New recommendations in teen suicide prevention

SALISBURY, Md. - The American Academy of Pediatrics is pushing for pediatricians to screen teenage patients for suicide risks.

Suicide is the second-leading cause of death among teens aged 15 to 19, according to the Academy's most recent report, released Monday.

It's an update to a report published in 2007, when suicide was the third-leading cause of death among adolescents. It has since passed homicide and is topped only by unintentional injuries – including drug overdoses and motor vehicle crashes – in terms of claiming the most teen lives.

A major addition to the new report comes in the form of a new risk factor: bullying. While bullying is not new as a phenomenon, its inclusion as an outright risk factor is, joining other markers like history of physical or sexual abuse, mood disorders, and substance abuse. Teens who may be lesbian, gay, or bisexual are also at a higher risk.

The author says teens at the greatest risk for suicide are those who were either victims of bullying were bullies themselves.

In the report, the AAP urges pediatricians to look for those risk factors by screening their adolescent patients. Included in the report are the following guidelines for doctors:

1. Ask adolescents about mood disorders, use of drugs and alcohol, suicidal thoughts, bullying, sexual orientation and other risk factors associated with suicide via routine history-taking. Consider using a depression screening instrument at 11- to 21-year-old health maintenance visits and as needed.

2. Educate yourself and your patients about the benefits and risks of antidepressants.

3. Recognize the medical and psychiatric needs of the suicidal teen, and work closely with families and other health care professionals in the management and follow-up of those who are at risk or have attempted suicide. Develop working relationships with colleagues in the community. Ensure good communication, continuity and follow-up through the medical home.

4. Become familiar with local, state and national resources related to suicide prevention in youths.

5. Consider additional training in diagnosing and managing adolescent mood disorders, especially if practicing in an area underserved by mental health professionals.

6. During routine evaluations, ask whether firearms are kept in the home and discuss with parents the increased risk of adolescent suicide with the presence of firearms. For teens at risk of suicide, advise parents to remove guns and ammunition from the house, and secure supplies of prescription and over-the-counter medications.

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