Rising reports of suicidal behaviors in children and adolescents have led to the recognition of a youth mental health crisis. However, reported rates can be influenced by access to screening and changes in reporting conventions, as well as by changes in social stigma. Using data on all hospital visits in New Jersey from 2008-2019, we investigate two inflection points in adolescent suicide-related visits and show that a rise in 2012 followed changes in screening recommendations, while a sharp rise in 2016-2017 followed changes in the coding of suicidal ideation. Rates of other suicidal behaviors including self-harm, attempted suicides, and completed suicides were essentially flat over this period. These results suggest that underlying suicide-related behaviors among children, while alarmingly high, may not have risen as sharply as reported rates suggest. Hence, researchers should approach reported trends cautiously.

In this paper we investigate the dual role of supply restrictions and drug treatment in combating the concurrent rise of opioid abuse and suicide in the United States over the last two decades. We find that supply-side interventions decrease suicides in places with strong addiction-help networks, implying that prescription drug abuse is associated with an inherent risk of suicide. Our findings support an important role for access to treatment services in policies designed to combat the opioid epidemic.

The continuing drug overdose crisis in the U.S. has highlighted the urgent need for greater access to treatment. This paper examines the impact of openings and closings of substance abuse treatment facilities in New Jersey on emergency room visits for substance abuse issues among nearby residents. We find that drug-related ER visits increase by 16.6% after a facility closure and decrease by 9.5% after an opening. The effects are largest in relatively under-served areas, among Black residents, and among males. They are smaller for the middle aged than for either younger or older people. The results suggest that expanding access to treatment results in significant reductions in morbidity related to drug abuse.