Johns Hopkins Psychiatry Grand Rounds | Preteen Suicide Assessment

Why It Matters

A validated, developmentally sensitive tool will enable clinicians to identify suicidal risk earlier, improving prevention strategies for a rapidly growing public‑health threat.

Key Takeaways

• Suicide rates in 8‑12 year olds rose 135% (2010‑2019).
• Existing self‑report tools miss pre‑teens due to developmental mismatch.
• Qualitative interviews highlight need for rapport and multi‑informant assessments.
• Impulsivity, ADHD, and hidden distress are key risk factors.
• New NIMH‑funded battery aims for validated, developmentally sensitive screening.

Summary

Johns Hopkins psychiatrists present a five‑year NIMH‑funded study developing a reliable, developmentally appropriate assessment for suicidal thoughts and behaviors in children ages eight to twelve. The initiative grew from a 2021 NIMH call to address the emerging public‑health crisis of pre‑teen suicide, and the team includes researchers from Brown, Bradley Hospital, and Johns Hopkins.

Between 2010 and 2019 suicide deaths among youth aged five to twelve increased by roughly 135%, and meta‑analyses show about 7.5% of children under 13 experience suicidal ideation. Existing tools such as the Suicidal Ideation Questionnaire often miss risk because items (e.g., writing a will) are developmentally irrelevant. Risk factors highlighted include irritability, impulsivity, ADHD, and hidden distress, with attempts in this age group showing less premeditation than in adolescents.

Qualitative interviews with 31 clinicians, 22 youth, and caregivers revealed five core themes: building rapport, using semi‑structured interactive interviews, ensuring developmental appropriateness (including non‑verbal activities), integrating multi‑informant perspectives, and accounting for cultural context. Clinicians noted discomfort asking younger children about suicide, while youths expressed a desire for direct questions and feared burdening adults. Caregivers emphasized the need for individualized, culturally sensitive dialogue.

The project’s next phase is to validate a comprehensive risk‑assessment battery across diverse, high‑risk samples, aiming to improve early detection and guide targeted interventions. Successful validation could reshape clinical protocols, inform training curricula, and ultimately reduce repeat attempts and long‑term morbidity among pre‑teens.

Original Description

Recorded Grand Rounds from Johns Hopkins Psychiatry and Behavioral Sciences. Elizabeth Reynolds, Ph.D. presented on the topic "Preteen Suicide Assessment: Insights from Clinicians, Families, & Youth” (February 23, 2026). Please note that the window for earning CME credit has expired. #suicideprevention #johnshopkins #suicide