The teen suicide rate had been declining for a decade, so a dramatic increase in 2004 worried experts.

They wondered whether the 18 percent increase in suicides among people younger than 20 was the start of a trend or a short-lived bump in the numbers.

Jeffrey Bridge, a researcher at Nationwide Children's Hospital, took a closer look.

"Our concern is that this may be the emergence of a public-health crisis," Bridge said last month.
What he found were numbers for two consecutive years that were much higher than what would have been expected based on recent history, said Bridge, who works at the hospital's research institute and is an assistant professor at Ohio State University.

The analysis looked at suicide deaths among those 10 to 19 years old and found that there were 326 more deaths than would have been expected in 2004 and 292 more deaths than expected in 2005.

The numbers went down in 2005, but not enough to erase the increase recorded in 2004, Bridge said.

The rate for 2005, the most recent year for which data are available, was 4.49 per 100,000 people in the age group.

Bridge's findings appeared in a research letter published in the Journal of the American Medical Association.

News of the 2004 increase, shared last year by the Centers for Disease Control and Prevention, came after antidepressant use among teens fell following warnings that the medications could, in some cases, increase the chances a young person would commit suicide.

While there was not -- and still is not -- any way to link the climb in suicide deaths to decreased use of antidepressants, the news prompted much speculation that there was a connection.

More research is needed, but Bridge's work should at least prompt heightened awareness of the threat of teen suicide and work to prevent it, said Dr. John Campo, chief of child and adolescent psychiatry and medical director of behavioral health at Nationwide Children's.

"They were able to say that there is less than a 5 percent chance that these numbers that we saw in 2004 and 2005 are really due to chance alone," he said.

"This says, 'You know what folks? Don't feel too satisfied here because this doesn't look like it's just a fluke.'"

Mary Brennen-Hofmann, coordinator of suicide-prevention services at North Central Mental Health Services, said any increase in suicide numbers prompts concern, but cautioned that two years of data don't confirm a trend in the wrong direction.

John Draper, project director of the National Suicide Prevention Lifeline, said that although nobody can be certain what is causing the shift in numbers, they should prompt attention to prevention and a reminder that help is available.


Warning signs

A teen who is thinking about suicide might:
* Talk about suicide or death, "going away" or feelings of hopelessness or guilt
* Pull away from friends or family
* Lose the desire to take part in favorite activities
* Have trouble concentrating or thinking clearly
* Experience changes in eating or sleeping habits
* Exhibit self-destructive behavior such as drinking alcohol, taking drugs or driving too fast
What can parents and others do?
* Watch and listen for warning signs
* Keep the lines of communication open and express concern, support and love
* If a teen doesn't feel comfortable talking with a parent, suggest another relative, clergy member, coach, counselor or doctor
* Ask questions, including asking directly if the teen has thought of suicide
* Get help from a qualified medical professional
* If the teen is in a crisis situation, the local emergency room can conduct an evaluation and refer you to the appropriate resources
* If you've scheduled an appointment with a mental-health professional, keep the appointment, even if the teen says he or she is feeling better
If you are contemplating suicide, or concerned about someone who is, call 614-221-5445 or 1-800-273-8255
Source: Nationwide Children's Hospital