Dear Dr. K. Ron-Li Liaw, Director of Child and Adolescent Mental Health, Children’s Hospital Colorado,
As an Emergency Medical Technician, I noticed an issue in Colorado Springs, Colorado. I work for Ambulnz, an ambulance transport company in Colorado Springs, and in the past several months I’ve responded to six pediatric patients ranging from suicide attempts and suicidal ideations with a plan to commit suicide. I know I am not the only crew out of all the ambulance companies in the area who respond to pediatric psychological calls daily. The children I have responded to are aged eleven to fifteen, and three of them suffer from autism spectrum disorder. I am curious as to why the issue is on a substantial rise, and if it is common for children with autism to suffer from psychological behaviors such as self-harm. Change is needed in the state of Colorado, as a medical community, we are failing to provide the appropriate care that the children are seeking.
EMT, Ambulnz, Colorado Springs, CO
For seven years I dedicated my life to the United States Army as a UH-60 Blackhawk helicopter Flight Instructor. During my many years in the military, I did not understand my purpose as a service member, my passion was to help others not live a life of imprisonment, so it felt. I knew change was needed, and that change was to fulfill the contract I committed to and become a Firefighter. As I transitioned out of the military, I was fortunate enough to attend Emergency Medical Technician school, a prerequisite to becoming a Firefighter. Searching for the prerequisites to achieve my goal as fast as possible, I found purpose and my passion for being an EMT.
I was not sure what I would expect as an EMT. In my head, I would play out Hollywood-type scenarios of severe trauma, whether it be a gunshot victim or a motor vehicle accident with a sucking chest wound. I would conceptualize my partner and I driving down the highway at a high rate of speed in the ambulance, coming to an immediate halt, rushing to the patient, shouting “give me the endotracheal tube”, and ultimately being the hero. The reality of an emergency attendant does not live up to Hollywood standards, rather than a hero responding to a mechanism of injury, most 9-1-1 calls are a nature of illness. As a first responder, I am part of something bigger than myself, I am a medical technician that serves the community with a passion. However, in my case, I am the black cloud of pediatric suicides.
From my experience as an Emergency Medical Technician in Colorado Springs, Colorado, the forefront of my daily shifts consist of pediatric suicide attempts and suicidal ideations in the past couple of months. In two months, I have responded to six children attempting suicide or having ideations of committing self-harm with the intent to die. My mind cannot comprehend the thought of why children are suicidal. These children have changed my perspective as a first responder, I realized I am more than a medical attendant to pediatric patients. I am an advocate and an unpaid counselor for these children, they are crying for help and telling the medical community there needs to be a change to decrease the rate of pediatric suicide attempts and ideation.
Mental health is a broad term used for a condition of a person’s psychological and emotional well-being. A child’s psychological state stems from more than just depression and stress, which seems to be a stigma. Other contributing factors that also contribute to adolescents attempting suicide are the COVID-19 pandemic and having special needs, such as autism. Three children that attempted suicide in my six pediatric suicide attempt patients in the past months are autistic. Researchers have conducted many studies based on the age, gender, household, and psychological mental status of adolescents. However, research findings are mixed due to researchers not considering psychiatric vulnerability (Kline 53).
Children are visiting the emergency room at an increasing rate for suicidal ideations. In regards to the increase of child suicidal ideations, The Center for Disease Control and Prevention, a United States federal agency for national public health, conducted a study of emergency room visits by pediatric patients for the year 2019 and compared their findings to the same research for the year 2020, and 2021. The 2019 research found fifty percent of visits were self-harm injuries, sixty percent were mental health disorder visits, and seventy percent of the visits are overdoses, all affecting kids aged twelve to seventeen (Anderson). In comparison to 2019, for children aged twelve to seventeen, visits for self-harm injuries increased in 2020 by 30 visits per week, and 210 visits per week in 2021 (Radhakrishnan). This study proves every year, emergency room visits by children are on a substantial rise and sustain some type of mental health disorder.
Of the six patients I have responded to, three of the children suffer from Autism Spectrum Disorder. Autism is a neurological disorder that affects the development of an individual with the inability to interact and communicate with others. One of the autistic adolescents I responded to was eleven years old, and the child drank half a bottle of bleach with the purpose of killing himself. The patient was nearly non-verbal; however, the child did state why he wanted to commit suicide, and he did state that drinking the bleach was his plan. As I entered the apartment the child was crouched in a corner, multiple law enforcement officers stood throughout the apartment paying no mind to the patient in need, and the mother was telling the police how her finger got cut, which was blamed on the patient. Rather than his mother showing concern for her son, he was left feeling “lonely”, he stated. The patient’s feeling of loneliness was a contributing factor to why he wanted to commit suicide.
Individuals that suffer from autism do feel a sense of loneliness. The Roots of Loneliness Project, an organization whose “mission is to explore the topic of loneliness through high integrity content, and open, and honest discussion published an article exploring the reality of autism loneliness” (Meet the Passionate). Emily Deaton, a writer for the project, wrote and published the article “Autism Loneliness: Why Those on the Spectrum Often Feel Alone”, in her article she interviewed several people that suffer from ASD which was medically reviewed by Christie Hartman, Ph.D., Psychology. Deaton discovered after speaking with various people on the autism spectrum, that their life experiences with loneliness were similar to one another (1). Deaton’s interview with these individuals shows that people with autism are subjected to feelings of loneliness.
At the height of the COVID-19 pandemic, children’s suicide attempts have increased. “Recent studies have reported deterioration in children’s mental health since the start of COVID-19 pandemic in 2020, with an increase in anxiety and mood disorders” (Gramigna). The study analyzed 830 children from the age of fifteen and younger where it found a 116% increase in children’s suicide attempts. The researchers speculated the increase in screen time, sensitivity to mitigation measures, adverse effects of economic conditions, family health, and social media may be the cause of the acceleration of suicidal attempts (Gramigna).
There is no doubt in my mind that a serious issue of pediatric suicide attempts and ideations is on the rise within Colorado Springs and the state of Colorado itself. Am I going to be the changing factor? I most likely will not be, but I can be the advocate the children need and a spark to a politician or the head of children’s psychiatry in the state of Colorado. My experience as an emergency medical technician, it shows that change is needed within the medical community to better assist these children in need. Using education and research, anyone from the level of EMT up to a doctor in psychology can impact the pediatric mental health issue of wanting to commit self-harm. Whether the COVID-19 pandemic or the feeling of loneliness amongst children on the spectrum of autism are factors of pediatric suicides and ideations of suicide, the medical realm can come together and make a difference.
Anderson, Mallory. “Pediatric ER Visits for Mental Health Conditions Have Risen During Pandemic.” KRDO, 21 Feb. 2022. https://krdo.com/news/top-stories/2022/02/21/pediatric-er-visits-for-mental-health-conditions-have-risen-during-pandemic/. Accessed 14 April 2022.
Deaton, Emily. “Autism Loneliness: Why Those on the Spectrum Often Feel Alone.” Roots of Loneliness. https://www.rootsofloneliness.com/autism-loneliness#What_Does_Autistic_Loneliness_Look_Like. Accessed 28 April 2022.
Gramigna, Joe. “Children’s Suicide Attempts Have Increased During COVID-19 Pandemic.” Healio. https://www.healio.com/news/psychiatry/20211013/childrens-suicide-attempts-have-increased-during-covid19-panedmic. Accessed 24 April 2022.
Kline, Emily A., et al. “Association Between Exposure to Suicidal Behaviors and Suicide Attempts Among Adolescents: The Moderating Role of Prior Psychiatric Disorders.” Child Psychiatry & Human Development, vol. 53, no. 2, Apr. 2022, pp. 365-74. EBSCOhost, https://doi.org/10.1007/s10578-021-01129-2. Accessed 25 April 2022.
“Meet the Passionate Team Behind the Roots of Loneliness Project.” Roots of Loneliness. https://www.rootsofloneliness.com/about. Accessed 28 April 2022.
Radhakrishnan L, et al. “Pediatric Emergency Department Visits Before and During the COVID-19 Pandemic — United States, January 2019—January 2022.” MMWR, vol. 71, no. 8, 25 Feb. 2022, pp. 313-18. CDC, https://dx.doi.org/10.15585/mmwr.mm7108e1. Accessed 14 April 2022.