A new study shows that suicidal thoughts and suicidal behavior may begin much younger than previously thought as nearly 40 percent of young adults who said they attempted suicide said that they made their first attempt before entering high school.

As previously reported about one of nine youths attempt suicide by the time they graduate from high school but new studies indicate that a significant amount make their first attempt in elementary or middle school.

Researchers at the University of Washington also found that attempted suicide during childhood and adolescence is linked to higher scores of depression at the time of the attempts, which validates for the first time young adults can reliably recall when they first attempted suicide.

"Young adults who end up having chronic mental health problems show their struggles early," said James Mazza, lead author and professor of educational psychology at the University of Washington.

"This study suggests that implementation of mental health programs may need to start in elementary and middle schools, and that youth in these grades are fairly good reporters of their own mental health."

While going through the struggle of becoming autonomous during a youth’s adolescence they also come across the pressure of drugs, alcohol, sexual relationships and sexual orientation, which can lead to stress and depression.

"Adolescence is a time when kids are preparing to be more independent from their parents or guardians, but lack the experience of how to do this," said Mazza, a school psychologist.

"And their support network, their friends, don’t have the experience either, especially in crisis situations."

Mazza and his research team asked 883 young adults ages 18-19 about their history of suicide attempts.

While 78 respondents, nearly 9 percent, said that they had tried suicide at some point, rates of suicide attempts showed a sharp increase around 6th grade, at about 12 years-old, and peaking around 8th or 9th grade.

The 39 respondents who reported multiple suicide attempts showed that their first attempt was significantly earlier than those making a single attempt, starting at the age of 9.

As part of their participation in the Raising Healthy Children project led by researchers at UW's Social Developmental Research Group at the School of Social Work, the participant’s depression scores were collected yearly.

Mazza used this information to compare the young adults' recollection of their suicide attempts with their past depression scores, showing that depression levels were higher at the time of the youths' reported first suicide attempts compared with their peers who had not attempted suicide.

Mazza also found an increase in depression scores at the time of the attempt compared with depression scores the year before and after.

"This suggests that kids are able to tell us, by their depression scores, that things aren't going well for them," Mazza said.

"We're likely not giving kids enough credence in assessing their own mental health, and this study shows that we can rely on self-report measures to help identify youth who may be at risk for current mental health concerns, including possible suicidal behavior."

Mazza told Medical Daily that most parents are unaware of their child’s suicide attempts and that if they see a change in their personality they may want to question them.

“The best way to find out is to ask the child directly if they seem to be struggling,” said Mazza.

Mazza says that a parent should make the child feel comfortable speaking about it and start the question off with, “I am concerned about you, I love you and you can tell me anything.”

He explained that if the child is not showing any signs of depression then the question would be awkward and that parents should look for hints such as “change in behavior, no longer interested in things they used to be interested in, if they’re being bullied, and if a child is perfectionistic, in which they have to do something perfect or they’d be a failure.”