WARNING: This article contains explicit information related to suicide and mental health that may not be suitable for all audience members. Discretion is advised.

A lot more children and teens are going to the hospital with suicidal thoughts and suicide attempts, a new study suggests.

Published in JAMA Pediatrics earlier this week, researchers found these rates had doubled between 2007 and 2015.

Speaking with CNN, Dr. Brett Burstein, lead study author and a pediatric emergency room physician at Montreal Children’s Hospital of McGill University Health Centre, said the numbers were “alarming.”

READ MORE: Immigrant, refugee youth end up in ER for mental health care more than others — study

“It also represents a larger percentage of all pediatric emergency department visits. Where suicidal behaviour among the pediatric population was just two per cent of all visits, that’s now up to 3.5 per cent,” he said.

Story continues below advertisement

Researchers used data from the National Hospital Ambulatory Medical Care Survey in the U.S., and found the average age children were evaluated at was 13. Additionally, 43 per cent of hospital visits were from children between the ages of five and 11.

Mara Grunau, executive director at the Centre for Suicide Prevention (CSP), told Global News it’s hard to pinpoint if the exact same trends are happening in Canada.

“The answer we would like to say is we can just look at the numbers and just read them, but it’s still much more complicated than that,” she said. “The biggest issue in suicide period is stigma. But when it comes to specific groups — and children would top the list — the stigma is significant.”

She added numbers suggest there are more children presenting with suicidal thoughts, but it could be children are just more aware of it.

“What’s really changed? Is it our perspective or is that behaviour? We don’t know.”

Research isn’t always accurate

For decades, mental health advocates have said children have been dying by suicide.

“We published a handbook almost a decade ago that was the first of its kind, and people refused to engage with [it],” she continued. “They said, ‘no, children do not understand the permanency of death and therefore could not understand suicide,'” adding a common narrative was that if children did die, it was always unintentional. Tweet This

Story continues below advertisement

CSP noted there is a low occurrence of suicide among children, but some research suggests suicide is the fourth leading cause of death among children between the ages of 10 and 14. In Canada in 2009, the site added, there were 25 recorded suicidal deaths of children in the same age group.

But Grunau added stats are not always accurate, either, nor do they make up the full picture.

READ MORE: Mom lets children skip school to take a ‘mental-health day’ — is this good parenting?

“We know from teachers, from anecdotal reports from private counsellors and parents that they’ve had kids at risk of suicide who show up in emergency rooms and have been dismissed or discharged,” she said. “It never would have been recorded as suicidal behaviour.”

She said the centre is working with educators, social workers or anyone else who works with children to figure out ways to make these conversations less difficult.

“I can appreciate where the stigma comes from. It’s difficult. I mean, to hear anybody in such despair that they are considering suicide is very difficult, let alone a child,” she continued. Tweet This

“It is difficult to reconcile, but we can’t move forward with the child and we’re not going to acknowledge what is actually going on.”

Story continues below advertisement

Why are these rates increasing?

Dr. Gene Beresin, executive director of The Clay Center for Young Healthy Minds at Massachusetts General Hospital, who was not part of the original study, told CNN stress could be a reason rates are going up.

“Kids are feeling more pressure to achieve, more pressure in school, and are more worried about making a living than in previous years,” he told the site, adding parents and caregivers are also more stressed in general.

READ MORE: From suicide tips on YouTube to the Momo challenge hoax, parents have more to worry about online

“I think in a lot of the stress research, what we’ve seen is what is healthy stress and what’s unhealthy stress,” Grunau said. “If there’s not enough stress, then we don’t develop resilience… we don’t want no stress, but we want a healthy amount so that we’re challenged but not overwhelmed.”

In previous generations, people were more focused on “soldiering on” to avoid being called “weak,” she added, but now people are more likely to speak up.

“I think people are more willing to express the stress and the impact of it… but that’s just that’s just anecdotal.”

Speaking with children

Others have also linked the increase in cyberbullying to an increase in suicides. There have also been cases of suicidal language and discourse being hidden on platforms like YouTube.

Story continues below advertisement

But one thing Grunau stressed is talking about suicide won’t make children more suicidal.

“Suicide is not a subjective behaviour,” she said. “Just talking about suicide does not incite the idea if [the child or teen] is not already at risk.” Tweet This

Parents need to know how to have these conversations with their children, even difficult ones. And if children have questions, there are some ways to talk about suicide. Children will sometimes see something on social media or hear about a story through friends — and they will have questions.

“You have to be persistent and calm about it in different ways to try and maintain that openness and trust, so that they know when things are really bad they’re willing to tell you,” she said. “When they do tell you something, hold it. Don’t jump in on it and don’t judge them, you don’t want to ruin that trusted relationship.”

READ MORE: Staff stretched thin as report says half of UNB students in counselling deal with suicidal thoughts

You should also notice changes in behaviour and ask children about it.

“If you are concerned about your child or anybody, ask them directly,” she said. “‘Hey, I am worried about you,’ or ‘you’re not yourself these days.'”

“If they say ‘yes,’ our tendency is to jump in and say, ‘but you won’t really do it’ or ‘think of your family,'” she said. “Try not to say those things. Try to be empathetic [and] recognize that for them, this is a real option right now.”

Story continues below advertisement

Where to find help

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help. The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues. Tweet This