Adverse childhood experiences (ACEs) are traumatic events during childhood which often lead to suicidal behaviors and poor mental health. This includes neglect, encountering violence, or suicide attempt from a family member. During the COVID-19 pandemic, an increase in ACEs was recorded.
The prevalence of ACEs has led to the 2021 Adolescent Behaviors and Experiences Survey (ABES) reporting a 37.1% rate of poor mental health in high school students, with 19.9% considering and 9% attempting suicide in 2020.
Poor mental health was 4 times as high in children with 4 or more ACEs during the pandemic than those with none, while rate of suicide attempts was 25 times higher. Emotional abuse alongside other specific ACE types was associated with higher risk of poor mental health and suicidal behaviors.
This ABES data was collected through a three-stage cluster sampling, obtaining nationally representative data from students in grades 9 to 12 in public and private United States high schools. There were 4390 students included in the analysis.
About 73% of students reported at least 1 ACE during the pandemic. Self-reported ACEs during the pandemic included emotional abuse, physical abuse, parent or caregiver job loss, and food insecurity. In students reporting 1 or 2 ACEs, poor mental health and suicidal behavior rates increased, indicating a dose-response relationship.
Along with a 3 to 4 times increase in poor mental health for students with 4 or more ACEs, suicide consideration was 57.4% compared to 5.3% in cases of no ACEs. Suicide planning was 48.6% vs 3.7% and attempted suicide was 38.7% vs 0.9%, respectively.
Authors of the CDC report recommended prevention and intervention strategies to reduce poor mental health and suicidal behaviors. These include early identification and trauma-informed mental health service and support provision.
There is an urgent need to reduce suicidal behavior, as suicide has been the second or third leading cause of death in adolescents aged 14 to 18 years for over a decade. Authors urged cross-sector approaches, partnerships, and policies to address ACE and suicide prevention in adolescents.
Anderson KN, Swedo EA, Trinh E, Ray CM, Krause KH, Verlenden JV, et al. Adverse childhood experiences during the COVID-19 pandemic and associations with poor mental health and suicidal behaviors among high school students — adolescent behaviors and experiences survey, United States, January–June 2021. MMWR Morb Mortal Wkly Rep. 2022;71:1301–1305. doi:http://dx.doi.org/10.15585/mmwr.mm7141a2