For months, Marie’s 11-year-old daughter wasn’t acting like herself. The fifth grader was often fatigued, sleeping more. She wasn’t eating enough, and spent more time alone.

“She wasn’t really motivated to do things with her friends,” Marie said.

The Chicago girl had been overwhelmed with worry for her father, who was recovering from diabetes complications after a serious infection. She also felt intense pressure at school, aiming for straight A’s.

“Ever since Dad went to the hospital, it just made it more intense,” she told her mom in a written note. “I don’t know how to feel. I’m having thoughts about hurting myself. I’m tired, and afraid of death.”

Earlier this year, she told her mom she’d tried to cut herself in the bathroom, and said she was hurting herself at school. Stateline is withholding Marie’s full name to protect her daughter’s privacy.

Marie took her to the emergency room. The ER staff tried to transfer the girl to a psychiatric facility, but several refused to take her. Most only served teenagers, while others didn’t accept her insurance plan. The emergency department team finally found a place for her at a child psychiatric facility nearly an hour away.

Marie’s daughter recently finished an intensive outpatient therapy program and is seeing a therapist regularly.

“We were able to get her the help that she needed,” Marie said. “But a lot of the times, there’s kids that struggle and unfortunately, do end up taking their life.”

In the past several years, numerous studies have pointed to a mental health crisis among America’s youth. Much of the attention has focused on teenagers, who have higher suicide rates.

But preteens are struggling, too.

The number of preteens — ages 8 to 12 — who die by suicide in the United States each year is relatively small. But the total in 2025 was 194, the most since at least 2001, according to preliminary data from the federal Centers for Disease Control and Prevention.

Since 2008, the rate of preteen suicide has increased by an average of 8.2% annually, according to researchers at the National Institutes of Health. Their analysis, published in 2024, found that Black preteens had the highest overall suicide rate, while girls and Hispanic preteens had the greatest percentage increase. Native American preteens also saw some of the most pronounced increases.

Suicide is complex and is often the result of a combination of factors. Talking with trusted adults and connecting kids with help can aid in prevention, and research shows most who have suicidal thoughts do not carry through with them. Mental health experts and advocates are calling for more mental health check-ins with preteens, earlier screenings and tailored interventions for Native, Black and LGBTQ+ preteens.

Jenny Britton, chief clinical officer at the Washburn Center for Children in Minneapolis, a nonprofit mental health practice, has noticed the long-term trend during her 25-year career.

“I’ve watched the age of kids who struggle with suicidal ideation and suicidality get younger and younger over that time,” she said. “Now, we’re seeing even as young as our 7- and 8-year-olds.”

Last year, the overall suicide rate in Minnesota increased 4% compared with the year before, according to preliminary state data. But the suicide rate among children ages 10 to 14, the youngest age group included in the state’s report, more than doubled compared with the five years prior, from 2.2 per 100,000 people to 5.8.

Four years ago, when the inpatient mental health unit opened at Children’s Minnesota, a Minneapolis-based health system, providers mostly saw teenagers, said Dr. Prachi “PJ” Striker, a child and adolescent psychiatrist. That’s still true, but over the past year and a half, the unit has seen more 10- to 12-year-olds who have harmed themselves, attempted suicide or said they’ve considered it.

“(We’re) seeing more of the younger age group coming in,” Striker said. “Depression, anxiety, hopelessness, feeling overwhelmed, suicidal thoughts.”

The American Academy of Pediatrics now recommends that pediatricians start screening all patients starting at age 12 for suicidal thoughts. But for preteens ages 8 to 11, the academy only recommends a suicide screening if the child is coming to the doctor for behavioral health concerns or has a history of suicidal thoughts.

But Striker said screening as early as age 8 can prevent kids from slipping under the radar.

“How do we start identifying kids who are in trouble faster?” Striker said. “Kids are feeling unsupported. They have more alone time. They’re more isolated. People aren’t really picking up on some of the clues of depression as early.”