Very Young Children, Suicide, and Abuse: What We, CPS, and Lawmakers Must Do

Trigger warning. This is a tragic topic written plainly.

Years of working with abused and neglected children in Child Protective services have made it clear to me that many if not most of the children in my caseload self-harmed. Several of them tried multiple times to kill themselves. A six year old girl (not in my caseload but in CPS and living near me) did successfully hang herself. A 12 year old boy in my caseload told me how he was going to die by making a policeman shoot him. He tried to kill himself a number of times while in my care

In my experience, almost none of the self-harm or suicidal behavior in CPS is ever made public. Few people know the depth and scope of the suffering and violence these children experience or how badly they don’t want to be here.

Hospitals and researchers are seeing a disturbing trend: suicide and self‑harm are rising among very young children, including those in elementary school. Children ages 5–11—who should be worried about spelling tests and soccer games—are instead showing up in emergency rooms after suicide attempts or deliberate self‑harm.

Behind most of these cases is a familiar story:

child abuse, neglect, and other profound trauma that children should never have to endure.

What we know about suicide in very young children

National research on children ages 5–11 has found that:

• Suicide is now the eighth leading cause of death among U.S. children 5–11.

• In a national study of child suicides ages 5–11, suspected or confirmed child abuse and neglect were present in 27.1% of cases, and 40.6% of children had experienced multiple traumatic events, including exposure to domestic violence and the death of a family member.

• Suicide in young children is “most often associated with mental health concerns, prior suicidal behavior, and trauma—including abuse, neglect or exposure to domestic violence.”

• Children’s hospitals report that suicide and self‑injury are now the most common mental‑health conditions seen in pediatric emergency departments, and ED visits for suicide and self‑injury among ages 5–18 increased 168.6% between 2016 and 2021.

• Across all age groups, CDC data show that suicide is now the second leading cause of death for youth 10–14 in the U.S., meaning this crisis reaches down into the youngest adolescents.

Even when suicide is not the outcome, self‑harm behaviors—cutting, head‑banging, ligatures, and other forms of hurting themselves—are appearing in children still in elementary school. A national ER study found that self‑harm visits for children 11–12 increased by 94% over the study period, signaling that serious self‑harm is moving into younger ages. Clinicians report that these children often carry a heavy burden of family conflict, maltreatment, developmental challenges, and untreated mental‑health problems.

This is not “teen angst.” It is a symptom of deep, chronic harm in the lives of very young children.

The link to child abuse and neglect

Child abuse and neglect are not just “risk factors” on a long list. For many children who attempt or die by suicide at very young ages, maltreatment is the central part of their story.

Trauma from abuse and neglect can:

• Teach children that they are worthless, unlovable, and powerless.

• Fill their daily lives with fear, shame, and confusion.

• Disrupt brain development and stress responses in ways that make impulse control and emotion regulation harder.

• Layer additional burdens such as poverty, racism, and family violence on top of everything else.

In the U.S. study of suicides among children 5–11, domestic violence, parental substance abuse, and family histories of psychological problems or suicide were documented in around 40% of cases, painting a picture of children living in highly unsafe and unstable homes. CDC also lists child abuse, neglect, and other adverse childhood experiences (ACEs) as major contributors to suicide risk across the lifespan.

When systems fail to identify and respond early, these children arrive in emergency rooms and child protection systems only after many opportunities to help have been missed.

Where child protection systems are falling short

Child Protection Services (CPS) is often the only public system with eyes on the most abused and neglected children. Yet too often:

• Reports are screened out without comprehensive review of a child’s full history, despite evidence that repeated trauma and prior suicidal behavior are common in young child suicides.

• Social workers are overloaded and lack access to integrated, child‑outcome data that could flag high‑risk, high‑trauma cases, even as hospitals document steep increases in self‑harm and suicidality among preteens.

• Mental‑health support for very young children is fragmented or unavailable, especially for those in foster care or unstable homes, despite strong evidence that early trauma‑focused treatment can reduce long‑term suicidality.

• Agencies rely on privacy laws and internal policies as reasons not to share de‑identified information about child outcomes with the public, advocates, or lawmakers—even though aggregate data on suicide, self‑harm, and maltreatment are routinely published at the national level.

When CPS is under‑resourced, under‑transparent, and forced to operate in crisis mode, it is not surprising that children with deep trauma—including abuse and neglect—slip through the cracks until they are in life‑threatening distress.

What CPS can do to help reverse these trends

Front‑line social workers did not create these conditions, but they can be supported to respond differently. Child protection agencies can:

• Use data to flag high‑risk cases early.
  Build and use tools that combine prior reports, substantiated maltreatment, exposure to violence, repeated mental‑health crises, and prior self‑harm to identify children at highest risk for suicide and self‑harm.

• Embed mental‑health expertise for children under 12.
  Ensure every CPS office has access to child mental‑health specialists trained in trauma, self‑harm, and suicidality in young children—and make consultation part of standard practice for high‑risk cases.

• Require full family‑history reviews.
  Prohibit screening or closing cases without checking the complete history of reports, placements, school suspensions, ER visits, and prior self‑harm or suicide attempts, reflecting what research shows about cumulative trauma in young child suicides.

• Support social workers’ mental health.
  Provide regular supervision focused on trauma, secondary traumatic stress support, and realistic caseloads so workers can spend time with children instead of just checking boxes.

• Partner with schools, pediatricians, and community programs.
  Create clear pathways for teachers, school social workers, and doctors to share concerns about self‑harm and suicidality in young children, and to receive feedback when they report.

What lawmakers and policymakers must change

Legislators set the rules and funding levels that determine whether CPS can do this work well. They can:

• Fund early, trauma‑focused mental‑health care for children under 12.
  Increase access to evidence‑based therapies for traumatized children, including those still living at home, not just those already in foster care, in line with national recommendations for addressing the youth mental‑health crisis.

• Require transparent, child‑outcome reporting.
  Mandate that CPS and related agencies publish de‑identified data on child deaths, suicide attempts, self‑harm, repeated maltreatment, and service involvement—broken down by age, race, county, and placement type, similar to how CDC and other federal agencies report suicide data.

• Stop using privacy as a shield.
  Clarify in statute and policy that privacy laws do not prevent agencies from sharing aggregate, non‑identifying data about child safety, mental health, and system performance.

• Tie policy decisions to child outcomes.
  Require that new laws, pilot programs, and system reforms be evaluated based on their impact on concrete child outcomes—such as reduced repeat maltreatment, fewer suicide attempts, and improved school stability for abused and neglected children.

• Invest in workforce and caseload reform.
  Set caseload standards, fund realistic staffing levels, and support training on trauma, self‑harm, and suicidality in young children so that national trends do not continue to worsen unchecked.

What communities and advocates can do

Very young children cannot call a legislator, write an op‑ed, or testify in a hearing.

They depend on adults to do that for them.

You can help by:

• Sharing KARA’s reporting with friends, on social media, and with your state and county representatives.

• Becoming Trauma Informed

• Asking your lawmakers what data your state collects and publishes about self‑harm and suicide among children involved with CPS.

• Supporting organizations that provide trauma‑informed services for abused and neglected children and that push for transparency and reform in child protection.

All adults are the protectors of all children. Very young children who are self‑harming or thinking about suicide are telling us, in the most painful way possible, that the systems meant to protect them are not working.

It is our job—social workers, policymakers, and community members together—to listen and to act.

Take a Deeper Dive in the Read More Below:

 

KIDS AT RISK ACTION / KARA / INVISIBLE CHILDREN

• Nationally: About 2 million adolescents and children attempt suicide each year in the U.S.5

• U.S. hospitals have reported a 166% increase in emergency visits for suicide attempts and self-injury among children ages 5–18 between 2016 and 20228.
• There is almost no reporting to be found about very young children attempting or committing suicide.

• 2021 Youth Risk Behavior Survey:

  • 22% of high school students seriously considered suicide in the past year

  • 10% actually attempted suicide in the past year

• Most recent Minnesota suicide metrics (2020 latest complete year):

  • More than 10,000 non-fatal self-harm injuries (which includes suicide attempts) were treated in hospitals across Minnesota7. For every suicide death, there were about 13 hospital-treated self-harm injuries. Females accounted for approximately 65% of all non-fatal self-harm injuries treated in hospitals7.

  • 5200 of these hospital-treated self-harm injuries occurred in patients aged 10 to 24 years. 

  • According to the 2021 Youth Risk Behavior Survey, 22% of Minnesota high school students seriously considered attempting suicide in the past year, and 10% actually attempted suicide in the past year1.

  • The 2019 Minnesota Student Survey found that among 8th, 9th, and 11th graders, 16% of female students, 8% of male students, and 42% of non-binary/transgender students reported either seriously considering or attempting suicide in the last year—totaling over 15,000 students3.

 

From US News reporting: Suicide has now become the fifth leading cause of death among both male and female preteens, report a team led by Donna Ruch, of Nationwide Children’s Hospital in Columbus, Ohio. Suicide has also been among the top 3 cause of death in 12-year-olds for much of the past ten years.

findings July 30 in the journal JAMA Network Open.

• #KidsAtRiskAction

• #InvisibleChildren

• #YoungChildSuicide

• #ChildSelfHarm

• #ChildAbuse

• #ChildNeglect

• #ChildProtection

• #ChildWelfare

• #CPSReform

• #YouthMentalHealth

• #TraumaInformed