Survivors promise it gets better as research shows surge in suicide deaths for young girls

WARNING: This story contains distressing details.

In light of a new Canadian study showing an unprecedented spike in suicide deaths among young girls, women who've made it to the other side of their tough teen years are urging struggling adolescents not to give up hope.

The research, published recently in the Canadian Journal of Psychiatry, shows the rate of suicides among girls ages 10-14 surging for nine straight years, peaking in 2018 at about twice the death rate for boys. Throughout those same years, the male death rate slowly declined.

"It's highly atypical for females to die by suicide more than males in any age group," lead author Dr. Rachel Mitchell told CBC News.

Just this week, in fact, a Senate committee released a report on suicide prevention that notes overall suicide rates in Canada have remained stable in recent years, with men accounting for 75 per cent of all deaths.

Mitchell, a child and youth psychiatrist at Sunnybrook Health Sciences Centre in Toronto, said she was so shocked by the results that she asked colleagues to double check her math. 

But the numbers match up with her clinical experience. She's seen the average age of patients referred to her office through emergency departments drop in recent years.

"Young children ages 10 to 14 are dying by suicide by their own hand, and that shouldn't happen. That rate should be zero," she said.

Hattie Zhang, a 21-year-old volunteer with Crisis Centre B.C., said she remembers those ages as the time when she began struggling with her mental health. She now tells young girls that they can get through this if they reach out for help.

"Depression … messes up your perception of what the future is going to be like, what you're like," she said.

"Don't let it trick you into thinking that this is it, that there's no help available, that you don't have a reason to go on."

The research is based on 18 years of publicly available data from the years Canadian Vital Statistics Database, which gives the age range (e.g. 10-14) and sex at birth of the children who've died, but not details on exact ages, race and ethnicity, sexuality or gender identity.

It shows that suicide rates decreased in both male and female children ages 10-14 from 2000 through 2009, when the rates diverged. The trend among girls began taking a strong upward turn at that point, increasing by an average of about seven per cent each year. 

By 2011, the rate of suicide deaths among young female adolescents had climbed above the male rate, and the gap grew steadily from there.

There are signs the trend has begun to reverse since then, but experts say fast-tracking research into the anomaly should be a priority.

Psychiatrists who specialize in studying suicide say there could be a number of factors behind this phenomenon, including girls hitting puberty at younger ages and the influence of social media.

"It really is our collective responsibility to understand these trends so that we can develop suicide prevention strategies that will address this vulnerable population," Mitchell said.

'So many moments of joy' to look forward to

Young people who've been through dark times say they want preteens and teens to know they can make it through those tumultuous years.

"I know it feels super hard and difficult right now, but there's so many moments of joy that you'll never get to experience if you give up now," said Amira Sidhu, an 18-year-old high school student from Surrey, B.C.

She said she remembers the years between 10 and 14 as the time when depression and feelings of hopelessness began creeping into her life.

That's something Zhang, now a psychology student at the University of B.C., can relate to.

"It was a really tough time," she said.

"I didn't know what was going on. It was very, very confusing … trying to figure out what's going on with me. Am I normal? Is this going to last forever?"

The two young women both said they were raised in homes where cultural norms held that feelings shouldn't be discussed. Their experiences seeking help have changed that, and they now speak openly with their parents about mental health.

For Zhang, the turning point came during a crisis in her late teens, when a perceptive friend noticed her distress and offered to walk her to the school counsellor's office.

"I think that's a single thing that changed my mental health journey, and perhaps even saved my life," she said.

In her role with Crisis Centre B.C., Zhang now gives workshops for elementary and middle school students about taking care of their mental health, and urges them to look out for their friends the same way.

Sidhu is a member of the youth engagement leadership table at Foundry B.C., which provides integrated health services for young people, and she encourages adolescents to speak up about their mental health early and often.

"There's no glory in suffering and violence and bottling everything up. It just ends up hurting you more," Sidhu said.

Signs of trend subsiding, but more recent data needed

Dr. Tyler Black, an emergency psychiatrist and clinical associate professor at the University of B.C. in Vancouver said the upward trend the study documents is "undeniable" and unique among Western countries.

But Black, who was not involved in the study, noted that more recent data from 2019 and 2020 shows the suicide rate among young girls dropping from peak levels and nearly closing the gap with boys.

Still, by 2020 the suicide rate among girls remained higher than it was a decade before, and Black said any increase in death rates for children should be a cause for concern.

"Even though it's a rare event, [suicide] still is the number one cause of death in kids, and kids shouldn't be dying," Black said.

He's particularly concerned about how long it takes for researchers to get statistics on suicide deaths in Canada, which makes it tricky to plan a response.

"It's 2023, and I can only tell you what happened in 2020," Black said. 

"Imagine being in my line of work and trying to do suicide prevention, but the latest data I have is three years ago. That's something that we really need to be alarmed about."

Effects of early puberty, social media

Mitchell has some theories about why her research showed such a dramatic surge in the death rate for young girls.

She describes the ages of 10 to 14 as some of the most challenging in a child's life. Girls today are also entering puberty earlier than previous generations, which complicates things even more.

"It's when you enter high school, it's when you start becoming more aware of your surroundings, and the influences of peers become so much more paramount," Mitchell said.

"There's all these social environmental pressures that are going on, but the actual brain hasn't adapted or hasn't developed to keep pace."

Then, there's the influence of social media.

"You see what is happening around you, right there at your fingertips — how your friends, how your peers are living their life — and you reference it to your own, and you can't escape it," Mitchell said.

At the Youth Wellness Hub Niagara in Welland, Ont., social worker Karlie Klinck said she is seeing a lot of younger teens these days, for issues ranging from disordered eating to suicidal ideation, and they are often heavy users of social media.

"There are differences in where you are at developmentally, on how you are able to work through what you are consuming online or seeing in TV shows, and I think a big piece for the younger folks is if they're … able to unpack and understand what they are consuming," she said.

Pros and cons of social media

Zhang has some experience with that. When she was struggling with her mental health in her teen years, she noticed insecurities around body image popping up as she scrolled through social media.

She also saw romanticization of what she calls the "beautiful sad girl" in some corners online.

"A lot of music, a lot of social media glamourize that," Zhang said, suggesting it may discourage some young people from seeking help.

Black said there is some evidence that social media can be more harmful for girls than for boys. He added that it's still unclear whether kids sharing suicidal thoughts through social media is a net positive or negative.

"There's lots of kids who, online, are able to express themselves in a way that makes them feel heard and seen and validated. On the other hand, there's a lot of attention that can be given to almost a competition of who's sickest," Black said.

WATCH | The National reports on new suicide study: 

Suicides among teen girls spiked in 2018 and researchers don’t know why

1 year ago

Duration 2:06

A new study shows that girls aged 10-14 died by suicide at twice the rate of boys in 2018. Researchers consider it very unusual and are trying to figure out why.

Mitchell and Black both noted that there are positives to social media for teenagers, including finding community and support they may not have at home or school, and bringing together marginalized groups.

But Mitchell said she expects that it will become standard for doctors to recommend social media limits for many youth experiencing mental health issues.

"It's going to be part of our treatment plan, similar to how for cardiovascular disease we recommend you undergo rehab or that you exercise three times a week," she said.

If you or someone you know is struggling, here's where to get help:

• Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (text between 4 p.m. and midnight ET).

• Kids Help Phone: 1-800-668-6868 (phone), live chat counselling on the website.

• Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.

• This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you're worried about.