Assessment, Referral, and Treatment of Suicidal Adolescents

• Published in: Pediatric annals 2012-12, Vol.41 (12), p.516-521
• Main Authors: Maheshwari, Richa, Joshi, Paramjit
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Antidepressants; Children & youth; Death; Depression; Depression (Psychology); Emotional Disturbances; Female; Humans; Interviews; Male; Males; Mental Disorders; Mental Health Programs; Primary care; Psychometrics; Referral and Consultation; Risk Assessment; Risk Assessment - methods; Risk Factors; Sexual Orientation; Suicidal Ideation; Suicide; Suicide - prevention & control; Suicide - psychology; Suicides & suicide attempts; Teenagers; Young Adult; Youth
• ISSN: 0090-4481; 1938-2359
• DOI: 10.3928/00904481-20121126-13

In 2009, there were 4,371 completed suicides in the United States in the age group 15 to 24 years, making it the third leading cause of death in this population.1 As many as 62% of patients younger than the age of 35 years who died by suicide had been in contact with a primary care provider in the year before their death; 23% of them were seen by a primary care provider in the month before their death.2 It is estimated that there are between 100 and 200 attempts for each completed suicide.6 The annual physical exam is an ideal forum in which to assess high-risk youth for suicide, but most patients report they are not being screened for emotional issues.7 Discomfort around assessing suicidal risk may have worsened after the Food and Drug Administration (FDA) issued a black box warning on antidepressant use in children and adolescents in 2004, stating, "the increased risk of suicidal thoughts and behavior ('suicidality') in children and adolescents being treated with antidepressant medications.