Evaluation and disposition of children and adolescents with suicidal behavior^*

* This algorithm provides an overview of evaluating and determining the level of care for youth who present with suicidal behavior. However, there are no evidence-based criteria for determining level of care. Full details of the evaluation and disposition of children and adolescents with suicidal ideation and behavior are discussed in the UpToDate topic.

Determining the level care requires a psychiatric evaluation that serves to individualize the disposition, and includes the factors addressed in this algorithm, as well as how comfortable the family is watching their child/adolescent at home and how confident they are that they can keep the child/adolescent safe. Other factors include history of suicidal ideation and behavior, adverse childhood experiences, current and past psychopathology and general medical illnesses and response to treatment, psychosocial stressors, symptoms of helplessness and worthlessness, and the availability of resources such as treatment facilities. These factors are used to judge the acuity of the patient's clinical status and the patient's capacity for maintaining safety; clinicians should err on the side of caution.

¶ Involuntary hospitalization may be necessary if the parents or legal guardians are not present or do not agree with hospitalizing the patient.