Deaths of despair are, by definition, middle-aged adults who have died from suicide or drug and alcohol poisoning.
New data just published in the Journal of the American Medical Association shows that children of parents who suffered deaths of despair have nearly double the risk for suicide or self-harm.
Deaths of despair is a term that was coined approximately a decade ago and unfortunately gained traction during the Covid pandemic. It describes a phenomenon that spans at least two decades. Deaths of despair are, by definition, middle-aged adults who have died from suicide or drug and alcohol poisoning. These types of deaths were highlighted in 2015 by researchers who were tracking a significant increase in deaths of individuals 45-54 years of age, who died in mental health and/or addictive crises. The number of deaths tracked showed such a spike that there were statistically significant drops in life expectancy across the general population.
Well-known deaths of despair include the singer Prince, Whitney Houston, as well as Anthony Bourdain, Heath Ledger, and Carrie Fisher; all of these individuals had well-known struggles with mental health problems and substance use issues. There have been thousands more deaths that were not celebrities and have caused untold grief to families left behind. The Covid pandemic acted as a catalyst and magnified these deaths with the added impact of social isolation, financial stress, and overall uncertainty.
As an addiction psychiatrist, I saw this phenomenon first-hand; so many people lost jobs, families. and loved ones through the pandemic. I treated patients who had built strong recovery programs that were derailed by Covid, the stress of sudden unemployment, financial insecurity, and severe disruption to in-person medical care. This often led to relapse and a spiral of mental health problems. Overdose rates spiked through Covid as well, reaching the highest level of overdose deaths ever recorded, over 100,000 during 2020-2022. After the worst part of Covid and the many deaths we have seen, there has been some improvement and hope. In Duval County, Florida, for example, overdose rates have dropped by approximately 30 percent due to new programs developed in the community to educate, treat, and support people who have mental health and/or addiction problems.
Therefore, it is important to highlight some of the newest research out now that shows a concerning trend. According to surveys done yearly, adolescent suicide rates have increased by 60 percent between 2007 and 2020. Even self-harm events, defined as a non-suicidal injury, usually cutting or burning oneself, but not to take one’s life, have spiked in our teens. There are several factors at play here, but one in particular warrants attention based on a recent study published.
Researchers have recently discovered that children ages 8-15, who had parents and caregivers who died from deaths of despair, have higher rates of suicide and self-harm compared with their peers. Girls, in particular, were more affected at younger ages, 8-11. If a teen lost one parent to a death of despair, their risk of a suicide event was nearly double, and with two parents, this risk went even higher. Losing a mother to a death of despair carried a greater negative risk for children and teens.
The overall number of children who have lost parents to drug overdose deaths reached a staggering number, 300,000, over the last 10 years and through Covid. These children and teens are often also exposed to neglect, abuse, or violence in the home; they may have lost a parent to the criminal justice system and have a higher risk of being exposed to drugs at a very early age. Genetics play a role as well, as researchers found children who were adopted still had higher risks if their biological parents were victims of deaths of despair.
These are grim facts, but important to know and be aware of them. What should we do to address them? Doesn’t our next generation deserve better?
Here are some key intervention recommendations based on recent data:
- Increased access to care for parents and caregivers with mental health and addiction problems. Improving care for the parents can improve the lives of the whole family and reduce the risks of deaths of despair. We have seen this in local and state communities, where grants from opioid settlements have funded access to programs for prevention and treatment of substance use and mental health disorders.
- Early screening and interventions for children and teens who are at risk for their own mental health and addictive disorders. There are great initiatives already available that can be implemented in schools and pediatrician offices more widely. The researchers in the recent study cite the Fast Track intervention as one program that targets behaviors and risk factors in children in order to reduce risks for developing substance use and mental health problems in adolescence.
- Treating sleep issues for children and teens. Quality of sleep is so important and our modern world makes this a lot harder for all of us. Children and teens need special attention in this area, as their brains are still under construction. Parents can help with modeling good sleep hygiene practices and helping their children do the same. Some of the basics are limiting digital media, engaging in regular exercise, and sticking to routines for bedtime.4. Monitoring and reducing screen use and social media exposure. In previous columns, I have written on the risks of social media on young minds and the benefits of in-person play and active parental involvement in children and teens. Meta, parent company of Facebook and Instagram, has just this week released new parental controls for teens and children that limit exposure to potentially harmful elements on social media sites.5. Be as involved as a parent or caregiver can in their children’s and teens’ lives. Know their friends, eat dinner together, spend quality time together. Research has continually shown time and interest shown in a child’s life can be a protective factor against emotional and substance disorders.
Ultimately, we have to address these issues. Our children and teens deserve the best care and attention we can give them.
