Although they can occur in childhood, suicide and suicide-related behaviors are usually first recognized during adolescence and have started to reach epidemic proportions in the pediatric population. Pediatricians, as primary health-care providers, have a significant role in the prevention of adolescent suicide. Identifying and addressing the risk factors, recognizing warning signs, and initiating appropriate interventions are crucial in mitigating this preventable cause of mortality in young people. However, adolescents are not consistently seen in the health-care setting. Although those with chronic medical illnesses may have more frequent visits with a health-care provider, many will have only emergency department visits as their sole health-care contact. This is concerning because up to 80 of adolescents who attempt or complete suicide have been seen in a health-care setting weeks or months before the incident, and most adolescents who die of suicide do so on their first attempt. It is, thus, imperative for the pediatrician to consider every health-care interaction with an adolescent as an opportunity for suicide prevention.
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