A new study published in JAMA Pediatrics looked at the association of youth suicides and county-level mental health professional shortage areas in the United States.
“We found that two-thirds of U.S. counties have significant shortages of mental health professionals,” study author Jennifer A. Hoffman told us. “Youth who live in counties with shortages of mental health professionals are more likely to die by suicide.”
Since the COVID-19 pandemic, youth have experienced worse mental health, creating increased demand for mental health services in a system that was already strained. Demand for mental health services far exceeds the current capacity of the mental health system for youth.
In the U.S., youth suicide between the ages of 10 and 19 increased in five states during the pandemic – Georgia, Virginia, New Jersey, California, Oklahoma, and Indiana. In 2021, a state of emergency regarding youth mental health was declared by the American Academy of Pediatrics. Visits to the emergency department for youth suicide attempts started to increase in May of 2020 with females between the ages of 12 and 17 visiting more often. In 2021, over the period of a month between February and March, visits by girls increased by over 50 per cent compared to the same month in 2019.
Children who die by firearm suicides are less likely to have a known mental health condition and a result, the researcher team anticipated that mental health professional shortages would not be related to firearm suicide rates. However, they found that youth firearm suicides do occur more commonly in counties with mental health professional shortages.
“We compared how youth suicide rates in each county relate to the degree of mental health professional shortages in that county,” Hoffman told us. “We accounted for other differences between counties, such as rurality and poverty.”
The researchers found that youth suicide rates are higher in counties with shortages of mental health professionals, even afteraccounting for different county characteristics such as rurality and poverty.
“As an emergency medicine physician, I routinely care for youth who have been waiting weeks or months to see a mental health professional,” Hoffman told us. “While waiting, their mental health often worsens, leading to acute crises that land them in the emergency department.”
Hoffman believes policymakers should increase federal funding to ensure all children can access mental health services. Solutions include improving access to telemedicine, expanding school-based mental health services, and supporting mental health care delivery within pediatric primary care offices.
“Workforce challenges must be urgently addressed so that children can access mental health care no matter where they live,” Hoffman told us. Since the onset of the pandemic, hospital emergency rooms across the county, including my own, have been inundated with youth experiencing severe mental health crises. We urgently need more federal investments to build the mental health workforce and expand access to community-based services focused on prevention, early identification, and treatment.”
Hoffman explained that more funds are needed to support existing programs under SAMHSA and HRSA that support pediatric mental and behavioral health, including the Pediatric Mental Health Care Access Program and the Behavioral Health Workforce Education and Training Program for Professionals.