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Study: 40% of Kids Who Attempt Suicide First Try in Elementary or Middle School

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Almost 40% of kids attempting suicide make their first try in middle or even elementary school, according to research that suggests that kids who think they want to kill themselves are considering it long before previously assumed.

About 1 in 9 children have attempted suicide before their high school graduation, but learning that they’re making plans as early as elementary school is especially chilling.

In a study published in the November issue of the Journal of Adolescent Health, researchers at the University of Washington surveyed 883 young adults ages 18 or 19 about previous suicide attempts and learned that 78 — close to 9% — had tried to commit suicide.

Suicide attempt rates rose steeply at age 12 — around sixth grade — and peaked two to three years later. The 39 teens who said they had tried to commit suicide multiple times reported first attempting when they were as young as 9, which is the average age of a third-grader. Teens who said they had tried just once were more likely to have attempted suicide later, in high school.

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The startling findings came about almost accidentally. The point of the research was to decide whether asking teens to recall previous suicide attempts was a reliable way of gathering data; in the process, researchers discovered that children were attempting suicide much earlier than they had thought.

The teens who participated had been asked previously, since they were in first and second grade, about their levels of depression and anxiety but not about suicidal behavior. To verify that their suicide attempt recollections were accurate, researchers compared the self-reported results with the children’s depression scores in the year that they first attempted suicide. “We found a significant bump,” says Jim Mazza, lead author and a professor of educational psychology at the University of Washington.

Kids who try to commit suicide have traditionally been assumed to be high schoolers, but indications that a significant proportion are considerably younger raises questions about how and when to target preventive efforts. “All high schools are supposed to have suicide prevention programs, but this suggests to us that assessing kids’ mental health in younger years is advisable.”

What that might mean is scheduling suicide prevention programs not only for high schools but also for middle schools and even elementary schools, as well as opening lines of communication between students and mental-health professionals. “We should be asking children in a more comprehensive way about their mental health,” says Mazza. “We should be providing kids with the ability to tell adults that they are not doing well, and we should be doing that in third, fourth, fifth grade.”

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Schools conduct academic testing all the time; Mazza says mental-health testing is just as critical. “My belief as a school psychologist is education does not equal just academics,” he says.

Coping strategies and decision-making skills should be emphasized and honed, he says, or a worst-case scenario may follow, particularly since children seem to be under more pressure to succeed than they were a generation ago.

Bonnie Rochman is a reporter at TIME. Find her on Twitter at @brochman. You can also continue the discussion on TIME‘s Facebook page and on Twitter at @TIME.