American Academy of Pediatrics Updates Guidance on Addressing Suicide Risk Among Adolescents

AAP recommends pediatricians and health professionals screen for suicidal ideation and risk factors of suicide 
 
ITASCA, IL – In an updated clinical report addressing adolescent suicide risk, the American Academy of Pediatrics (AAP) offers guidance for pediatricians and pediatric health care providers to assess the possibility of suicide, reduce risks and connect adolescents and their families with mental health resources. 
 
The clinical report, “Suicide and Suicide Risk in Adolescents’” will be published in the January 2024 issue of Pediatrics (online Dec. 11).  Clinical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics. 
 
The AAP, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association recently declared a national state of emergency in children’s mental health, partly based on a significant increase in suicides among youth 10 to 24 years old. During the beginning of the COVID-19 pandemic in 2020, emergency department visits for suicide attempts further increased among adolescents 12 to 17 years of age (50.6% higher in girls and 3.7% higher for boys).  
 
“Suicide is complex but often preventable,” said Janet Lee, MD, FAAP, one of the authors of the suicide report. “Because of their long-term relationships with teens and their families, pediatricians and other pediatric health care providers are in a unique position to have open communication with young people to discuss mental health and suicidality. This clinical report supports pediatricians in the work they do every day around suicide prevention by helping them recognize risk factors and highlighting evidence-based interventions.” 
 
In the clinical report, the AAP recommends pediatricians and health professionals screen for suicidal ideation and risk factors of suicide. A range of interventions are recommended, including:

• Personalize coping strategies for patients such as religious activities and group exercise
• Gauge potential access to deadly devices, particularly firearms, during preventive care visits and provide counseling to decrease or eliminate access
• Engage parents and families in suicide prevention and treatment efforts such as sleep hygiene, community engagement
• Explore school-based interventions that educate students and staff on recognizing signs of depression 

 
The updated clinical report highlights the online Blueprint for Youth Suicide Prevention that serves as a resource for health care providers to support adolescent patients who may be at risk for suicide. The Blueprint outlines a 3-tiered pathway that begins with a brief screen lasting no more than one minute. Next is a brief suicide safety assessment for anyone who screens positive that evaluates the frequency of suicidal thoughts, plans, mental health symptoms, and suicide history. The final component is to identify the next steps for care. 
 
The AAP also makes recommendations around language to be used when speaking with youth and families about suicide, including phrasing such as “suicide attempt” instead of “failed suicide attempt.” AAP also advocates for adequate payment for providing suicide risk screening and assessment services, as well as funding for additional time, training and care coordination services for professionals who manage mental health conditions. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.