According to most recent data, suicide is the second leading cause of death for adolescents aged 15 to 19. The guidelines recommend pediatricians routinely ask adolescent patients if they have thoughts of harming themselves, and screen for bullying, pathological internet use, and other risk factors including a family history of suicide, a history of physical or sexual abuse, and mood disorders.
If an adolescent is considered to be at moderate or high risk of suicide, the guidelines recommend that arrangements for immediate mental health professional evaluation should be made during the office visit. For teens considered to be at low risk of suicide, the guidelines recommend close follow-up and/or a referral for a timely mental health evaluation.
While the report documents evidence to suggest antidepressants may increase risk of suicide in some adolescents, it also notes “for appropriate youth, the risk of not prescribing antidepressant medication is significantly higher than the risk of prescribing.” It is recommended that pediatricians work closely with families to closely monitor adolescents’ mental health and behavioral status, particularly when initiating or changing antidepressant treatment.
“Pediatricians can enhance continuity of care and adherence to treatment recommendations by maintaining contact with suicidal adolescents even after referrals are made. Collaborative care is encouraged, because it has been shown to result in greater reduction of depressive symptoms in a primary care setting,” the report noted.
For related information, see the Psychiatric News Alert “CDC Report on Suicide Underscores Urgent Need to Identify At-Risk Individuals.”