Overview of Adolescent Suicide

Available with English captions and subtitles in Spanish.

David A. Brent, MD, University of Pittsburgh, presents as part of the 2022 Suicide-Focused Assessment and Treatment: An Update for Professionals course.

Adolescents and Suicide

The suicide rate in adolescents and preadolescents has been increasing since the mid-2000s.

In this talk, Brent explains why young people should be screened for suicide risk, techniques clinicians can use to assess such risk, as well as effective interventions.

Watch now to learn more about:

  • How to assess youth for suicide risk
  • How to develop a safety plan
  • Which protective factors can prevent suicide

According to Brent, screening for suicide risk in youth should be performed at each well-visit, and at every emergency department and inpatient admission. It should also be done more frequently in patients in mental health and substance use treatment.

“It is important to screen for suicidal risk in youth because many youth who screen positive for suicidal risk do not present with behavioral health issues,” Brent shares. “Screening for suicidal risk will identify youth missed by depression screens alone.”

The most commonly used screening instruments for suicide include the Ask Suicide-Screening Questions (ASQ), Computerized Adaptive Screen for Suicidal Youth (CASSY), and the Columbia Suicide Severity Rating Scale (C-SSRS).

When assessing youth for suicidal risk, Brent says it is important for clinicians to start by asking about ideation.

“You want to know if people have nonspecific thoughts about suicide, and then whether they have specific thoughts about wanting to die.”

He adds that a clinician should also find out which factors are keeping someone from acting on suicidal thoughts and what might increase the likelihood of acting on them.

“It’s important to emphasize that asking about suicidal thoughts absolutely does not increase the risk for suicidal behavior. So, there’s no reason not to do it,” Brent states.

According to Brent, adolescents make suicide attempts for multiple reasons. “Often, in addition to wanting to die, it may be related to escaping mental pain, communicating anger, or trying to get somebody to pay attention to them,” he shares.

“It’s important to understand those motivations because it affects your treatment plan and helps that person address those issues in therapy. Then they don’t have to resort to suicidal behavior to get those needs met.”

View the Slides

Safety planning involves a structured set of responses designed to help a patient reduce suicidal urges. It’s designed to prevent the progression from suicidal ideation to suicidal behavior. It should either decrease distress or help a patient cope with it.

A safety plan consists of:

  • Identification of triggers
  • Plan for avoiding or coping with triggers
  • Personal coping strategies
  • Interpersonal coping strategies
  • Clinical and emergency contacts

“There’s an abundance of evidence that these types of interventions can decrease subsequent suicidal behavior,” Brent said.

In this talk, Brent also outlines effective treatments for addressing suicidal behavior, which include dialectical behavior therapy (DBT), cognitive behavior therapy (CBT), mentalization, as well as psychotherapy and medications for depression.

He adds that protective factors against suicide in youth include having a strong parent-child connection, parental supervision and availability, involvement in school, religious affiliation, and relationships with peers.


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About David Brent

Dr. David Brent is a child and adolescent psychiatrist who has worked as a researcher in the area of adolescent suicide for four decades at the University of Pittsburgh, where he is a distinguished professor and holds an endowed chair in suicide studies.

Brent currently leads an NIMH-funded center, with many goals, including training a diverse, national cohort of early career scientists focused on youth suicide.