The suicide rate for Colorado’s older children and teens last year reached its lowest level in nearly two decades, with fewer than half as many youth taking their own lives as at the worst point, in 2020.
In May 2021, at the height of a pandemic that killed thousands of Coloradans and disrupted everything from school to sleepovers, and other health leaders rang the alarm about a youth mental health emergency in the state.
Four years later, that the number of youth mental health visits has largely plateaued around pre-pandemic levels, which it described as “already concerning.”
The most recent state data shows suicide rates and self-reported distress among teenagers are down from their pandemic highs — and, in some cases, lower than they had been for more than a decade. Experts attributed that to the combination of a generation uniquely open to discussing mental health, evidence-based prevention programs and efforts to catch people at risk of self-harm when they show up in hospitals.
But providers say too many young people still aren’t getting help until their problems are severe, and some early indicators suggest the mental health of Colorado’s younger population could be taking another turn for the worse.
Last year, 39 kids between 10 and 18 died by suicide, a rate of 5.85 deaths per 100,000 youth — a significant drop from 2020, when 87 preteens and teenagers took their own lives, at a rate of 12.91 deaths per 100,000 youth, according to the .
After adjusting for population growth, the last time the suicide rate was lower was in 2007.
Suicide rates for youth also are down nationwide, as are self-reports of suicidal thoughts and attempts, .
The data marked one of the first reversals after more than a decade of increasing despair. From , the rate of students nationwide reporting suicidal thoughts or making a plan to die increased about 2.9% every two years, and self-reported attempts increased about 2.2% every two years.
The lower suicide rate is encouraging, but adults shouldn’t assume everyone is fine and forget about youth mental health, said Eddie Chen, a senior at and leader of the community action team with the . The group focuses on raising awareness and reducing stigma in Colorado.
“I definitely think people are doing better, but that doesn’t mean we’re not in a state of emergency,” he said.
While most of the signs are positive, a few clouds remain on the horizon: emergency room visits for mental health and substance use concerns are up this summer at Children’s Hospital Colorado.
Preventing suicide deaths is a major accomplishment, but the challenge now is connecting young people to the help they need not only to survive, but to have healthy, thriving lives, said Zach Zaslow, vice president of advocacy and community health at Children’s.
“We’re keeping kids alive… but we’re also seeing deeper mental health struggles,” he said.
Mental health crisis dates to early 2000s
Arguably, Colorado’s youth mental health emergency really began in 2008, when providers started noticing a pattern of young people increasingly suffering from anxiety, depression, substance use and other behavioral health conditions, said Dr. Jessica Hawks, a child and adolescent psychologist at Children’s.
While studies haven’t proven any one factor caused worsening mental health, the timeline coincides with increased market penetration of smartphones and social media, and with more kids reporting poor sleep, she said.
Broadly defined, about one in five young people has a mental health concern, including certain behavioral and learning disorders, said Dr. K. Ron-Li Liaw, chief of mental health at Children’s. Of that group, about half get some type of treatment, and only about 20% get high-quality treatment, she said.
Still, the .
In 2023, high school students in Colorado were more likely to report their stress levels were manageable and less likely to report persistent sadness or thoughts of suicide than they were in 2021. Middle school students reported their stress levels were unchanged, but fewer said they had persistent sadness or thoughts of suicide.
No one factor explains the change, but young people are more willing to talk about their mental health than in the past, which is a “silver lining” of the pandemic, as is the increased availability of telehealth therapy, Liaw said.
Requiring all hospitals to screen Medicaid patients for suicide risk was also an important improvement, because it likely caught people who otherwise wouldn’t have sought help for thoughts of dying, Liaw said. But it only helps if hospitals can handle the volume of patients who need resources, she said.
About 10% of patients at Children’s screen positive for thoughts of suicide.
“That’s an enormous lift” for providers to respond to each one, Liaw said.
The state health department attributed “much of” the reduction in suicide deaths to efforts focused on mental health and suicide prevention, including:
- The , which offers free therapy sessions to teens
- , a curriculum that some schools use to build students’ resilience
- The , which offers suicide prevention and safe storage information
- The , which pays for therapy for youth at risk of suicide
- The , which has a crisis specialist regularly call people discharged after a mental health emergency
“One youth suicide is too many, but the decrease in youth suicide in 2024 is promising,” Lena Heilmann, director of the state health department’s Office of Suicide Prevention, said in a news release. “We hope to build on this progress as kids head back to school, where they will have more opportunities to connect with a broader network of caring adults and their peers.”
Colorado was able to make progress because it put one-third of the pandemic relief funds dedicated to mental health toward children and teens, Zaslow said. Setting up the and allowing Medicaid to pay for the behind-the-scenes work of coordinating patients’ mental health care will help improve the system, he said.
Two bills passed during the last legislative session, which and , should benefit youth mental health over time, Zaslow said.
More mental health providers needed
Despite the progress, Colorado needs more mental health providers, particularly those willing to take insurance, Hawks said. Kids commonly face a six-month wait for outpatient mental health care, which people would never accept for kids with physical health needs, she said.
Colorado needs to invest in resources such as residential treatment facilities that can bridge the gap after a crisis, or serve kids who need more than outpatient care but haven’t yet gotten sick enough to be hospitalized, Liaw said.
Ideally, the state would also do more to protect children from the negative effects of electronic devices and social media, Liaw said. The research on how technology affects young brains hasn’t caught up with the ever-evolving platforms that youth use, but parents and providers can reasonably assume that a constant stream of often-stressful information is going to be harmful to some kids, she said.
Districts and schools vary in how they approach cellphones, with some banning them during the school day in the name of protecting students’ mental health, and others leaving it up to individual teachers to police phone use during class.
Adults need more education about how to talk to young people about using social media safely, and about how to have a relationship where kids are comfortable talking to them, Chen said. If parents can avoid getting upset over smaller things, that increases the odds their kids will talk to them if something is seriously wrong, he said.
Signs of worsening mental health
Liaw said she worries that youth mental health may be worsening again, as Colorado is contemplating state budget cuts and the federal government is restricting support for families via Medicaid and food assistance.
Emergency room visits for mental health and substance use crises at Children’s are up 26% for June and July compared to the same time in 2024, even though crises typically abate when kids aren’t dealing with the stress of school, she said.
“Usually it’s a pretty sleepy time in the summer,” she said.
The number of days that kids spend in the hospital for behavioral health reasons is also up 90% in the first seven months of this year compared to the same period in 2024, Liaw said.
She attributed that to a combination of more patients needing care for mental health or addiction problems, and to longer stays when the hospital can’t find appropriate placements for kids who don’t need to be there, but aren’t ready to go home, she said.
Zaslow likened the situation to hiking a 14er for a few hours. Depending on which way you look, you could be impressed by how far you’ve come — or overwhelmed by what lies ahead.
“It is a long climb to make things better,” he said.
