Suicide Among Southeast Michigan’s Youth: A Health Crisis Call to Action

by Stephen Modell, M.D. and Sarah Hartzell, Ph.D.

Youth suicide prevention in Southeast Michigan and nationally has, this last year, experienced fits and starts. In October 2024, Superior Township leadership voted its final approval for a residential center conceived by Garrett’s Space for youth struggling with suicide and suicidal thoughts. In contrast, the proposed 44 percent reduction in funding to the Centers for Disease Control and Prevention could obliterate research into implementation and evaluation of suicide prevention strategies. The Trump administration’s plan to eliminate the 988 Suicide Prevention and Crisis Lifeline’s connection for LGBTQ+ individuals could have imperiling effects. Suicide completion rates in those 25 and under living in Washtenaw County increased 88 percent between 2020 and 2022, surpassing state figures. Preliminary numbers being tracked show a possible reversal in 2023; this momentum needs to be maintained, not reversed.

Peering deeper into this youth public health scourge, the age-adjusted suicide death rate is highest among Native Americans and non-Hispanic whites, and climbing in African American youth. The suicide rate in Michigan for African Americans climbed from 5.7 deaths per 100,000 in 2017 to 9.1 in 2020. In 2022 Michigan saw 67 deaths by suicide among 15 to 19-year-olds and 12 deaths in 10 to 14-year-olds. It is the 2^nd leading cause of death in the latter, and 3^rd in the former age group. Yet, suicide is considered one of the most preventable public health crises. Major causes, such as firearm use in males and poisoning in females, are addressable. Sensitivity is required since rural families, the disabled, and members of the LGBTQ community are disproportionately affected.

A policy review published by researchers at New York and Columbia Universities in the December 2024 issue of the Annual Review of Public Health found that “social determinants of health,” nonmedical factors influencing health outcomes, play a role. It showed that the inclusion of sexual orientation protections in state hate crime laws was associated with a 1.2 percent decrease in high school student-reported suicide attempts.

In terms of income, Medicaid expansion, which enables health care coverage for families up to 138 percent of the federal poverty level, has been found to increase the number of Medicaid-supported mental health admissions for those 18 and up, an observation that has been weakly correlated with decreased suicide rates for multiple racial-ethnic groups. The simple provision of free meals to students through the government’s Supplemental Nutrition Assistance Program (SNAP) has led to a calculable decrease in lives that would otherwise be lost to suicide.

Society can also act to deter suicide attempts by removing access to lethal means. A 2024 article in JAMA Pediatrics indicated that by 2022, firearms were the leading cause of child and teen deaths in 25 states, including Michigan. In our state, 95 children and teenagers die each year from gunshot wounds, about 39 percent by suicide. The homestead is the most frequent site. As in the Oxford shooting, three-quarters of school shooters acquire their guns from home.

As discussed in the 2024 Ann Arbor Osher course on gun violence, supposed liberal countries such a Switzerland are models of mandated action we can follow in the form of gun licenses and storage requirements. Policies that restrict youth access to another lethal means, medications, are also important. Short of legislation, residents can take meaningful action. Steps involve purchasing safe storage products and following proven safe storage methods, often with the advice of knowledgeable community leaders, including law enforcement.

Texas’s recent practice of allowing ammunition in grocery vending machines is neither advisable nor emulable here in Michigan since it introduces safety concerns and could normalize gun use.

School programs emphasizing awareness-raising interactions between students have proven especially effective. As discussed at the 2025 Kevin’s Song Conference on Suicide in Livonia, Michigan has exemplary peer-to-peer student training and advocacy activity programs. Examples include Redford’s Hope Squad, Oakland’s “Here for You,” and Grosse Pointe’s community/university-linked programs. School mental health workers, school nurses, teachers, and public health professionals can work together to establish effective school-based youth suicide prevention programs.

What can the individual do? Vote your conscience for legislators who favor funding for suicide prevention programs and research. Follow organizations including the American Public Health Association (APHA; https://apha.org/policies-and-advocacy/advocacy-for-public-health/action-alerts) and the National Alliance on Mental Illness (NAMI; https://nami.quorum.us/AdvocacyAlerts) for relevant action alerts. An APHA Action Alert exists now to oppose federal Medicaid cuts, Medicaid being essential for mental health services in underserved youth of all backgrounds. Take a course on gun safety, and judiciously discuss gun safety with your son or daughter.

Teachers can undergo preparedness training; the United Educators website (https://www.ue.org/risk-management/health-and-well-being/suicide-prevention-training) is a useful starting place. Parents and school personnel can learn the suicide warning signs and helpful actions through the Suicide Prevention Resource Center, healthychildren.org, and Michigan.gov OK2SAY websites. The 988 Suicide and Crisis Lifeline and 1 (800) 273-TALK National Suicide Prevention Lifeline are always available but need advocacy; contact your legislator on the value of preserving the LGBTQ+ youth network.

As parents and concerned community members, we must fight resignation to what might feel like a new norm by ensuring an enduring right to life for our children and teenagers.

Co-authors:

Stephen Modell, M.D. is a Research and Dissemination Activities Director in the Department of Epidemiology, University of Michigan School of Public Health, and former Action Board Chair of the American Public Health Association (APHA). Sarah Hartzell, Ph.D. is the Regional Coordinator for BeHERE NV, an initiative working to build the behavioral health workforce in Nevada. Her Ph.D. dissertation examined whether COVID-19 stay-at-home orders impacted new behavioral health diagnoses and suicide attempts in the United States. The authors work together in APHA’s School Health and Wellness section.