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Suicides increased in 2021, especially among younger people

‘It’s all over the country,’ lead study author says of the rate increase among 15-to-24-year-olds

A Yale group called Elis for Rachael holds a candlelight vigil on the New Haven Green for Rachael Shaw Rosenbaum, a student who died by suicide in March 2021. (Stan Godlewski for The Washington Post)
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The U.S. suicide rate resumed its upward climb in 2021 after two years of decline, with young people and men hit hardest by the persistent mental health crisis, according to provisional data released Friday by the government.

The 4 percent increase almost wiped out modest decreases in the two previous years, bringing the country back near the most recent peak in suicide deaths, 48,344 in 2018. There were 47,646 suicides in 2021, according to the data, boosting the rate to 14 per 100,000 people, up from 13.5 in 2020.

“A four percent rise is certainly disappointing,” said Christine Yu Moutier, chief medical officer of the American Foundation for Suicide Prevention. “However, what had been predicted at the beginning of the pandemic was that there would be a major escalation.”

Suicide is a complex, multifaceted problem whose causes can defy generalization. In individuals, it is linked to depression, family history of suicide, physical illness, childhood trauma and substance abuse, among other factors. In interviews, experts also cited a recent increase in guns in the home, loss of jobs and loved ones to the pandemic, last fall’s covid-19 surge and the influence of social media on teens as a few of the issues that may aggravate those risks.

“You can have people exposed to the same stressors and for the most part, most people are not killing themselves,” said Jane Pearson, an adviser on suicide research to the National Institute of Mental Health. “People with mental disorders are at higher risk, but we also know that if people can manage their mental disorders, they are at lower risk.”

Suicides have been increasing steadily since 1999, going up 35 percent over two decades, before dropping 5 percent cumulatively over 2019 and 2020. The 2021 data are not final, but are not expected to change much, said Sally C. Curtin, a statistician at the National Center for Health Statistics and lead author of the new report.

In recent years, concern has grown about increased suicides among Black Americans, Native Americans and younger people. “It’s all over the country,” Curtin said of the rise in suicide among younger people. “What would a kid on a farm in Iowa and a kid in New York City have in common?”

Suicide is the second leading cause of death for people aged 10 to 34, and the new data from NCHS, part of the Centers for Disease Control and Prevention, support that trend. The rate for people aged 15 to 24 rose 8 percent and the rate for people aged 25 to 34 rose 4 percent. People in the 35-to-44-year-old and 65-to-74-year-old age groups also saw statistically significant increases.

In December, U.S. Surgeon General Vivek H. Murthy issued an advisory report on the mental health of younger people, warning that “even before the pandemic, an alarming number ... struggled with feelings of helplessness, depression, and thoughts of suicide.” Both Congress and the Biden administration are working on plans to improve mental health services, especially for younger people, amid a dire shortage of caregivers.

The nationwide hotline for mental health emergencies switched to a simple 988 number in July and saw a 45 percent increase in calls, texts and chats in its first month.

Suicides are also committed overwhelmingly by men and boys. In 2021, like many other years, male suicides outnumbered female suicides by about 4 to 1, the data show. There were 38,025 suicides among men and 9,621 among women. The report found that the small increase in the 2021 women’s suicide rate was not statistically significant.

The gender disparity is most commonly explained by the stigma attached to men admitting that they are struggling with psychological issues and seeking help, Moutier said, a situation that many hope is beginning to change. It is also attributed to the fact that more men than women use firearms as a suicide method, leading to many more completed suicides.

Many experts had expected to see an increase in suicides during 2020, the first year of the pandemic, which brought lockdowns, loss, grief and uncertainty worldwide. But suicides declined that year, only to increase in 2021, when coronavirus vaccines became widely available and many people returned to their pre-covid lives. Experts said an explanation for that is still unclear.

“You’d expect the more acute time to have more of an impact,” Pearson said. “But we also know a lot happened in 2020 and 2021.”

“The tale of this pandemic in terms of mental health is going to be many, many years to process,” added Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, an advocacy group.

The new data also revealed an unusual monthly pattern for suicides, which typically peak in the spring months of April and May, according to Moutier. In 2021, the largest percentage increase in suicides over 2020 came in October, when 4,211 people died, 11 percent more than a year earlier.

Again, the reasons are largely unknown. Perhaps the covid surge that fall or the return to school and work contributed, speculate people in the field.

“There is no doubt we are experiencing a mental health crisis in this country,” said Miriam E. Delphin-Rittmon, assistant secretary for mental health and substance abuse at the federal Substance Abuse and Mental Health Services Administration. “Largely due to the ongoing covid-19 pandemic, which continues to have ripple effects, we’re seeing increased levels of anxiety and depression in children, as well as adults, and increased substance use.”