poison Helpline at 1-800-222-1222 for free, confidential advice from experts, 24 hours per day, seven days per week.
