- “Have you ever felt so upset you wished you were not alive or wanted to die?”
- Have you ever hurt yourself or tried to hurt yourself?”
- “Have you ever tried to kill yourself?”
- “Have you ever thought about or tried to commit suicide?”
- "Have you ever done something you knew was so dangerous that you could get hurt or killed by doing it?” [AACAP: 2001]
- The child or adolescent must not have a persistent wish to die or plans to harm him- or herself.
- Follow up for thorough psychiatric evaluation must be assured.
- Proper adult supervision must be in place.
- The evaluator should initiate discussion of removing lethal means (guns, medications, e.g.), and expressly recommend their removal.
- It may also be valuable to provide education about other risk factors such as substance abuse.
- Lithium has been shown to decrease risk of suicide in adults with bipolar disorder, and may be considered in the therapy of children and adolescents with bipolar disorder and suicidality, though its use entails careful monitoring of blood levels due to its low therapeutic index.
- Tricyclic Antidepressants (TCAs) should not be used as first-line medication for depression in suicidal children and adolescents due to their lethality in overdose and lack of established efficacy in this age group. [AACAP: 2001]
|Author:||Thomas G. Conover, MD - 2/2009|
|Content Last Updated:||9/2013|
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