Suicide risk assessment and prevention in children and adolescents.(Suicide)

Suicide is the third leading cause of death among adolescents and young adults ages 12 to 24. In particular, thoughts of suicide are relatively common among high school students, and of those who act on these thoughts, risk of successfully completing a suicide rises greatly. There are approximately 50-100 attempts for each completed suicide and 10% of adolescent attempters will make further attempts within 1 year.

As mental health professionals, our efforts need to focus on reducing risk factors in an effort to prevent attempts.

Epidemiological factors that guide risk assessment

Suicide is universally rare before age 12. Due to cognitive immaturity and limited access to means, a young child is not generally able to design and carry out a realistic suicide plan. When assessing adolescents who have suicide plans, it is helpful to remember that although the vast majority of attempts by adolescents are by overdose (75.5%), for completed suicides the most common method is firearms (72.3%). Thus, removing access to firearms is one of the most protective actions we can take to protect adolescents.

Boys tend to use more lethal methods than girls, with aggression and substance abuse commonly linked to completed suicide. In addition, boys are 5 times more likely to complete suicide than girls; although girls are 6 to 9 times more likely to make suicide attempts than boys. In terms of race, adolescent suicide rates are highest among American Indians/Alaskan Natives. Hispanic adolescent females are also at especially high risk for suicide attempts.

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