CALGARY - A global study shows there was an increase in emergency department visits for attempted suicide among children and adolescents during the COVID-19 pandemic.

The study, published in Lancet Psychiatry, analyzed 42 studies that represented more than 11 million pediatric patients in 18 different countries around the world.

It compared data on visits before the pandemic with those during the pandemic until July 2021.

The numbers show that visits for suicidal behaviour went up despite a decrease in overall pediatric emergency department visits.

“When we look at the rate of suicide attempts for children and adolescents, we found that it increased by 22 per cent during the pandemic compared to before the pandemic,” Dr. Sheri Madigan, a clinical psychologist at the University of Calgary who's the lead author on the study, said in an interview.

An average emergency department before the pandemic, she said, would see about 101 suicide attempts per month. That went up to about 125 visits per month during the pandemic, Madigan said.

Researchers also found an eight per cent increase in emergency department visits for suicidal thoughts.

There was a higher rate of suicidal behaviour for girls than boys, and older teenagers were more likely to self-harm.

Co-author Dr. Daphne Korczak, a child and adolescent psychiatrist at the Hospital for Sick Children in Toronto, said the findings align with what she has experienced at her clinic.

“There has been this accumulation of pandemic-related stressors - social isolation, school closures, online learning,” she said. “At that same time, there has been this withdrawal of sources of support - friends and schools and routines.

“Having that sustained over months and years, they are quite long periods in the life of a child.”

Korczak said the combination of stress and lack of support can lead to feelings of being overwhelmed, stuck or unable to cope.

“Some kids became hopeless and couldn't see any other solution except to seriously harm themselves,” she said. “That's very worrying.

“In comparison to adults, who have decades to develop coping strategies and friendships and defence mechanisms that work for them in times of stress, children are still developing these and they are much less able to transfer their daily activities and lives to an online forum.”

The study, she said, points to a need for more help for kids.

“We have to put the resources and effort in at school, in the community, at home to re-engage children and adolescents, in particular, in new and interesting and positive activities, in addition to providing mental health supports when they need them,” Korczak said.

Madigan added that the results didn't come as a shock, because another study she led found that depression and anxiety symptoms doubled in children and adolescents during the first year of the pandemic.

“We really said that we had a mental health crisis on our hands about a year and a half ago when the previous study came out,” she said.

At the time, researchers warned that supports were needed or it could lead to a catastrophe.

Some provinces have started to put money into mental health supports for children and youth, but Madigan said governments and social agencies need to consider prevention strategies in addition to intervention.

She added that there has been a lot of debate since the start of the pandemic about whether the kids are all right.

“Now that more data have been published and analyzed, we can more precisely answer that question,” said Madigan. “The kids are, in fact, not all right.”

This report by The Canadian Press was first published March 9, 2023.