Merck Manual

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Identifying Children and Adolescents at Risk of Suicide

Identifying Children and Adolescents at Risk of Suicide


Specific Factors

Risk factors for suicide

Disorders that affect the brain

Family history

A family history of suicidal behavior

A mother with a mood disorder

A father with a history of trouble with the police

Lack of communication with parents

Increased rates of suicide in adults

Parents' use of opioids

Triggering events

Difficulties in school, including being disciplined or suspended

Loss of a loved one (such as a boyfriend or girlfriend), especially by suicide

Separation from parents

Lack of social contacts, sometimes due to having no job or not going to college

Victim of bullying

Reports of suicide in the media, which may lead to a copycat suicide


Access to firearms or prescription medications

A previous attempt at suicide

Barriers encountered when trying to access mental health services and/or a feeling that a stigma is attached to seeking such help

Sexual/gender minority status







Warning signs of suicide

Mental and physical symptoms

Preoccupation with morbid themes


A feeling of hopelessness

Low self-esteem

Dramatic changes in mood

Changes in appetite

Sleep disturbances

Tension, anxiety, or nervousness

Poor control of impulses

Changes in behavior

Poor hygiene and neglect of personal appearance (especially if it is an abrupt change)

Withdrawal from social interactions

Playing hooky from school

A decline in grades

An increase in violent behavior

Giving away favorite possessions


Statements about feeling guilty

Statements suggesting a wish to be dead, such as “I wish I’d never been born” or “I’d like to go to sleep and never wake up”

Direct or indirect threats to commit suicide