Serious suicidal thoughts, suicide plans, and mental health service use among youth during the COVID-19 pandemic

Using the 2021 U.S. National Survey on Drug Use and Health youth sample (N = 10,702, ages 12 -17), we examined the prevalence and corelates of serious suicidal thoughts (SST) and of suicide plans and mental health service use among those with SST during the COVID-19 pandemic. Of all youth, 12.8 % reported SST and 16.7 % were unsure or refused to answer the SST question. The latter youth were more similar to those with than without SST in mental health status. Of youth with SST, 43.1 % made suicide plans and 56.6 % used any mental health services. Multivariable analysis showed that clinical factors (major depressive disorder, substance use disorder, self-perceived negative mental health effects of the COVID-19 pandemic), female sex, and nonmetropolitan residence were associated with higher likelihood of SST. Positive home and school experiences were associated with a lower likelihood of SST and suicide plans, but higher likelihood of any mental health service use among those with SST. Black and Hispanic youth and youth in small metropolitan areas were significantly less likely to have used any mental health services. Our findings have important implications for improving access to mental health services for youth with SST, especially minoritized youth and those in nonmetropolitan areas.