Adolescent suicide is a major public health concern. In the United States, suicide is the second leading cause of death among 10 to 24 year olds, and rates of completed suicide among youth have continued to increase in recent years. In a nationwide survey, an alarming 18% of US high school students reported seriously considering suicide in the past year. Suicidal ideation is a risk factor for a future suicide attempt and a host of other negative outcomes, such as impaired functioning. Thus, early identification and treatment of suicidal thoughts are critical, and the identification of at-risk youth is a key goal of suicide prevention initiatives.

Half of parents surveyed were unaware of their teenagers’ thoughts of killing themselves, and more than 75 percent were unaware of their teens’ recurrent thoughts of death, according to a study published in the February 2019 issue of Pediatrics. In the study, “Parent-Adolescent Agreement about Adolescents’ Suicidal Thoughts” (published online Jan. 14), researchers interviewed 5,137 adolescents ages 11-17 years old and their parents, who were recruited through a community-based pediatric health network in Philadelphia. The teens were asked about lifetime suicidal ideation: “Have you ever thought about killing yourself?” and also about thoughts of death, phrased as, “Have you ever thought a lot about death or dying?” Recurrent thoughts of death or dying, while not necessarily suicidal ideation, are associated with elevated distress and listed as a symptom of major depressive disorder. Parents responded to the same questions about their adolescents’ lifetime suicidal thoughts and thoughts about death. Researchers found a high lack of parental awareness of youth suicidal ideation or thoughts of death, and also a significant number of teens who denied suicidal thoughts reported by parents. The authors suggest that, because many teens at risk of suicide may go undetected, that pediatricians adopt a multi-informant approach to suicide screening.