Suicide and Suicide Risk in Adolescents

Publication Date: December 11, 2023
Last Updated: January 8, 2024

Summary of Guidance for Pediatricians and Pediatric Health Care Providers

  • Be mindful of individual, relationship, and community/societal factors, including history of trauma or other adversity, when assessing suicide risk in patients.
  • Screen for suicide risk as part of well-child visits starting at 12 years of age and during higher-risk situations, such as any presentation of a behavioral or mental health concern or for youth with additional risk factors. Be aware that screening only for depression is not sufficient to identify suicide risk.
  • Screen for suicide risk during ED visits and medical hospitalizations.
  • Screen for substance use disorders, because substance use is often associated with depression and self-treatment and is a risk factor for suicidal thoughts and behaviors.
  • If suicide screen is positive, conduct a BSSA and subsequent safety planning and/or referrals as appropriate.
  • For all adolescent health supervision visits, and especially visits with adolescents who have suicidal thoughts, assess for access to lethal means, with counseling on safe firearm and medication storage. Removal of firearms and medications from the home entirely should also be assessed, especially if an adolescent is having SI.
  • Include the family in suicide prevention and treatment efforts, when possible, because family-based interventions have been shown to be effective in preventing future suicide attempts in youth.
  • During health supervision visits and visits addressing mental health concerns, counsel families around sleep hygiene, community engagement, and connectedness, because these factors can help to promote emotional wellness and may be protective against suicidal thoughts.
  • Treat depression with a referral to a psychotherapist and with antidepressant medication, when indicated, because depression increases the risk of suicide. When indicated and available, refer to a child and adolescent psychiatrist or other mental health provider.
  • Be aware of use of language when speaking with youth and families about suicide. Attempt to replace questionable terminologies with sensitive terminologies as follows:
    • Use “die by suicide” instead of “commit suicide.”
    • Use “death by suicide” instead of “successful suicide.”
    • Use “suicide attempt” instead of “failed suicide attempt.”
  • Recognize the importance of setting aside one-on-one time during appointments with adolescents to discuss potential suicidal behavior, other mental health issues, and the teen’s history of trauma and adversity.
  • Advocate for increased research on prevention strategies for the high rates of suicide in youth in the child welfare and juvenile justice systems.
  • Advocate for suicide prevention research for other high-risk groups, such as LGBTQ youth, American Indian/Alaska Native and Black youth, other youth in minoritized racial and ethnic groups, and youth living in rural areas.
  • Advocate for increased access to youth mental and medical health care, including evidence-based, trauma-informed interventions and gender-affirming care, when indicated, and particularly for populations that have been historically discriminated against and underresourced.
  • Advocate for adequate payment for providing suicide risk screening and assessment services, as well as payment for additional time, training, and care coordination services for HCPs who manage mental health conditions.
  • Advocate for adequate payment for integrated behavioral/mental health care into primary care and for evidence-based trauma-informed mental health care when indicated.


General Resources

  1. Blueprint for Youth Suicide Prevention
  2. 3-digit dialing code 988 (suicide prevention)
  3. 1-800-799-7233 (domestic violence)
  4. 1-866-488-7386 (Trevor Project: LGBTQ crisis support)
  5. 1-877-565-8860 (trans lifeline)
  6. Crisis Text Line: Text HOME to 741741
  7. Family Acceptance Project is an initiative to prevent health and mental health risks for LGBTQ youth and provides research-based resources for ethnically, racially, and religiously diverse families:
  8. American Foundation for Suicide Prevention “Mental Health Resources for Underrepresented Communities” (



Suicide and Suicide Risk in Adolescents

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