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Concussions and Suicide Risk in High School Students

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New research has found that high school students who have had concussions in the past year are more likely to have suicidal thoughts, plans, or attempts. This risk increases with the number of concussions. The study, the first to examine this link in a national sample, emphasizes the need for mental health evaluations in youth with concussions. Key findings include higher rates of reported concussions in males, more frequent sadness and suicidal behavior in females, and a lack of research on the topic in youth populations.

High school students, particularly males, with a history of concussion in the last year, showed a higher tendency for suicidal thoughts, planning, or attempts compared to those without a concussion history, according to a study by a research team that includes a researcher at the University of Michigan.

Boys who experienced two or more concussions in the past year were twice as likely to report a suicide attempt compared to those with a single concussion. For girls, the likelihood of suicidal behaviors was comparably higher irrespective of the number of concussions.

“This type of research is never easy to discuss, but it is vitally important to understand who is at risk and why,” said study co-author Steve Broglio, professor of kinesiology and director of the University of Michigan Concussion Center. “Anyone who has concern for any student-athlete should not be afraid to reach out and help find the appropriate resources.”  

A First of Its Kind Study

This is believed to be the first known study to examine the relationship between suicidal behaviors and concussion frequency in a nationally representative sample of U.S. high school students. 

“From broader literature, we know that brain injuries, like concussion, can precipitate or exacerbate mental health challenges,” said lead author Jacob Kay, a rehabilitation scientist at Prisma Health Children’s Hospital and the University of South Carolina. “Our study further highlights the importance of evaluating mental health among both male and female youth that have sustained a concussion. This is particularly true for those who have sustained multiple concussions in a short time.” 

Key Findings of the Study

Other study highlights include:

  • 15% of students reported one or more concussions and 6% reported two or more concussions in the past year
  • 17% of males and 13% of females reported one or more concussions in the past year
  • 44% of females vs. 24% of males reported feeling sad or hopeless
  • 24% of females vs. 13% of males reported having suicidal thoughts
  • 19% of females vs. 10% of males reported planning suicide
  • 10% of females vs. 5% of males reported attempting suicide
  • 3% of females and 1% of males reported an injury from an attempted suicide
  • Medical professionals should closely evaluate and monitor mental health in youth, especially those with a recent history of repetitive concussions 

Sex Differences and Implications

In general, research indicates that females may struggle a bit more following concussion, Kay said. There are several biological and sociocultural explanations for observed sex differences that are yet to be fully understood. Though the authors emphasize caution in drawing causation from the present study, they speculate their findings indicate males may engage in suicidal behaviors in a more impulsive manner. 

There is also a known “silent struggle” among males regarding mental health, Kay said. 

“In the context of concussion, this could mean there are even fewer red flags among males intending self-harm,” he said.

Interest is growing in the relationship between concussions and mental health, but research on youth is lacking. This study sought to examine that association by looking at concussion frequency and mental health outcomes among biological male and female high school students. Researchers analyzed 2017 and 2019 data from 17,397 respondents from the National Youth Risk Behavior Surveillance System. 

Reference: “Concussion Exposure and Suicidal Ideation, Planning, and Attempts Among US High School Students” by Jacob J. M. Kay, Colt A. Coffman, Adam Harrison, Abbas S. Tavakoli, Toni M. Torres-McGehee, Steven P. Broglio and Robert Davis Moore, 16 November 2023, Journal of Athletic Training.
DOI: 10.4085/1062-6050-0117.22

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