children s health issues
Suicidal Behavior in Children and Adolescents
Prevention
Directly asking at-risk children about suicidal thoughts can bring out important issues that are contributing to the child’s distress. Identifying these issues can, in turn, lead to meaningful interventions. Research indicates that over 50% of children who showed up in an emergency department for any reason screened positive for suicidal thoughts and behaviors. As a result, hospitals have been required since 2019 to assess for suicide as part of standard medical care. Physicians should also inquire about firearms, the leading cause of death for youth in the US (60% homicides, 35% suicides, 4% unintentional). Physician counseling combined with provision of a cable gun lock has been reported to increase safe storage of firearms. Crisis hotlines, offering 24-hour assistance (see sidebar Suicide Intervention: National Suicide Prevention Lifeline ), are available in many communities and provide ready access to a sympathetic person who can give immediate counseling and assistance in obtaining further care. Although it is difficult to prove that these services actually reduce the number of deaths from suicide, they are helpful in directing children and families to appropriate resources. The following may help reduce the risk of suicide: Getting effective care for mental, physical, and Substance Use Disorders None Being able to easily access mental health services Getting support from family and the community Learning ways to peacefully resolve conflict Limiting media access to suicide-related content Having cultural and religious beliefs that discourage suicide Suicide prevention programs can help. The most effective programs are those that try to make sure that the child has the following: A supportive nurturing environment Ready access to mental health services A school or other social setting that promotes respect for individual, racial, and cultural differences In 2022 a new 3-digit dialing code (988), referred to as the 988 Suicide and Crisis Lifeline, was activated in the United States. A call, text, or chat to 988 will route callers to the National Suicide Prevention Lifeline (whose previous Lifeline phone number, 1-800-273-8255, will continue to remain available). Trained counselors, in English and Spanish, available 24/7, will provide support and connect callers to resources if necessary. The service is confidential and free of charge. 