Child Suicide and the Schools

Abstract

To the Editor. Child death by suicide is a serious and growing problem. A steep rise in the rate of suicide now makes it one of the leading causes of death for adolescents and young adults, and the available data may be underreported if, as many experts believe, numerous “accidental” deaths are actually suicides.1 Since 1990, 72 children <19 years old have died by suicide in Cuyahoga County, Ohio,2 reflecting the fact that, like politics, child suicide is a very local problem. As early as 1990, the American Academy of Pediatrics Committee on School Health recommended that pediatricians work with local school personnel to implement suicide-reduction strategies. The Committee observed that successful prevention programs would have to involve community school personnel, physicians, students, and their parents.3 The recent suicide of a Cleveland school child who was under medical care for depression prompted the belated question as to why the physicians and mental health professionals who were treating the child for depression did not notify the school, and involve school professional personnel in surveillance of the child's behavior and performance. Should we, then, be notifying the schools when we recognize that a patients is at risk of suicide? Are the schools really willing and able to help? What are the pros and cons of school notification, and what are the …