Suicide and Adolescent Girls

For the first time, suicide has replaced car accidents as the leading cause of death for adolescents between 10 and 14 in the U.S.

Think about that: middle school-aged children are already feeling such pressure and stress that they feel suicide is the only answer.

Why isn’t this on the front page of every major newspaper?

Using new data from the Centers for Disease Control and Prevention (CDC), the New York Times reports that while more boys kill themselves than girls in the U.S., the recent increase in the suicide rate was significantly higher for girls than for boys—an alarming nine times higher. And while the total number of children dying from self-harm in the U.S. is relatively low—425 deaths in this age group in 2014—the rapid increase is tremendously concerning.

As I’ve written for Ms. previously, the current available research on suicide among adolescents is not prolific—but there is growing concern that cultural norms and perspectives, as well as the rise of social networking and the earlier-than-ever onset of puberty, are contributing to depression, self-harm and suicide, particularly among young adolescent girls. This concern is not limited to the United States. Around the world, adolescents face social norms—socially and culturally-driven expectations—about who and what girls and boys “should” and “shouldn’t” be. When girls and boys don’t feel they conform to these expectations, their mental health may suffer. And the more these adolescents engage with the rest of the world, through either traditional or social media, for example, the more likely they will be to believe that they just don’t fit “the norm.”

Just as we are grappling with the recently-released data indicating that the suicide rate among 10 to 14 year-olds in the U.S. has caught up with traffic deaths in this age group, so too are those of us who work in global health struggling with the relatively new fact that suicide has overtaken maternal mortality as the leading cause of death for girls aged 15 to 19 worldwide. Yes, suicide is now the leading cause of death among older adolescent girls worldwide. What is happening here?

Adolescents, no matter where they live, face a host of challenges as they navigate the rocky waters between childhood and adulthood. During adolescence, both boys and girls experience rapid physical growth and changes, accompanied by shifts in cognitive and emotional development. At the same time, environmental factors, including influences from family, peer groups, schools, communities and societal expectations more broadly, can work to either support or hinder young people’s wellbeing.

It is also during adolescence that gender roles—and gender stereotypes–begin to firmly take hold. Gender inequalities that exist in nearly every country in the world can increase girls’ vulnerability to depression – and potentially, to self-harm and suicide. For girls, these inequalities can include inequitable access to resources and education, limited power to make decisions about their own lives and low social status as compared to boys.

As a result of these dynamics, girls in many parts of the world may be forced to drop out of school to take care of household chores, younger siblings, or, in many cases, their own children. Girls may be forced into marriage–as 15 million are each year–before they even turn 18. They may experience violence at the hands of an intimate partner or family member, as is the case for nearly a third of girls aged 15 to 19. Psychological distress, hopelessness and depression may emerge due to a loss of education, violence or limitations on freedom and autonomy.

Meeting the needs of girls is critical to achieving a range of development outcomes, and we cannot meet girls’ needs if we neglect their mental health. But by and large, the global community has failed to understand and address the drivers of poor mental health among adolescents, and we have yet to understand how best to respond to their mental health needs.

There is some good news, in that global attention to these issues is increasing. The promotion of mental health and wellbeing was included in the recently-adopted United Nations’ Sustainable Development Goals, and the World Health Organization’s Comprehensive Mental Health Action Plan for 2013 to 2020 highlights steps toward recognizing and addressing suicide and self-harm worldwide. Despite this recognition, though, there has not been nearly enough funding or attention to mental health during the critical formative period of adolescence.

As we move toward a new administration under a president who claims that “no one has more respect for women” than he does, we can only hope that the U.S. steps up to the task and works to address the gender inequalities that appear to be contributing to depression and suicide among adolescent girls and young women, both in the United States and around the world.



Dr. Suzanne Petroni is an expert in global health, youth development and public policy, with a 25-year career that has spanned the U.S. government, philanthropy and NGO sectors. She is the senior director, Global Health, Youth and Development at ICRW.