The Suicidal Adolescent

Suicide attempts are more common during adolescence than at any other time of life, and suicidality in adolescents most commonly comes to the attention of the clinician in the form of a failed suicide attempt. Although a variety of factors contribute to the high rates of suicidality in this age group, as in other age groups, attempters are more alike than they are different. Attempts to classify this frequently benign form of behavior as a distinct entity such as “parasuicide” or “deliberate self-harm” solely on the basis of demographic (predominantly female) and method (ingestion) variables rely on statistical probability but are insensitive to the subgroup of attempters who have significant underlying psychiatric disorders and those who will eventually complete suicide. The clinician should not assume that an adolescent suicide attempt is attention seeking or a “cry for help” but rather should evaluate each case systematically, paying close attention to the events, cognitions, and emotions that led to the behavior. These will provide the best guide to selection from among treatment options, including hospitalization, psychotherapy, and treatment with medication.