Teen suicide and the new DSM: Let’s give common sense a chance
Among the many, many changes being proposed to the DSM is one that I consider ridiculously brilliant: A separate, standardized questionnaire to assess the risk of suicide among teens.
It's ridiculous because everyone knows that teens are different but for some reason teens are often screened as though they are adults. For example, teenage boys are less likely to have depression, more likely to abuse alcohol and often exhibit aggressive behavior before a suicide attempt. Teen girls often have depression but are less likely to abuse alcohol. For both, suicide is often spontaneous and impulsive. Meanwhile, adult suicides often follow detailed planning, worsening of depression, heavy drinking, increased anxiety, and agitated behavior.
The recommendation for a separate assessment scale for teens is brilliant because the proposal recommends testing teens without verbally asking questions. Instead, teens will tested on paper or on a computer. It seems teens are reluctant to verbally answer personal questions asked by adult authority figures. (Imagine that.)
Finally, the proposal recommends that the results are recorded in a teen's medical records. Seems like common sense, but apparently, doctors don't always record the results of a suicide risk assessment in medical records.
“While clinicians must currently evaluate individuals in their care for suicide risk, there are a number of different scales in use and the evaluation is sometimes not included in the written record,” said David Shaffer, M.D., a member of the Disorders in Childhood and AdolescenceWork Group. “The use of a single research-based scale and accompanying record of assessmentmay help clinicians better assess suicide risk as well as provide important information forresearchers to help us more accurately identify and treat those at greatest risk for suicide.”
How could this proposal possibly be controversial?




