Prevention of youth suicide: The role of the primary care physician

• Objective: To review prevalence and warning signs of suicide, assessment of suicide risk, as well as risk factors, protective factors, and prevention and management strategies related to suicidality among adolescents. • Methods: Literature review. • Results: Suicide ranks as the third leading cause of death among adolescents in the United States. Primary care physicians may represent the only providers of mental health services for adolescents or may serve as gatekeepers in identifying and referring high-risk youth. Many factors increase the risk of suicide among adolescents, including a previous attempt, repetitive self-injurious behavior, and depression, while other factors, such as school connectedness, family cohesion, and lack of access to lethal means, help protect against suicidal behavior. Resources exist to help primary care providers improve their skills in identifying, assessing, and managing adolescents considering suicide. Office protocols and mental health partnerships also increase the likelihood of engaging in best practices and facilitating care for suicidal youth. • Conclusion: Primary care physicians can play a major role in helping prevent youth suicide by screening for risk factors, promoting protective factors, detecting warning signs, assessing suicide risk, and appropriately treating/managing distressed youth and/or referring patients for mental health care. Primary care settings should support physician efforts by establishing office protocols and specific procedures.