Eight in every 100 school-age children have experienced suicidal ideas and behaviours, according to one of the largest studies on childhood mental health.

The study, published this week in The Lancet Psychiatry, looked at risk and protective factors associated with childhood suicidality, a term that spans suicidal ideas, plans and attempts.

“It is worrying that up to eight out of 100 school-age children have thought or have attempted suicide at some point during their very young life,” said the study’s senior author, Dr. Sophia Frangou, psychiatry professor in the faculty of medicine and the President’s Excellence Chair in Brain Health at the Djavad Mowafaghian Centre for Brain Health at UBC.

For the study, an international team of researchers, led by Frangou, analyzed data from the Adolescent Brain and Cognitive Development (ABCD) study. ABCD is the largest long-term study of brain development and child health in the United States, comprising of 11,875 children aged 9-10 years-old. The study involved 22 research sites, a catchment area encompassing more than 20 per cent of the entire U.S. population in this age group.

The research team evaluated each child and their primary caregiver, commonly their mother, for suicidal thoughts and behaviours. They also examined a wide range of measures related to the children’s mental and physical wellbeing, behaviour, cognition, and social and family environment to identify the most important risk and protective factors.

They found that children with psychological problems and children exposed to family conflict were most likely to report suicidal thoughts. The likelihood of suicidality was also increased with longer screen-time use, particularly on weekends. By contrast, children reporting higher levels of parental supervision and more school engagement were less likely to ever have engaged in suicidal ideas or behaviours.

“Successful prevention is critically dependent on reducing risk factors while promoting factors that can have a protective effect,” said Frangou. “The risk and protective factors we identified in this study are particularly useful as they can be addressed here and now and modified through interventions aimed at identifying and targeting childhood mental health disorders, increasing school engagement, and providing support to families.”

According to the Canadian federal government and the National Institute of Mental Health, suicide is the second leading cause of death for children and adolescents in Canada and the U.S. Suicidal thoughts and attempts are amongst the strongest predictors of completed suicide and an important target for prevention.

Frangou and her research team, together with other collaborators, are currently using brain imaging to identify brain activity that corresponds with suicidality in children and adolescents. They also plan to use data from the follow-up assessments of the ABCD study to map the trajectories of suicidality in youth, and examine how these may be influenced by social interactions.