Working Paper: NBER ID: w31493
Authors: Adriana Corredor-Waldron; Janet Currie
Abstract: Rising reports of suicidal behaviors in children and adolescents have led to the recognition of a youth mental health crisis. However, reported rates can be influenced by access to screening and changes in reporting conventions, as well as by changes in social stigma. Using data on all hospital visits in New Jersey from 2008-2019, we investigate two inflection points in adolescent suicide-related visits and show that a rise in 2012 followed changes in screening recommendations, while a sharp rise in 2016-2017 followed changes in the coding of suicidal ideation. Rates of other suicidal behaviors including self-harm, attempted suicides, and completed suicides were essentially flat over this period. These results suggest that underlying suicide-related behaviors among children, while alarmingly high, may not have risen as sharply as reported rates suggest. Hence, researchers should approach reported trends cautiously.
Keywords: teen mental health; suicide; hospital visits; reporting changes; screening practices
JEL Codes: I12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Changes in screening recommendations (I12) | Increased identification of suicidal ideation among teens (I12) |
| Changes in ICD coding practices (C42) | Increase in recorded cases of suicidal ideation (I12) |
| Increased identification of suicidal ideation among teens (I12) | Reported rates of suicidal ideation have surged (I30) |
| Reported trends in suicidal behaviors (I12) | Actual underlying behaviors may not have risen as sharply (E39) |