American Girls' Suicide Rates Spike

Chart shows suicide rates in young Americans since 1990; two sizes; 1c x 5 3/4 inches; 46.5 mm x 146.1 mm; 2c x 3 1/8 inches; 96.3 mm x 79.4 mm (Carrie Osgood - AP)

The CDC is advising health officials to consider focusing suicide prevention programs on girls ages 10-19 and boys between 15-19 to reverse the trends. It also said the suicide methods suggest that prevention focused solely on restricting access to pills, weapons or other lethal means may be of limited success.

As for why rates are up, Richard Lieberman, who coordinates the suicide prevention program for Los Angeles public schools, said one cause could be a rise in depression during tumultuous adolescent years.

"There's a lot of pressure in and around middle school kids. They're kind of all transition kids. They're turbulent times to begin with," he said. "The hotline's been ringing off the hook with middle school kids experimenting with a wide variety of self-injurious behavior, exploring different ways to hurt themselves."

Arias said the declining use of antidepressants in those age groups might play a role. But it's "not the only factor" that health officials will be studying.

Four years ago, federal regulators warned that antidepressants seemed to raise the risk of suicidal behavior among young people, so black box warnings were put on the drugs' packaging.

When partial teen suicide data was published earlier this year, experts noted at the time that the drop in sales of the drugs corresponded with a rise in the suicide rate. Now there is concern that some children who need the medication aren't getting it.

"Suicide is a multidimensional and complex problem," Arias said. "As much as we'd like to attribute suicide to a single source so we can fix it, unfortunately we can't do that."

More education is needed, some specialists said, so that teachers, parents and others can quickly spot troubled teens.

"It underscores the need for more evaluation methods for school personnel and pediatricians to be able to better identify at-risk youth," said Dr. Alec Miller, director of the adolescent depression and suicide program at Montefiore Medical Center in New York. "They are out there, and everyone needs to be better trained in identification."

He said people who commit suicide tend to have a psychiatric condition, even if it has not been formally diagnosed.

Arias said warning signs include mental illness, alcohol and drug use, family dysfunction and relationship problems.

"For some, talking about suicide is awkward," she said. "Our goal is to stop suicides, and to do that we need everyone's willingness to talk about it.

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On the Net:

http://www.cdc.gov/ncipc/dvp/suicide