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Abstract
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In this issue of Pediatrics, Luk et al1 describe the risk of suicidal behavior within a 7-year nationally representative longitudinal sample of US adolescents. They found that sexual minority adolescents had an earlier onset of suicidality and faster progression from suicide ideation to a suicide plan, compared with that of heterosexual adolescents. The increased risk for suicidal ideation and behavior among this vulnerable population of youth is well described.2 The findings in this report regarding the early emergence and rapid progression of suicide risk among sexual minority adolescents suggest that early identification of risk and implementation of risk reduction interventions are critical.
Rates of suicide3 and suicide-related emergency department visits4 are increasing among adolescents in the United States. Screening for depression is currently recommended at annual visits from the age of 12 years,5 and the American Academy of Pediatrics (AAP) has developed resources, tool kits, and trainings to facilitate this activity.6,7 In recent research, it is suggested that screening for depression alone may not capture many suicidal youth8,9 because 32% of patients at risk for suicide in an inpatient medical sample were not identified by depression screening. In other reviews,10,11 authors cite accumulating evidence that suicide risk is better captured by direct questions about suicidal ideation. Validated instruments to identify suicide risk are available, and accurate identification of risk allows referral for emergency consultation or treatment that has the potential to prevent suicidal behavior.
In addition to screening all youth for depressive symptoms and suicidal ideation, routine screening for sexual minority status has the potential to enhance prediction of suicide risk among youth, given the early and elevated risk among sexual minority youth. Higher risk for suicidal behavior among gender minority adolescents, including transgender and gender diverse adolescents, has been increasingly documented,12 indicating that screening for both sexual and gender minority (SGM) status has the potential to improve care for SGM youth. Screening for SGM status during adolescence would also allow providers to make more effective referrals for SGM youth to mental health service providers who ...
Language: en |