A spike in youth suicides? That’s not the Boise area’s only worrying mental health metric
Last year, the Boise area hit a terrible milestone: Fourteen young people died by suicide in Ada County, according to data shared by the Ada County Sheriff’s Office. That compares with one in 2022.
At least four of those students were students in the Boise School District, the Idaho Statesman reported.
The deaths sent a shock through the community, serving as a wakeup call about Idaho’s youth suicide rate — the fifth-highest nationwide from 1999 to 2020, according to the Office of Juvenile Justice and Delinquency Prevention, part of the federal Department of Justice. They prompted the Boise School District to introduce a suicide-intervention curriculum for this school year and sparked a wider conversation about the need to destigmatize struggles with mental health.
But for clinicians and law enforcement in the area, the deaths were just one of several worrying trends in the landscape of young people struggling with mental health — especially in the years since COVID-19, which experts say played a formative role for kids who spent a year out of school, isolated from peers.
Boise’s Cottonwood Creek Behavioral Hospital, which opened in 2019, saw its adolescent inpatient admissions jump from about 650 in 2020 to about 1,200 in 2021, and to over 1,300 in 2022 before falling to about 1,000 in 2023. Martina Velic, the hospital’s director of admissions, attributed the trend to COVID-19 — to kids being really “secluded and isolated,” and “not being able to go anywhere, and just not being able to really live day to day as they had been used to.”
The population Velic sees is typically experiencing suicidal thinking, homicidal thinking or acute psychosis, she said — and her team is seeing first episodes of psychosis happening to younger and younger children.
“When I was in graduate school, we learned about that starting in the early 20s,” she told the Statesman by phone. But “now we’re seeing 13-, 14-, 15-year-olds. It’s really unfortunate to see that.”
As to why teenagers are affected this way: “I think that’s one of those things that we won’t know for years to come, until the data is collected and more research is out there,” she said.
Wendy Seagraves, a clinical supervisor and social worker with Ada County Juvenile Court Services, has also seen how the “loss of normalcy” during the pandemic unmoored young people. Her team of eight clinicians has seen an uptick of generalized anxiety, depression and trauma responses. Her team, too, used to see children 14 and older, but these days they see children as young as 11 — and even older teenagers are “a couple of years behind” in their emotional development, she said.
COVID-19, political climate add to mental health woes
Velic noted that COVID-19’s second- and third-order effects may also be playing a role. As many families in the Boise area struggled economically, or as housing prices got less affordable, that played “into overall stress in the home … when parents are struggling, then the kiddos are struggling,” she said.
She noted that more than half of Cottonwood Creek’s patient population qualifies for Medicaid, which could correlate with instability at home, a lack of food, or other stressors.
Seagraves pointed to the tenor of national and local politics.
“I think, as a society, just where we’re at right now, there’s the divisiveness,” she said. “We think it doesn’t hit the kids, but it really does, like they’re seeing how unkind a lot of society is.”
She said she’s seen this manifest in more bullying, which in turn is magnified by teenagers’ phone use.
“It impacts their emotional regulation,” where “you are comparing yourself to everybody else,” she said. “There’s so much of, ‘well, this person said this, so I need to respond — and it’s causing more fights.”
Morgan Van Ry, Cottonwood Creek’s business development manager and former community liaison, has seen mental health treatment and prevention become politicized, too, leading to some parents’ resistance to allow those resources into public schools.
“I think that it’s very political, and I think there’s still a lot of the mentality of ‘pull yourself up by your bootstraps. Mental health isn’t real. Gender dysphoria isn’t real. Get over it when you’re being bullied,’” she said. “So when there’s mental health or counseling or anything in that realm, parents get offended, or they don’t want that pushed on their child.”
Fewer Ada County teens in juvenile detention
As much as the pandemic disrupted teenagers’ development, it also gave the local criminal justice system an opportunity to adjust its approach to putting children with behavior problems into detention, said Alison Tate, the director of Ada County’s youth resource and assessment center, called The Bridge.
Before COVID-19, there were 40 or 50 teenagers in juvenile detention in Ada County, she said. In the first quarter of 2024, there were 12.
“We think that much of that decline is due to the education we’ve been doing with partners, with law enforcement and judges, about the harms of detention” for young people, she said.
Young people who spend time in jail may face increased recidivism rates, exacerbate any existing mental illnesses, and “pull youth deeper into the juvenile and criminal justice system,” according to one study, written by the Justice Policy Institute and shared on the U.S. Department of Justice’s website.
The Bridge opened last year following the Legislature’s 2022 appropriation of $6.5 million to establish youth assessment centers throughout Idaho. It is part of a “growing movement” nationwide to divert young people from the criminal justice system. It serves as a hub families can turn to to get referred to services — anything from equine therapy to tutoring to substance abuse treatment — before problems escalate.
Even if one child in a family is referred to the program, its staff will try to work with the whole family, to try to help younger children before their own problems may worsen.
“We have families in the system where we get every kid at about the time they start turning 11 or 12,” Tate said.
Tate said children’s mental and behavioral health problems rarely crop up in isolation. She referred to Ada County Juvenile Services’ data on “adverse childhood experiences” — “potentially traumatic events … such as violence, abuse, and growing up in a family with mental health or substance use problems.”
Among children in Ada County detention, over 60% had experienced at least four potentially traumatic events, compared with 16% among the general population. And while about 60% of adults have experienced at least one adverse childhood experience, 95% of youths in detention have had that experience.
Sgt. Craig Durrell, who supervises some of the Sheriff’s Office’s school resource officers, echoed this idea.
“We never look at situations where it just is what it is,” he said. “If a kid brings a vape to school, the idea is to dig into that a little bit to find out what’s going on here … The goal isn’t just to write a criminal report and get them charged criminally. We actually seek to divert away from that as much as we can. The goal really is to peel the onion back a little bit, find out where all this is coming from.”
Even as life returns to normal in the years after COVID-19, doctors and law enforcement said teenagers continue to suffer.
“We had talked about (the 2021-22 school year) being the first normal year back, but I think that the 2022-23 year was really, actually, truly the first normal year back, because up until that point, we’d always had something,” whether that was alternating school-day schedules or the option for online classes, said Sheriff’s Deputy Shannon Garza, a school resource officer at Lake Hazel Middle School.
Though Cottonwood Creek’s admission rates slowed in 2023, for its director of social services, Velic said, “he doesn’t feel like we’re even at the peak of repercussions that we’re going to see because of COVID and the isolation.”
“We’ve maybe settled for a minute,” she said, “The peak is still yet to come.”
Need help?
Call or text Idaho’s crisis line at 988.
This story was originally published September 3, 2024 at 10:13 AM.
CORRECTION: This story was updated on Sep. 10, 2024 to correct the number of young people in Ada County who died by suicide in 2023 to 14.
