Last year, the Boise area reached a terrible milestone: Sixteen young people committed suicide in Ada County, according to data provided by the Ada County Sheriff’s Office. By comparison, in 2022, that number was one.

At least four of those students are from the Boise school district, according to the Idaho Statesman.

The deaths sent shockwaves through the community, serving as a wake-up call about Idaho’s youth suicide rate — the fifth-highest in the nation from 1999 to 2020, according to the Office of Juvenile Justice and Delinquency Prevention, part of the federal Department of Justice. They prompted the Boise School District to introduce suicide intervention curriculum this school year and sparked a broader conversation about the need to destigmatize mental health struggles.

But for doctors and law enforcement officials in the area, the deaths were just one of several troubling trends in the landscape of young people struggling with mental health issues — especially in the years since the COVID-19 pandemic, which experts say has played a crucial role in children spending a year out of school and isolated from their peers.

Cottonwood Creek Behavioral Hospital in Boise, which opened in 2019, has seen its teen admissions jump from about 650 in 2020 to about 1,200 in 2021 to more than 1,300 in 2022, then decline to about 1,000 in 2023. Martina Velic, the hospital’s director of admissions, attributed the trend to COVID-19 — kids who are truly “isolated and isolated” and “can’t go anywhere and just can’t live day-to-day like they’re used to.”

Velic said the people she studies typically have suicidal thoughts, homicidal thoughts or acute psychosis, and her team is seeing first episodes of psychosis in increasingly younger children.

“When I was in graduate school, we found out about it in the early 20s,” she told the Statesman by phone. But “now we’re seeing 13-, 14-, 15-year-olds. It’s really sad that we’re seeing it.”

As for why teens are being affected this way, “I think it’s one of those things that we won’t know for many years until more data is collected and more research is done,” she said.

Wendy Seagraves, a clinical supervisor and social worker at Ada County Juvenile Court Services, also noticed how the “loss of normalcy” during the pandemic has left young people feeling disempowered. Her team of eight clinicians has seen an increase in generalized anxiety, depression and trauma responses. Her team also used to see kids 14 and older, but now they’re seeing kids as young as 11 — and even the older teens are “a few years behind” in emotional development, she said.

COVID-19 and the political climate are contributing to mental health issues

Velic noted that the second- and third-order effects of COVID-19 may also be playing a role. As many Boise-area families have struggled economically or seen housing prices become less affordable, that has had an impact on “general stress in the home… when parents are struggling, kids are struggling,” she said.

She noted that more than half of Cottonwood Creek’s patients qualify for Medicaid, which may have something to do with home instability, lack of food or other stressors.

Seagraves noted the tone of national and local politics.

“I think as a society, right where we are right now, there is a divide,” she said. “We think it doesn’t affect kids, but it really does, like they see how unkind a significant portion of society is.”

She added that she has seen this manifest itself in increased incidents of bullying, which in turn is exacerbated by teenagers’ use of mobile phones.

“It affects their emotional regulation,” where “you compare yourself to everyone else,” she said. “There’s so much of, ‘Well, this person said this, so I have to respond — and that causes more arguments.”

Morgan Van Ry, business development manager at Cottonwood Creek and a former community liaison, also noted that mental health treatment and prevention have become a political issue, leading to resistance from some parents to allowing these resources in public schools.

“I think it’s very political, and I think there’s still a lot of the mentality of, ‘Pull yourself up by your bootstraps. Mental health isn’t real. Gender dysphoria isn’t real. Get over it when you’re being bullied,’” she said. “So when there’s mental health or counseling or anything like that, parents get offended or don’t want that imposed on their child.”

Fewer Ada County teens in juvenile detention centers

The pandemic has not only disrupted teen development, but it has also given the local justice system an opportunity to change its approach to incarcerating kids with behavioral health issues, said Alison Tate, director of Ada County’s youth assessment and resource center, The Bridge.

Before COVID-19, Ada County had 40 or 50 teens in juvenile detention centers, she said. In the first quarter of 2024, there were 12.

“We believe that this decrease is largely due to the education we conducted with our partners, law enforcement officials and judges, on the harmful effects of detaining” young people, she added.

According to a study conducted by the Justice Policy Institute and made available on the U.S. Department of Justice website, young people who spend time in prison may be at risk for higher rates of recidivism, exacerbation of existing mental health conditions and “more youth involvement in the juvenile and criminal justice systems.”

The bridge opened last year after the Legislature allocated $6.5 million in 2022 to establish youth assessment centers across Idaho. It’s part of a “growing movement” nationwide to divert young people from the criminal justice system, serving as a hub where families can go to get referrals for services — from horseback therapy to tutoring to substance abuse treatment — before problems get worse.

Even if only one child in a family is referred to the program, staff will try to work with the entire family to help younger children before their own problems become worse.

“We have families in our system where all the kids go when they’re 11 or 12,” Tate said.

Tate said children’s mental and behavioral health issues rarely occur in isolation. She referred to Ada County Juvenile Services’ data on “adverse childhood experiences” — “potentially traumatic events … such as violence, abuse, and growing up in a family with mental health or substance use issues.”

Among children in the Ada County jail, more than 60% have experienced at least four potentially traumatic events, compared with 16% in the general population. And while about 60% of adults have experienced at least one adverse childhood experience, 95% of youth in custody have.

Sergeant Craig Durrell, who oversees some of the Sheriff’s Office’s school police officers, shares that idea.

“We never look at situations where it’s just the way it is,” he said. “If a kid brings an e-cigarette to school, the idea is to dig into that a little bit to find out what’s going on here… The goal isn’t just to write a criminal report and charge them with criminal charges. We’re really trying to distract from that as much as possible. The goal is really to peel the onion back a little bit to find out where this is all coming from.”

Even as life returns to normal in the wake of the COVID-19 pandemic, doctors and law enforcement officials say teenagers are still suffering.

“We talked about (the 2021-22 school year) being the first normal year back, but I think 2022-23 was really the first normal year back because up until this point we’ve always had something,” whether it was staggered school schedules or the option to have classes online, said Deputy Shannon Garza, a school resource officer at Lake Hazel Middle School.

Although Cottonwood Creek’s admissions rate has declined in 2023, Community Services Director Velic said he “doesn’t feel like we’re at the peak of the repercussions that we’re going to face with COVID and isolation.”

“Maybe we’ve calmed down for a moment,” she said, “the peak is still ahead of us.”

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