Repeated childhood trauma does cruel things to children. Things that never go away. Those things (often violent behaviors/thoughts/self-harm/suicide) can be managed with help.

Without help, depression, pain and sadness often become overwhelming.


One in five children between ages 10-18 engage in intentional

self-harm activities like cutting, burning or hitting themselves.

In a study of hospital presentations for self-harm in England, 39% of the 387 children
aged 5-12 years old were aged 5-11 years.61.5% of these children had self-poisoned, with
50.6% ingesting painkillers.. 45% of those who self-injured had cut or stabbed
themselves, while 28.9% used hanging or asphyxiation methods

● Suicide is the 8th leading cause of death among children aged 5-11 years in the United

Suicide rates among children aged 10-14 years

have nearly tripled between 2007 and 2017 in the U.S.

● Most child suicides (95.5%) occurred at home,

often in the child’s bedroom (65.6%)

Hanging/suffocation (78.4%) and firearms (18.7%,

often unsecured guns at home) were
the most common methods.

Linking Child Abuse and Suicide
● Children who experienced sexual abuse were 3 times more likely to attempt suicide
compared to those who did not experience abuse.

● “…Nearly 5% of children who had experienced child abuse attempted suicide in the 10
years after their admission, and more than 36% of patients had a record of repeated
suicide attempt in the 20 years after the initial admission.”

Child Protective Services
● CPS agencies received an estimated 3,987,000 referrals involving approximately 7.18
million children in 2021, a rate of 27.6 referrals per 1,000 children.

● Among children first investigated for neglect as infants,

around 80% had at least one

subsequent CPS referral by age 18.

It is repeated childhood trauma that bring children into Child Protection. Usually over years. Most abuse is never seen or reported. The  oldest child generally suffers four years of abuse and trauma before CPS is involved.

Even when reported, CPS is overwhelmed in most states and too often unable to provide the resources a child needs to heal and build the skills they need to live a full life.

Many children go to their grave without ever

having told anyone about their abuse.

Children involved in the CPS system need and deserve mental health evaluation and services. They have suffered extended exposure to violence and deprivation (or they would not be in Child Protective Services).

Helping children heal from repeated trauma and abuse while still young is more kind and effective than waiting for damaging behaviors to surface and cause serious problems that hurt them and people around them.

Many states and communities do not test for ACEs when children are removed from their homes and placed into CPS. There is no federal mandate to do so. The ACEs testing is simple and painless. Compiling this information would have lasting value to the child, CPS system, and the community. Suicide has been a leading cause of death for children 10-14 for many years.

ACEs testing is an easy and inexpensive way to evaluate the mental health needs of abused and neglected children entering the scary Court Child Protection System. If this data were used for the child it would help both the child and the institution by knowing the depth and scope of the mental health issues being dealt with.

There needs to be more awareness about the mental health issues of children being referred to CPS. Without more data from CPS about the numbers of children living with ACES we will never know the needs of most at risk children.

CPS knows but rarely shares data critical to understanding so much of what is impacting our communities today.  It can’t be reported to the news, because the information isn’t there. We all suffer because of this.

KARA reports on the issues of invisible children

This article submitted by Former CASA Guardian Ad Litem volunteer Mike Tikkanen

Signup For KARA’s FREE Friday Morning Updates

All Adults Are the Protectors of All Children


“What we do to our children, they will do to our society”

(Pliny the Elder, 2000 years ago)

Less is not more in keeping children safe.

Please share this with your State Rep

and let them know you support

at risk children in your community.

Find your State Rep here.

and share this with people in your circles.

Read the JAMA report below about 

Children/Adolescents With Suicidal Ideation

and the Emergency it is today:

From JAMA:Despite being preventable, suicide remains the second-leading cause of death for children and adolescents in the US.1 Up to 80% of children and adolescents who die by suicide interfaced with the health care system in the year prior to their death,2 indicating an opportunity for improved risk recognition and intervention. In October 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a national emergency in child and adolescent mental health, because existing severe mental health challenges among children and adolescents worsened during the COVID-19 pandemic. Pediatric mental health clinicians and treatment facilities are critically overburdened, delaying access and resulting in increased emergency department (ED) use for mental health concerns.”

Also from the JAMA article: Pediatric emergency medicine clinicians have witnessed the worsening public health epidemic of mental illness in children and adolescents. Over the past decade, pediatric ED visits for mental health have disproportionately increased relative to non–mental health emergencies.3 ED clinicians frequently manage previously unrecognized mental health disorders, self-harm behaviors, nonfatal ingestions, and suicide attempts among children and adolescents.

Suturing self-inflicted lacerations, providing chemical restraint for acute agitation, and engaging these patients with suicidal ideations in safety planning have become common practice in the ED.


However, despite an increasing referral base from health care clinics, mental health crisis centers, schools, and community-based services, ED clinicians and staff lack formal training in the management of mental and behavioral health crises and are insufficiently skilled in suicide risk recognition and safety planning. This results in an increasing number of children and adolescents experiencing extended boarding times in the ED while awaiting evaluation and disposition planning by a licensed mental health clinician. The role of ED clinicians is currently to stabilize and determine disposition of patients with mental illness. The system is completely encumbered by the limitations ED clinicians face in offering equitable, competent, timely, community-informed, and individually focused care for children and adolescents with unmet mental and behavioral health needs.

Student Interns Hannah Rabinovitz and Analize Monson from Baypath University contributed to this article