In conversations about youth mental health, we often notice what shows up on the surface — changes in behavior, mood, or functioning. But some of the most important contributing factors are less visible and harder to name. Child sexual abuse is one of those factors, with impacts that can be deep and long-lasting.
Child sexual abuse (CSA) refers to the involvement of a child (person under 18 years old) in sexual activity that the child does not fully understand, is not developmentally prepared for, or cannot give informed consent for. Child sexual abuse often includes a significant developmental, physical, or age asymmetry between the child and the other person, with the activity often serving the sexual gratification of the older individual. In clinical practice, it is important to understand CSA as a broad spectrum that includes both contact and non-contact forms of harm. This can involve physical abuse, exposure to sexually explicit material, and the creation, sharing, or distribution of child sexual abuse material online. Research and clinical experience show that these experiences can have similarly significant psychological impacts.
The Connection Between Child Sexual Abuse and Suicide Risk
A large research review found that child sexual abuse is strongly linked to suicidal thoughts and behaviors in young people. Those who experienced it were over three times more likely to attempt suicide and more than twice as likely to experience suicidal thoughts, making it the form of abuse most strongly associated with suicidality.
Why Children Often Do Not Disclose Abuse
Sexual abuse often takes place in situations where silence and shame make it difficult for a child to speak up. In many cases, adults who abuse children use manipulation to maintain control, making the child believe they are at fault, that they will be punished for telling someone, or that they are responsible for what happened. In many cases, the adults abusing the child are someone known to them: a family member, coach, educator, neighbor, family friend, faith leader, and so on. This is why so many children may not tell anyone about the abuse until years later.
The Lasting Health Impact of Childhood Trauma
This type of trauma and layered manipulation, guilt, and shame can have lasting impacts on a child’s mental and physical health. According to the landmark ACE Study, Adverse Childhood Experiences (ACEs) can change the body's biology, increasing the risk for heart disease by 22% and depression by 78%.
Prevention and Early Intervention Matter
This is why primary prevention, early identification, and early intervention are paramount for supporting child health. We can protect children’s well-being through:
- Educating Children: Primary prevention begins by teaching children about bodily autonomy, boundaries, and consent. The Connecticut Alliance to End Sexual Violence has certified member organizations across the state that offer age-appropriate education programs in PreK-12 schools.
- Empowering and Equipping Adults: The safety of a child should never be the onus of the child themselves. Adults must be equipped to recognize the signs of abuse and understand how to respond in a trauma-informed way through resources like Our Kids Center.
- Normalizing Mental Health Conversations: We can make mental wellness a regular part of family life by checking in often. Rather than waiting for a crisis, normalize these talks by asking open-ended questions about a child's feelings. This builds a foundation of trust, making it easier for them to share if they ever face something difficult.
If a child discloses a traumatic event or that they are struggling with their mental health, the most critical first step is to reassure them that they are not alone and it is not their fault. It’s important to immediately follow through with connecting to the appropriate resources to help the child begin to heal.
Connecticut Children’s Commitment to Child Health and Safety
Connecticut Children’s is dedicated to improving the physical and emotional health of children through family-centered care, research, education, and advocacy. A key priority in our 2025 Community Health Improvement Plan (CHIP) is strengthening alignment across services so families experience care as connected, not fragmented. Connecticut Children’s Office for Community Child Health provides the infrastructure that supports this population health approach.
Across the organization, teams including the Injury Prevention Center, Suspected Child Abuse and Neglect (SCAN) Program, Center for Care Coordination, Youth Suicide Prevention Center, psychologists, psychiatrists, social workers, behavioral health providers, and others work together across departments to prevent, identify, and respond to child abuse and its impacts.
This integrated approach reflects a shared commitment to ensuring that children and families do not have to navigate these experiences alone. Healing is possible, no matter how much time has passed.
Upcoming Community Panel on Online Safety and Youth Mental Health
The Connecticut Children’s Youth Suicide Prevention Center team and Injury Prevention Center team are proud to present a panel discussion focused on child online safety and youth mental health. This conversation will explore the intersection of technology, child sexual abuse, and mental health, with an emphasis on prevention, awareness, and community engagement.
This panel is open to all members of our community and will take place on May 21st from 2:00–3:30 pm EST via Zoom. You can register for this free and impactful event here.
While these issues can be difficult to hear about, there is hope: we all have a collective responsibility to protect children, and it is well within our power, no matter our profession, to do so.
Resources
If you or someone you know has experienced CSA or is struggling with their mental health, help is available through the below free, confidential 24/7 hotlines:
CT Alliance to End Sexual Violence: 1-888-999-5545 (English) or 1-888-568-8332 (Español)
RAINN: 1-800-656-4673
988 Lifeline - If you need emotional support, reach out to the national mental health hotline: 988. Call, text or chat 24/7.