Providers are in a unique position to identify youth at risk for suicide and to implement care strategies to diminish it, according to new guidance for providers.

The Blueprint for Youth Suicide Prevention was put together by the American Academy of Pediatrics, the American Foundation for Suicide Prevention and the National Institute of Mental Health. It is the first major interdisciplinary effort to provide mitigation guidance for providers and communities. 

Pediatric health clinicians are in a unique position to identify youth at risk and to implement strategies meant to support them. Eight in 10 adolescents saw a healthcare provider within the year before their death by suicide, and nearly half of youth had visited an emergency department the same time period. 

“Most youth who are thinking about suicide pass through the healthcare system with their suicide risk unrecognized because they were not asked directly about suicidal thoughts and behaviors,” the blueprint says. Universal suicide risk screening, as well as protective factors like coping skills and community support, can help prevent suicide. Collaborative or integrated care models have also been shown to reduce suicidal ideation.

Before launching a prevention program, providers should get the support of diverse top leadership. All healthcare staff should be involved in training, and feedback from patients and their families should be welcome. As another first step, providers should aim to connect with mental and behavioral health resources in their community or via telehealth. It is also critical for providers to bear in mind the difference between screening (quick identification that requires further assessment) and assessment (comprehensive evaluation). Both are critical, according to the blueprint. 

When screening, providers should aim to use evidence-based clinical pathways to manage patients who screen positive for suicide risk. These include a brief screen followed by a brief safety assessment and finally disposition, where next steps for care are identified. Providers should also rely on trauma-informed care principles when talking to patients and their families. 

It’s critical providers learn their individual patient population needs, like culture differences, which will determine best approaches to treatment. Providers should use inclusive language and posters, ask patients their pronouns, seek patient and family feedback and offer a translator. Ongoing support for staff should be provided, such as quarterly check-ins.

Patients at imminent risk of suicide require safety and need immediate safety precautions, like removing all potentially dangerous objects from the room and not leaving the patient alone in the room. Families of patients who need further mental health evaluation should be referred to external resources and should have a safety plan in place in case of emergency.