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The National Institutes of Mental Health awarded a $2.5-million grant to UNC School of Medicine researchers Adam Bryant Miller, PhD, and Andrea Pelletier-Baldelli, PhD, in the UNC Department of Psychiatry, to study the alarming rise of suicidal behavior in young girls.


Shortly after the COVID-19 pandemic erupted in 2020, patients across the country filled emergency departments, experiencing respiratory issues, cardiac arrest, and chest pain. But another group of patients sought emergency care at alarmingly high rates at the same time: young girls between the ages of 12–17. They reported suicidal thoughts, and some came to emergency departments because of suspected suicide attempts. This was a 50.6% increase compared to 2019.

However, early summer 2020 was not a spike. It was a canary in a coalmine. Suicide risk for teenage girls has remained historically high since 2020, and researchers have taken notice.

Ringing the Alarm

Prior to the pandemic, a growing number of children under the age of 12 were reporting suicidal behaviors, alarming researchers and health professionals alike. They were witnessing this change right in front of their eyes, whether through firsthand clinical experience, reading reports from the Centers for Disease Control Prevention (CDC), or observing younger people participating in studies about suicidal thoughts and behaviors.

In 2019, an emergency taskforce from the Congressional Black Caucus sent a formal call to action to congress. A report, titled, “Ring the Alarm: The Crisis of Black Youth Suicide in America” drew particular attention to the rise in suicide deaths among Black youth over the past generation.

Shortly thereafter, prominent leaders in the National Institutes of Mental Health (NIMH) convened to create a new research initiative to understand why suicide risk was rising, and staying high, among preteens across the United States.

A New, Pressing Research Initiative

Andrea Pelletier-Baldelli, PhD

The NIMH hosted a series of roundtable discussions made up of researchers from across the country to address this troubling issue. Adam Bryant Miller, PhD, an associate professor of psychiatry and associate director of the Child and Adolescent Mood and Anxiety Disorders Program (CHAAMP) in the UNC Department of Psychiatry, was one of those researchers.  Miller’s primary research focus is on understanding how early childhood traumatic experiences increases suicide risk throughout childhood and adolescence.

Miller and Andrea Pelletier-Baldelli, PhD, an assistant professor in CHAAMP who is an expert in social motivation and severe mental illness risk in adolescents, jointly applied for an R01 grant from the NIMH to investigate social motivation as a risk factor for preteen suicide risk among young girls.

Statistically speaking, young girls are more likely than young boys to seriously consider and attempt suicide. Researchers have looked into why, with many studies concluding that girls are more sensitive to social stressors, such as bullying or being rejected by a peer, compared to boys of the same age. This sensitivity to social stressors could explain why there is such a discrepancy in suicidal thoughts and attempts in girls compared to boys.

Study to Stem the Tide

In September, the research duo was awarded a four-year, $2.5-million grant from the NIMH to investigate how childhood adversity exposure may lead to changes in the social motivation of preteen girls between 8- and 12-years-old.

Their research also involves identifying specific windows of time that girls are more vulnerable to social stressors and what, on a biological level, may explain this sensitivity to social stress. Hormones drive puberty, and this might make girls feel more vulnerable emotionally.

“We are especially interested in preteen girls who may develop a heightened desire to avoid negative social feedback, both in-person and online, and how this avoidance paired with reduced effort to engage with others may confer increased risk for suicide,” said Pelletier-Baldelli. “We hope this investigation into social motivation as new risk factors will help youth, their families, friends, and clinicians gain insight into how suicidal thoughts and behaviors develop in preteen girls.”

The study will carefully monitor changes in puberty-related hormones, such as estrone, dehydroepiandrosterone, androstenedione, and testosterone, using saliva samples. Researchers will also assess how often the young girls experience suicidal thoughts through short surveys that are sent through smartphones twice a day.

“One of the exciting parts of this study is that several other research groups were also awarded grants to study preteen suicide risk,” said Miller. “We each will operate independently, but this consortium will hopefully allow us to pool data to answer larger questions about preteen suicide risk than what we would be able to alone.”

Media contact: Kendall Daniels, Communications Specialist, UNC Health | UNC School of Medicine