Abstract
Introduction
Although youth mental health concerns intensified during the COVID-19 pandemic, national post-pandemic trends in suicidal thoughts and behaviors remain unclear. This study examined trends in suicidal ideation and suicide planning among adolescents from 2021 to 2024 and identified demographic, substance use, and mental health correlates.Methods
Data were drawn from the 2021-2024 National Survey on Drug Use and Health for adolescents aged 12-17 years (N = 36,372). Weighted prevalence estimates were calculated, and multivariable logistic regression models examined associations between substance use, demographics, and suicidal ideation/planning. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were reported.Results
Suicidal ideation increased from 12.8% in 2021 to 13.2% in 2022 before declining to 11.8% in 2023 and 10.0% in 2024. Suicide planning followed a similar pattern (7.41%, 7.46%, 6.02%, and 5.13%, respectively). Compared with 2021, adjusted models showed no significant differences in suicidal ideation across years, whereas suicide planning was significantly lower in 2024 (AOR = 0.76, 95% CI: 0.61-0.96). Female sex, alcohol, tobacco, and marijuana use were associated with greater odds of both outcomes, while past-year major depressive episode demonstrated the strongest associations (ideation AOR = 20.4; planning AOR = 19.4). Adolescents aged 15-16 years had lower odds than those aged 12-13 years.Conclusions
Persistent disparities in suicidal ideation and planning highlight the continued need for targeted prevention and early intervention efforts.