One hundred New Jersey children under age 13 have attempted suicide by intentional drug overdose since January 2018, the state’s poison control center reported this week.

The majority of cases involved 12-year-olds, but some children trying to take their lives were as young as 9.

“Suicide in young preteens is becoming more and more common, signaling a real public health threat for our state,” said Diane Calello, executive and medical director of the New Jersey Poison Control Center.

Ten years ago, the number of preteens attempting suicide by poisoning in New Jersey was in the 20s. Last year, that number climbed to 70. The center is on pace to see a further increase this year, Calello said.

And those numbers likely undercount the problem, she added, since New Jersey law doesn’t require hospitals and other health-care facilities to report drug overdoses to the poison center.

What’s more alarming, Calello said, is that the numbers in the Garden State are no anomaly.

Pennsylvania is also seeing an increase in attempted suicides by poisoning. From 2010 to 2017, phone calls to the Poison Control Center at Children’s Hospital of Philadelphia about adolescents attempting suicide increased by nearly 50 percent — even as overall call volume decreased.

It’s part of a national phenomenon in which the number of adolescents and young adults attempting suicide by self-poisoning across the country has more than doubled in the last decade. (This does not include accidental overdoses from recreational drug use.)

Previous studies have shown the number of teens going to the emergency room with suicidal thoughts jumped during that time, too.

Suicide is the second-leading cause of death (after accidents) among Americans ages 10 to 24. While guns are the most common method resulting in death, self-poisoning is tried more often.

Locally and nationally, the increase in suicide attempts — though not necessarily deaths — is driven largely by young women, who account for more than a quarter of the suicide attempts by drug overdose. This fits a well-established trend that women attempt suicide more often than men, though men die more often from suicide. Researchers believe this has to do with the means used. Men more often use guns, which are more likely to result in death.

While researchers can’t say for sure what’s causing the increase in suicidal behaviors, they suggest several societal changes in the last decade could be affecting it.

Previous studies have shown the rate of suicide attempts increased most rapidly after 2011. Since then, the advent of social media, the proliferation of smartphones, and the opioid crisis have all impacted mental health in a large way.

Calello, who works in pediatric emergency care, said she has seen many cases where, immediately prior to their suicide attempt, kids received bullying texts or social media communication.

More kids today are also dealing with mental illnesses, she said. Given the lack of child psychiatrists in the country, it can be hard to get proper care.

While this trend is concerning, she said, it’s important to know that there are many approaches to suicide prevention.

Screening children for suicide risk during primary-care visits and in school could be a first step.

Some researchers have also developed a suicide prediction score meant to help therapists identify those at greatest risk. Other scientists are looking to brain scans for potential biological markers of suicide.

Awareness campaigns that teach children and adults to look for warning signs that might otherwise be mistaken for an adolescent phase are key, Calello said. Those signs include changes in sleeping or eating patterns, becoming more withdrawn, and talking about feeling hopeless or trapped. People should monitor social media and text for these signs too.

Diane Calello is executive and medical director of the New Jersey Poison Control Center at Rutgers NJ Medical School's Department of Emergency Medicine.
Courtesy Diane Calello
Diane Calello is executive and medical director of the New Jersey Poison Control Center at Rutgers NJ Medical School's Department of Emergency Medicine.

People of all age should also feel comfortable initiating conversations on this topic.

“A lot of times kids will reach out to their peers, and no adult ever finds out until it’s too late,” Calello said. So it’s important to tell kids to talk to a grownup. “Right away. Because they could stop a tragedy.”

Parents should also check in regularly with their children. If they notice signs of concern, experts recommend asking children directly if they have ever had thoughts about ending their life. Don’t use euphemisms, such as “Have you been having disturbing thoughts?” or “Are you thinking of the S-word?” Instead, ask the person: “Are you thinking of killing yourself?”

A psychiatry professor at Columbia University has developed a set of questions that anyone — not just medical professionals — can ask to identify people at risk of suicide.

Safely storing guns and medications in the home can also prevent suicide. But keeping medicines high and out of reach is often not enough.

“Kids know where things are kept and how to get it,” Calello said. “If somebody has a prescription they no longer need, get rid of it.” This includes all types of medications — prescription, over-the-counter, dietary, herbal, and vitamins.

Take advantage of federal and state drug take-back days and consider keeping particularly strong medications locked up.

If you suspect a drug overdose, seek care immediately, Calello said. You can call the national poison control hotline at 1-800-222-1222, and it will automatically route you to your local center.

It’s critical that anyone attempting suicide get counseling and support immediately afterward, experts say, as research shows they are at higher risk to try it again.

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text TALK to the Crisis Text Line at 741741. The Poison Control Hotline can be reached at 1-800-222-1222.