Resources for Child and Youth Populations
According to the CDC, suicide is now the second leading cause of death among youths aged 10-241 , with the fastest-growing rates among youth ages 10–142 . There is significant racial disparity where the rate of suicide among Black youth ages 13 and younger is twice that for White youth3 . Suicide prevention and treatment for youth must be developmentally appropriate, attend to critical social determinants of health, assess the presence of adverse childhood events (ACEs) and trauma, incorporate parental or guardian support, and address consent considerations4 . When youth are identified as being at risk for suicide, clinicians need to be well-versed in the assessment and management of suicidality. Suicide risk assessment and collaborative safety planning should incorporate a discussion of barriers to health and safety, including physical and environmental factors (where the family or child lives), presence of firearms or other lethal means (e.g. medications) in the home, and neighborhood safety.
Effective youth suicide prevention requires primary prevention strategies as part of a comprehensive approach that incorporates the health system and extends into schools and the community5 . When focusing specifically on health care settings, one relevant approach is the Zero Suicide framework, which has been adapted for application in pediatric settings to improve care for youth at risk of suicide. Health systems implementing the Zero Suicide framework have developed and implemented care pathways specifically for use with pediatric populations that incorporate the use of validated tools, best practices, and necessary integration with the support systems crucial for effective suicide prevention with children and adolescents. While the systems transformation needed for effective youth suicide can present challenges, comprehensive approaches to preventing youth suicide are imperative to saving lives.
View the following video to learn about Nationwide Children's Hospital's experience implementing Zero Suicide:
- SAMHSA's National Guildelines for Child and Youth Behavioral Health Crisis Care
- Children’s Hospital of Philadelphia Clinical Pathway for Youth
- Seattle Children's Hospital Zero Suicide Initiative Pathways
- Ask Suicide-Screening Questions (ASQ) Toolkit
- Prevention in Practice: Care Transitions at New Hampshire Hospital
Search for tools and resources related to suicide prevention with children and youth populations below.
- 1.Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (June 2020). Retrieved from www.cdc.gov/injury/wisqars
- 2.Horowitz, L., Tipton, M. V., & Pao, M. (2020). Primary and Secondary Prevention of Youth Suicide. Pediatrics, 145(Suppl 2), S195–S203.
- 3.Bridge, J. A., Horowitz, L. M., Fontanella, C. A., Sheftall, A. H., Greenhouse, J., Kelleher, K. J., & Campo, J. V. (2018). Age-related racial disparity in suicide rates among US youths from 2001 through 2015. JAMA pediatrics, 172(7), 697-699.
- 4.Thompson, M. P., Kingree, J. B., & Lamis, D. (2019). Associations of adverse childhood experiences and suicidal behaviors in adulthood in a US nationally representative sample. Child: care, health and development, 45(1), 121-128.
- 5.Robinson, J., Bailey, E., Witt, K., Stefanac, N., Milner, A., Currier, D., ... & Hetrick, S. (2018). What works in youth suicide prevention? A systematic review and meta-analysis. EClinicalMedicine, 4, 52-91.
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Treat | Readings
Honoring Children, Mending the Circle: Cultural Adaptation of Trauma‐Focused Cognitive‐Behavioral Therapy
Bigfoot, D. S., & Schmidt, S. R. (2010). Honoring children, mending the circle: cultural adaptation of trauma‐focused cognitive‐behavioral therapy for American Indian and Alaska Native children. Journal of clinical psychology,66(8), 847-856.
Identify | Readings
The Columbia-Suicide Severity Rating Scale (C-SSRS): Initial validity and internal consistency findings from three multi-site studies with adolescents and adults.
Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M., . . . Mann, J. J. (2011). The Columbia-Suicide Severity Rating Scale (C-SSRS): Initial validity and internal consistency findings from three multi-site studies with adolescents and adults. American Journal of Psychiatry, 168(12): 1233–1234.