How common is teen suicide?

PETER JENSEN, MD: We know that in actual fact teen suicide has increased over the years to a point where- it used to be below the adults levels, and now it's actually risen to adult levels. It's the second most common leading cause of death among adolescents. So it's a major public health problem. And really only surpassed by auto accidents as a cause of death in teenagers.

LISA CLARK: Now there are some studies which suggest that fully a quarter, 25 percent of adolescent kids, consider suicide at some point.

PETER JENSEN, MD: Suicide thinking, or thinking about death and dying, is not a terribly uncommon thing among adolescents. That's correct. It's a very different thing, on the other hand, to actually form a plan, to make a specific attempt. Suicide attempts are relatively common. Completed suicide, of course, is much less common. But again, when it does happen, it's a devastating condition for the family and all involved.

LISA CLARK: What sorts of factors may lead up to a suicide attempt? What can parents be on the lookout for?

PETER JENSEN, MD: In terms of children who actually complete suicide, we know that the greatest risk factors are having a mental health disorder. Sometimes concomitant or co-occurring substance use would put a youth at risk. But depression, probably the single leading cause would be associated with the suicide.

Now there are often precipitants. So while a child might have depression, or a youth might have depression, there may be also a stressful event that happens on top of that depression that seems to be a final, if you will, straw. Sometimes a youth, we know from some situations, will form a plan and say, you know, "If this happens, then that's it, I'm going to do it."

LISA CLARK: Right. Romantic breakups are a common catalyst.

There is a preponderance of white older adolescent males who attempt suicide, or complete suicide. Why do you think that is?

PETER JENSEN, MD: Well there's a very interesting difference between boys and girls. While girls actually make many more attempts than boys, boys, or youth, are much more likely to succeed because they turn to fatal means. They are, the most common means of trying to- of killing oneself is a gun -actually a long gun in boys. And these are obviously fatal methods. Whereas, it's an overdose attempt, or a wrist slashing in girls. And these are rarely fatal.

LISA CLARK: Does that indicate that girls are more likely not to really want to go through with this, but it's more of a cry for help perhaps?

PETER JENSEN, MD: I don't think we know that. And while there are some things that we think of as a suicide gesture, I think every time that someone is contemplating suicide and makes an actual attempt, it should be treated absolutely very seriously. And it demands a medical evaluation. Sometimes people might assume that it was just a manipulation. And while there can be sometimes a person who will do that, it really demands an evaluation by a medical, or probably a psychiatric professional needs to get involved.

LISA CLARK: When should parents intervene? If you have a child who just mouths off and says, "Oh I could kill myself for doing that"- when do you say that's just blowing off steam, or that's something I need to take seriously. How can you decide?

PETER JENSEN, MD: Well whenever a child voices that, that "I'm going to kill myself," I always take that as a warning sign. So when parents tell me this, or tell their primary care provider this, I always urge those professionals to get that child an official expert evaluation. It's not normal to say, "I'm going to kill myself." There may be a manipulation involved and it may not necessarily be a suicide risk. But there's something else going on for that child that probably deserves an evaluation.

LISA CLARK: Any final advice for parents on things to look out for, things they should be aware of if they suspect this might be an issue for their child?

PETER JENSEN, MD: Parents should be aware of the signs of depression: a change in mood, a loss of interest in normal activities, thoughts or discussion of death, withdrawal from friends. Substance use, we know is a risk factor. And other impulsive behaviors, sometimes in a subset, particularly boys, might be linked to suicide-completed suicide and suicidal behavior. So if parents have concerns, they probably should act on them because by the time you have concerns, you've been stewing for quite awhile. And when you really realize you're worried, it's time to act.

LISA CLARK: And as you say, early intervention can mean the difference between life and death.

Thank you so much, Dr. Jensen, for being with us.

And we appreciate you joining us as well. I'm Lisa Clark.