While it is a difficult and sensitive subject to discuss, adolescent suicide is a real issue that must be addressed. According to the Centers for Disease Control and Prevention, in 2015 suicide was the third leading cause of death among people between the ages of 10 and 14, and it was the second leading cause of death among those between the ages of 15 and 34. (CDC, 2017) Recognition of the signs and symptoms, as well as contributing factors, is an important part of preventing this from occurring.

Some signs that may be noticeable include talking about dying, changes in normal behavior or personality, changes in sleep patterns including insomnia and nightmares, changes in appetite, or fear of losing control. (Kaslow, 2014) Risk factors for suicide include recent losses, drug or alcohol use, previous suicide attempts, a current mental health illness, feelings of hopelessness, helplessness, guilt, or even worthlessness. (Kaslow, 2014)

When looking at primary means of preventing suicide, educating adolescents about the risk factors and building their resiliency to suicide is the goal to helping prevent this from occurring. (Caldwell, 2008) Secondary prevention involves early intervention once the risk factors have emerged to prevent suicidal actions. (Caldwell, 2008)

This is a critical step in the process of assisting those struggling with these thoughts. Tertiary preventions are designed to keep these adolescents safe once any self-harming behaviors have started (Caldwell, 2008) which may include seeing Crisis Intervention or seeking treatment through inpatient or outpatient mental health services.

There are numerous resources available to assist anyone that is having suicidal ideation. A local service in my area is Crisis Intervention. There are people available to talk on the phone to coach and help those who are in need. People can even some into our local hospitals and they have staff who serve as Crisis Intervention specialists to meet with patients about their concerns.

Another service that is available is the National Suicide Prevention Lifeline which "is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week." (National Suicide Prevention Lifeline, n.d.) There are many more services available for those in need and more education for the public on the services available is needed to help save lives.

As the nurse working with an adolescent that I suspected might be depressed, I would implement several interventions. First, I would do my best to build a therapeutic rapport with them to open the dialog for further assessment. I would have the discussion with them about their mental state and if they were feeling depressed or ever had suicidal thoughts.

I would also discuss with them the stressors and resources that are available to assist them. I would also make sure the parents or guardian for the adolescent was understanding of the risk factors and signs of depression and suicidal ideation and when to seek help.

I would encourage them to discuss these feeling with their primary care provider and make sure they were aware of the resources available to assist them as well as treatment options. As stated earlier, early intervention is essential for improved outcomes which would be my primary goal.

Caldwell, D. (2008). The suicide prevention continuum.

Centers for Disease Control and Prevention. (2017). 10 leading causes of death, United States 2015, all races, both sexes

Kaslow, N. J. (2014). Suicidal behavior in children and adolescents.

National Suicide Prevention Lifeline. (n.d.). National Suicide Prevention Lifeline.