CHICAGO – With an increase in suicide and suicide risk in youth and young adults across the U.S. since 2007, the American Medical Association (AMA) adopted policy during the Special Meeting of its House of Delegates aimed at preventing suicide in young people. The adopted policy report outlines risk factors for youth suicide, including the role of mental health, substance use disorder, adverse childhood experiences, increased use of digital devices, bullying and cyberbullying, and the impact of the COVID-19 pandemic. The report also identifies evidence-based interventions, protective factors, as well as resources to enhance resiliency aimed at mitigating youth suicide risk.

According to a recent Centers for Disease Control and Prevention (CDC) study, there was a 31% increase in the proportion of mental health–related emergency department visits for youth aged 12–17 years during 2020 as compared to 2019. Particularly concerning, CDC data also showed increased rates of suicide ideation and suicide attempts in 2020 during the COVID-19 pandemic as compared with 2019 rates. Given these staggering statistics, the AMA is publicly calling attention to the escalating crisis in children and adolescent mental health in the U.S. in the wake of the COVID-19 pandemic and has adopted policy aimed at addressing this serious health concern.

“We were deeply concerned by the dramatic increases we were seeing in youth suicide and suicide risk even before the mitigation measures and disruptions caused by the COVID-19 pandemic. As a nation we must do everything we can to prioritize children’s mental, emotional and behavioral health and step up our efforts to prevent suicide and mitigate suicide risk among our nation’s youth,” said AMA Board Member Willie Underwood III, M.D., MS.c, M.P.H. “Physicians play a vital role and we must ensure that all physicians who see youth patients, not solely pediatric psychiatrists and addiction medicine physicians, have the ability, capacity, and access to the tools needed to identify when a young person is experiencing a period of imminent risk and help prevent suicide attempts.”

Under the new policy, the AMA will:

• Encourage the development and dissemination of educational resources and tools for physicians, especially those more likely to encounter youth or young adult patients, that address effective suicide prevention. This includes screening tools, methods to identify risk factors and acuity, safety planning, and appropriate follow-up care—including treatment and linkages to appropriate counseling resources;  
• Support collaboration with federal agencies, relevant state and specialty medical societies, schools, public health agencies, community organizations, and other stakeholders to enhance awareness of the increase in youth and young adult suicide and to promote protective factors, raise awareness of risk factors, support evidence-based prevention strategies and interventions, encourage awareness of community mental health resources, and improve care for youth and young adults at risk of suicide;  
• Encourage efforts to provide youth and young adults better and more equitable access to treatment and care for depression, substance use disorder, and other disorders that contribute to suicide risk;  
• Encourage continued research to better understand suicide risk and effective prevention efforts in youth and young adults, especially in higher risk sub-populations such as Black, LGBTQ+, Hispanic/Latinx, and Indigenous/Native Alaskan youth and young adult populations, and among youth and young adults with disabilities;  
• Support the development of novel technologies and therapeutics, along with improved utilization of existing medications to address acute suicidality and underlying risk factors in youth and young adults; 
• Support research to identify evidence-based universal and targeted suicide prevention programs for implementation in middle schools and high schools; 
• Advocate at the state and national level for policies to prioritize children’s mental, emotional and behavioral health; 
• Advocate for a comprehensive system of care including prevention, management and crisis care to address mental and behavioral health needs for infants, children and adolescents; 
• Supports increased screening for Adverse Childhood Experiences (ACEs) in medical settings, in recognition of the intersectionality of ACEs with significant increased risk of suicide, negative substance-use related outcomes including overdose, and a multitude of downstream negative health outcomes; 
• Supports the inclusion of ACEs and trauma-informed care into undergraduate and graduate medical education curricula. 

The new policy builds upon AMA’s existing policy to prevent teen and youth suicide, including encouraging significant funding for suicide prevention and intervention directed toward American Indian/Alaska Native youth—given that this population has had the highest suicide rate over the last 20 years. Existing AMA policy also aims to reduce suicide risk among LGBTQ+ youth, recognizing the special risk for LGBTQ+ teens and need for partnerships with public and private organizations to help reduce suicide among these teens. AMA policy also supports lethal means safety counseling and encourages physicians to work with families to reduce access to lethal means of suicide. The AMA is committed to helping address the youth suicide crisis and will continue to support policies aimed at preventing more young people from dying by suicide.