Study tracks Texas youths being treated for depression

Nearly half of Texas youths being treated for depression or suicidal thoughts reported at least one suicide attempt, and 90% had experienced suicidal ideation, according to a study led by UT Southwestern Medical Center researchers. The findings, published in the journal Suicide and Life-Threatening Behavior, represent the data from a registry established in 2020 by the Texas Youth Depression and Suicide Research Network (TX-YDSRN).

The study offers baseline data on nearly 1,000 participants collected during the COVID-19 pandemic, when mental health issues spiked among school-age children and teens. TX-YDSRN is a research initiative funded by the 86th Texas Legislature as part of the Texas Child Mental Health Care Consortium (TCMHCC) that was created to improve the evaluation of and response to the increase in youth depression and suicide.

UT Southwestern serves as the network's coordinating hub and source of research oversight and training under the direction of Madhukar Trivedi, M.D.

"Given that youth depression and suicide are increasing nationally and that Texas ranks very low on access to mental health care, these findings give us an idea of the scope of the challenge. The study will also provide a road map to improve care for depression and suicide in youths across Texas," said Beth D. Kennard, Psy.D., Professor of Psychiatry and member of UT Southwestern's Peter O'Donnell Jr. Brain Institute and Peter O'Donnell Jr. School of Public Health.

For the past decade, deaths by suicide, rates of suicide attempts, and suicidal ideation have increased among young people. A 2023 report from the Youth Risk Behavior Survey of ninth-12th graders in the U.S., who responded in 2019 and 2021, found that 14.3% of males and 30% of females reported having seriously considered suicide within the previous 12 months.

The UTSW-led study included data on a diverse population of 8- to 20-year-olds receiving care in a participating clinic who screened positive for depression and/or suicidal ideation or behavior. Researchers found that they had moderate to severe depression and anxiety. Those who had attempted suicide or had suicidal ideation had more severe mental illness, poorer school adjustment and social connectedness, lower resilience, and higher rates of trauma exposure than those without suicidality, data showed.

"The study remarkably showed that close to half of this sample reported at least one prior suicide attempt and many were experiencing significant suicidal intent," said Dr. Trivedi, who is a Professor of Psychiatry, Chief of the Mood Disorders Division, and founding Director of the Center for Depression Research and Clinical Care (CDRC) at UTSW.

"There is an urgent need for prevention and intervention strategies for suicidal ideation and behavior in youths. These findings highlight important demographic and clinical correlates, which can inform future efforts for more targeted treatments," added Dr. Kennard, who is also Director of the Suicide Prevention and Resilience program at Children's Health.

Those who had attempted suicide had higher levels of substance abuse (34.4%) compared with those with ideation (16%) and those with neither attempts nor ideation (10.7%).

As part of TX-YDSRN, UTSW has connected youths in need of mental health services to clinicians while also providing learning opportunities for practitioners and others in research methods and assessment practices. The longitudinal project will follow participants for two years to identify risk factors, best practices, and contributors to health disparities.

"This project has an incredible opportunity to not only help us better understand the current state of depression and suicidal symptoms in our Texas youths but also to lead us to solutions to improve treatments," Dr. Trivedi said. "Currently, only about one-third of youths improve with the first depression treatment they receive. Through this project and the engagement of the psychiatry experts at all 12 academic medical centers in Texas, we will find better solutions to reduce depression and suicide in our children."