A recent study¹ found that standardized screening for suicide risk in primary care can detect youth with suicidal ideation and prompt a referral to a behavioral health care center before a fatal or serious suicide attempt is made.

The US Preventive Services Task Force (USPSTF) states that there is insufficient evidence to recommend routine suicide screening in primary care. However, the task force suggests that pediatricians “perform routine depression screenings for adolescents aged 12 to 18 years when appropriate services are in place to ensure accurate diagnosis, treatment and follow-up care.”² The American Academy of Child and Adolescent Psychiatry (AACAP) and the American Academy of Pediatrics (AAP) Task Force on Mental Health jointly published an article, recommending that primary care providers (PCPs) complete routine behavioral screening for adolescents, as long as appropriate mental health follow-up services were available.³

The American Academy of Pediatrics recommends asking about depression, substance abuse, suicidal thoughts, and other risk factors associated with suicide risk in routine history taking throughout adolescence.⁴

The American Academy of Child and Adolescent Psychiatry recommends that clinicians be aware of patients at high risk for suicide (older male adolescents or adolescents of either sex, regardless of age, who have a current mental disorder or disordered mental state [such as depression, mania or hypomania, or mixed states], especially when complicated by comorbid substance abuse, irritability, agitation, or psychosis).⁵

The American Medical Association Guidelines for Adolescent Preventive Services (GAPS) recommend that all adolescents be asked annually about behaviors or emotions that indicate risk for suicide.

Tools

• Web-Based Behavioral Health Screen (BHS) for Adolescents and Young Adults: An Innovative Suicide Prevention Tool . Matthew Wintersteen and Alana O'Malley. 2010.
• Best Practices Registry Suicide Prevention Resource Center.
• Assessment of Suicidal Behaviors and Risk Among Children and Adolescents Goldston, D. (2000). Technical report submitted to NIMH under Contract No. 263-MD-909995, August 2000.
• SAFE-T (Suicide Assessment Five-Step Evaluation and Triage) was developed in collaboration with the Suicide Prevention Resource Center and Screening for Mental Health.
• Suicide Behaviors Questionnaire (SBQ-R) assesses suicide-related thoughts and behavior.
• Resources from the American Foundation for Suicide Prevention.
• Practice Parameter for the Assessment and Treatment of Children and Adolescents With Suicidal Behavior. American Academy of Child and Adolescent Psychiatry, 2001.
• Standardized Screening for Suicidal Adolescents in Primary Care, Matthew B. Wintersteen, PhD, Pediatrics, May 2012.
• American Academy of Child and Adolescent Psychiatry, Committee on Health Care Access and Economics Task Force on Mental Health. Improving mental health services in primary care: reducing administrative and financial barriers to access and collaboration. Pediatrics. 2009;123(4):1248–1251. 
• Suicide and suicide attempts in adolescents. Committee on Adolescents. American Academy of Pediatrics. 2000.
• American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with suicidal behavior. J Am Acad Child Adolesc Psychiatry 2001;40(7 Suppl):24S-51S.