9 in 10 completed suicides by teens had a serious mental illness, or multiple disorders, at the time of death and up to two years before. Before suicidal behavior can be prevented, those at risk need to be identified. Since not all potential suicide attempters are in close contact with a mental health professional, those around them (e.g. friends, family, school staff, and primary care givers) should be equipped with tools to properly identify risk and make a timely referral.

Parents, you know your teen better than anyone else. If you suspect your teen may have a serious mental illness (take our screening to determine if there are "red flags"), or if your teen asks for your help to find the right diagnosis (see our Diagnosis section) or the right therapy (see our Finding Help section), seek professional help immediately. Believe your teen if they come to you for asking for help, as well as friends or family he/she may have confided in. Parents are unaware of 90 percent of suicide attempts made by their teenagers.

Immediate risk factors include agitation, intoxication, and a recent stressful life event (final straw) and it's typically friends who are close to the teen to witness these changes. Often suicidal teens will reach out to their circle of friends for support or intervention, but the young friends may not know when it's appropriate to break confidentiality and tell a trusted adult or parents or to call 911 or emergency services.

Identifying a high-risk teen is half the battle, the other is finding help and getting him correct mental health treatment. If a teen does not have a treatment provider, often their pediatrician will see them, but underrecognition and under-treatment of psychiatric disorders in the primary care setting presents a challenge for identifying those at risk.