SALT LAKE CITY — The number of Utah teenagers lost to suicide per year jumped 141 percent from 2011 to 2015, accompanied by even greater increases in known incidents of self-harm and the number of youths who say they have considered taking their own life, according to a new report released Thursday by the Utah Department of Health.
The department released the data collected with the help of the Centers for Disease Control and Prevention to address what it calls the "urgent public health problem" of increasing youth suicides in recent years, seeking an analysis of what contributes to it.
"This research, along with previous research, demonstrates the need for every single person, family, faith group, school, organization and system, to take a deep look at how we do or do not engage in activities … that actively promote social connections and close relationships," said Kimberly Myers, suicide prevention coordinator for the Utah Department of Human Services.
An analysis of a 2015 survey of Utah teens shows "significant risk factors for suicide ideation were being bullied at school or online and (drug) use in the previous month," the report states.
Demographic factors associated with higher susceptibility for suicide ideation and attempts included being female, not white, in early high school and having "low parental education."
The report also found that "students who reported participating more frequently in religious activities … had lesser risk."
"Supportive social environments were found to be protective for suicide ideation and attempts," the report states. "Supportive social environments are characterized by ones in which youth feel involved, valued and able to ask for and receive help when they need it." Such environments include families, schools and community groups, according to the report.
Although surveys showed girls were generally at greater risk of suicide ideation, 78 percent of Utah youths who died from suicide between 2011 and 2015 were boys.
Michael Friedrichs, epidemiologist for the state Bureau of Health Promotion, pointed out that it's not only youth suicides that are increasing, but also the number of teens considering suicide in general. In all, 19 percent of youths surveyed in 2015 had considered suicide within the previous year, compared with just 11 percent who gave that answer to the same question in 2011, he said.
Additionally, 8.6 percent of respondents said they had attempted suicide within the previous year.
"There’s many ways in which youth in today’s world can be made to feel alienated," Friedrichs said. "We need to work together across sectors to increase connectedness and reduce isolation."
Between 2011 and 2014, there were 3,005 emergency room visits and 690 hospital stays related to self-inflicted injuries among Utahns ages 10 to 17, the report says. The rate of emergency visits and hospitalizations both nearly doubled in 2014 compared with 2011.
As of 2015, the youth suicide rate in Utah of 11.1 per 100,000 population was more than 2.5 times greater than the national average. That represents a significant shift since 2007, when Utah's youth suicide rate was just 25 percent higher.
Because of the steep increase in suicides, the state filed a special request with the CDC in January to conduct an epidemiologic investigation reserved for only demonstrably compelling public health issues, said Utah Department of Health spokeswoman Jenny Johnson.
Johnson said investigators from that federal agency visited the state for two weeks in March, aggregating as much data as they could from the Utah Violent Death Reporting System, the state's Prevention Needs Assessment survey of students, hospitalization records, school suicide prevention initiatives, interviews with victims' families, information maintained by the state medical examiner's office and other sources.
Solving youth suicide
In spite of the data showing that the crisis of youth suicide in Utah is worsening in recent years, there remains strong reason to have hope that those considering taking their own life can be helped, said Taryn Hiatt, the American Foundation for Suicide Prevention's area director for Utah and Nevada.
Hiatt would know; she's the survivor of multiple suicide attempts.
"I can't tell you how grateful I am to stand before you today alive," she told health experts and reporters at the report's unveiling Thursday, later adding with emotion, "I don't want to see one more young person miss out on the life that I would have missed out on if I had died one of all those times I tried."
Hiatt decried her observations that many young people are made to feel that what they carry inside about wanting to take their own life is the "one thing they are willing to take to the grave."
"It's all about connection. We have got to connect as human beings and be willing to sit with people in those dark moments," she said. "Our brains get sick, but here's the beautiful part: They can also get better."
Curbing the trend of youth suicide in Utah will require several different strategies, according to recommendations from the CDC report.
The agency recommended that state officials consider policies to increase access to mental heath care services to youths; strengthen family ties; promote connectedness and involvement in school, at home and with peers; better identify youths who are at risk; reduce other forms of violence; and reduce teen access to lethal options.
Fatal victim tendencies
One finding that health officials called unexpected was the discovery that 12.6 percent of Utah youths lost to suicide between 2011 and 2015 had "experienced a technology-related restriction prior to their death." That statistic included the taking away of cellphones, gaming systems, tablets or computers, and didn't specify whether it was the cause or result of a family conflict, the report explained.
"Given how broad this variable was, additional research is needed to understand the implications of this finding, including the extent to which this represents interruption to social support networks, distress over losing access to the electronic device, anger over being punished or some other factors," the analysis cautioned.
Still, Amber Montero, a supervisor at the 24/7 CrisisLine call center at the University of Utah Neuropsychiatric Institute, wonders whether restricting internet access to a teenager in distress could backfire in a surprising way.
"Are they being restricted from helpful sources? Who knows?" she said, adding that she would like to see more research into the issue.
On top of the calls the crisis center receives, many teenagers choose to reach out by sending messages through the SafeUT app, Montero said. She explained to the Deseret News earlier this year that crisis workers will sometimes spend hours at a time messaging back and forth with a distressed teenager using the app.
Thursday's report also found just 35 percent of youths who died from suicide between 2011 and 2015 had previously received a mental illness diagnosis. It found 16 percent had previously attempted suicide and that almost 24 percent had disclosed their intent to kill themselves within a month of their death.
Additionally, 55 percent of youth suicide victims had experienced a crisis within two weeks prior to dying, 20.5 percent had a history of cutting themselves, and 47 percent left a suicide note.
The statistics paint a stark picture, but it is just as important to remember the human beings behind the numbers, Myers said.
"Statistics are human beings with the tears wiped away," she said, paraphrasing a quote credited to author Paul Brodeur. "We are talking about a unique person with flaws and talents, with people who loved them and people who worried about them."
Need for LBGTQ data
Among 150 Utahns ages 10 to 17 who died from suicide from 2011 to 2015, sexual orientation data was able to be collected for just 40 of them. Of those 40, six "were identified as sexual minorities," according to the report.
"Given the (scarcity) of data on sexual orientation, yet its potential importance in understanding risk and protective factors for suicide and other health disparities, the (Utah Department of Health) is making efforts to include questions on this topic" in future surveys, the agency wrote Thursday.
Friedrichs said state health officials are working with schools and others to ensure they they inquire about sexual orientation in all future surveys about suicidal ideation. He said the time has come to "no longer not have this information."
"We can't describe what we can't measure," Friedrichs said.
Troy Williams, executive director of Equality Utah, said in a statement that he's pleased the state understands more data collection is "needed to better understand the risk faced by LGBTQ youth."
"That gives me hope," he said.
"We must work hard to create a culture that tells all young people they belong," Williams said. "It truly saves lives."
Anyone experiencing thoughts of self harm or suicide can reach a crisis worker 24/7 at the University of Utah Neuropsychiatric Institute by calling their hotline at 801-587-3000 or using the SafeUT app.