Tag: suicide

Teen Depression Screening

It is estimated that only about half of teens with depression get diagnosed and then, only about half of them get treated.

We should do better.

And we can, if we start routinely screening all teens for depression.

Teen Depression Screening

The idea of having pediatricians screen for depression isn’t new.

And it hasn’t always been just about screening kids for depression.

In 2010, the American Academy of Pediatrics began to recommend that pediatricians screen new mothers for postpartum depression using the Edinburgh Postpartum Depression Scale or a simpler 2-question screen for depression.

“The primary care pediatrician, by virtue of having a longitudinal relationship with families, has a unique opportunity to identify maternal depression and help prevent untoward developmental and mental health outcomes for the infant and family.”

AAP on Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice

Next, in 2014, the AAP began to recommend that adolescent depression screening begin routinely at 11 years of age. This recommendation was added to the 2015 Recommendations for Preventive Pediatric Health Care, a policy statement that was published by the AAP Committee on Practice and Ambulatory Medicine and the Bright Futures Periodicity Schedule Workgroup.

They also continued to recommend screening for maternal depression at 1-, 2-, 4-, and 6-month visits.

A score of 3 or higher on the PHQ-2 could be a sign that your child is depressed.
A score of 3 or higher on the PHQ-2 could be a sign that someone is depressed and needs further evaluation.

The latest recommendation is that all “adolescent patients ages 12 years and older should be screened annually for depression (MDD or depressive disorders) with a formal self-report screening tool either on paper or electronically (universal screening).”

Other depression screening tools are also available, including the:

In addition to yearly depression screening, the latest guidelines also talk about the need to establish treatment plans and safety plans for teens who are depressed.

Signs and Symptoms of Teen Depression

Let your kids know that there are hotlines to call if they ever need to talk to someone when they are feeling anxious or depressed.

Do you think your teen is depressed?

Have they been sad or angry on most days?

Does it seem like they don’t care about their usual activities anymore, aren’t sleeping well, are always tired, or have had a big change in their weight recently?

Are they doing poorly at school, seem extra sensitive to criticism, or have a lot of unexplained aches and pains?

Has your teen had thoughts of dying or suicide?

Call your pediatrician if you think that your teen is depression, or seek more immediate help if you think that your teen might hurt themselves.

Does your teen know how to TXT 4 HELP?
Does your teen know how to TXT 4 HELP?

Unfortunately, signs and symptoms of depression aren’t always easy to recognize in teens.

Hopefully, with universal depression screening, more teens will get diagnosed as early as possible.

What to Know About Depression Screening

It is recommended that pediatricians screen all teens for depression each and every year.

More on Depression Screening

Child Access Prevention Laws and Gun Safety

There are many types of gun violence that gun safety advocates are concerned about, including:

  • homicides
  • mass shootings
  • school shootings
  • suicide
  • unintentional shootings

The problem isn’t just gang-bangers killing themselves, as some people who try to minimize the gun violence problem try to claim.

The American Pediatric Surgical Association, in an editorial about Firearms, Children, and Health Care Professionals, does a good job in pointing this out.

They state that “the risk of firearm homicide, suicide and unintentional injuries is more than 5-fold greater in the United States than 23 other high-income countries considered collectively. Firearm-related injury and death are issues for all Americans, in all communities. The risk of dying by firearm is the same for residents of the largest cities as it is for the residents of the smallest counties and holds true for adult and pediatric patients alike. This parity in risk is due to the predominance of firearm suicides and unintentional firearms deaths in the rural counties and the predominance of firearm homicides in the urban counties.”

Gun Safety Laws

Many new and proposed gun safety laws will hopefully help to reduce gun violence, including:

  • universal background checks and the closure of the gun show loophole
  • mental health restrictions for gun purchases
  • limitations on access to high-capacity magazines and assault-style weaponry
  • repealing the Dickey Amendment, which restricts the CDC from doing research on gun violence
  • child access prevention (CAP) laws

And we need to make mental health services more readily available to those who need them.

The March For Our Lives and National School Walkout events in March are already pushing lawmakers to make changes to keep kids safe from gun violence.
The March For Our Lives and National School Walkout events in March are already pushing lawmakers to make changes to keep kids safe from gun violence.

Surprisingly, many of these gun safety laws are supported by most members of the NRA, even if they are strongly opposed by the NRA itself.

CAP Laws

Most gun safety advocates are pushing for stronger CAP laws as a way to decrease the number of children injured and killed by unintentional shootings.

CAP laws work to limit a child’s access to guns in and around their home.

All too often, a toddler, preschooler, or older child will find a loaded, unsecured gun under a bed, on a nightstand, or in a closet, etc., and unintentionally shoot themselves or another family member.

“The safest home for a child is a home without guns, and if there is a gun in the home, it must be stored unloaded and locked, with the ammunition locked separately.”

American Academy of Pediatrics

CAP laws are not just about accidental shootings though. Kids who get access to unsecured guns also use them in suicides and school shootings.

Studies have found benefits to CAP laws, including declines in unintentional firearm death rates in children, decreases in non-fatal gun injuries, and decreases in suicide rates among teens.

Current CAP Laws

While some states have some sort of CAP law on the books already, many others don’t.

In Texas, “A person commits an offense if a child gains access to a readily dischargeable firearm (a firearm that is loaded with ammunition, whether or not a round is in the chamber) and the person with criminal negligence and failed to secure the firearm (to take steps that a reasonable person would take to prevent the access to a readily dischargeable firearm by a child, including but not limited to placing a firearm in a locked container or temporarily rendering the firearm inoperable by a trigger lock or other means) or left the firearm in a place to which the person knew or should have known the child would gain access.”

However, many other states, including Alabama, Alaska, Louisiana, Maine, New Mexico, Ohio, South Carolina, Washington, Vermont, and Wyoming, don’t have any kind of laws that would prohibit allowing kids access to unsecured firearms.

Again, that is a surprise since even the NRA advises that it is a gun owner’s responsibility to “store guns so that they are inaccessible to children and other unauthorized users.” They also state that it is a basic gun safety rule to “always keep the gun unloaded until ready to use.”

Some other states have weak or limited CAP laws that simply make you criminally liable if a child or teen gets access to a gun and uses it in a felony. For example, in Oklahoma, it is “unlawful for any parent or guardian to intentionally, knowingly, or recklessly permit his or her child to possess any of the arms or weapons,” but only if they are “aware of a substantial risk that the child will use the weapon to commit a criminal offense or if the child has either been adjudicated a delinquent or has been convicted as an adult for any criminal offense.”

And no states have all of the features of a comprehensive CAP law, which most experts advise would:

  • define a minor as being under 18 years for long guns and under 21 for handguns (in some states, a minor is only those who are 13 years old and under when it comes to child access prevention laws)
  • require that all firearms be stored with a locking device
  • impose a criminal liability on people who negligently store firearms where a minor could gain access, even if the firearm is unloaded and the minor doesn’t gain access or use the firearm
  • impose civil liability for damages if a minor gains access to a firearm that was stored negligently and causes damage after firing it

California is getting close though and is often thought of as being a leader in gun safety laws. Their CAP law was amended in 2013 (the Firearm Safe and Responsible Access Act) to make it a misdemeanor to leave an unsecured gun where a minor could find it, even if they don’t, in addition to being a misdemeanor or felony if they find and use the gun. Gun dealers also have to post warning signs educating gun buyers about the state’s CAP law.

Proposed Gun Safety Laws

According to the Giffords Law Center to Prevent Gun Violence, there are pending gun safety bills in at least 23 states, including many bills that would strengthen background checks.

Still, only 27 states and the District of Columbia have child access prevention laws.

And there is currently no national CAP law.

A bill that was introduced in 2013, the Child Gun Safety and Gun Access Prevention Act of 2013 would have come close by amending the Brady Handgun Violence Prevention Act to make it “unlawful for any licensed importer, licensed manufacturer, or licensed dealer to sell, transfer, or deliver any firearm to any person (other than a licensed importer, licensed manufacturer, or licensed dealer) unless the transferee is provided with a secure gun storage or safety device.”

Another version of the bill that was far more broad would also “Prohibit keeping a loaded firearm or an unloaded firearm and ammunition within any premises knowing or recklessly disregarding the risk that a child: (1) is capable of gaining access to it, and (2) will use the firearm to cause death or serious bodily injury.” It would also have raised the minimum ages that young people could purchase and possess handguns and long guns.

The Child Gun Safety and Gun Access Prevention Act of 2013 never made it out of committee though. It’s not hard to imagine that by “by raising the age of handgun eligibility and prohibiting youth from possessing semiautomatic assault weapons,” the bill, introduced by Congresswoman Sheila Jackson Lee from Texas, could have prevented the latest school shooting at Stoneman Douglas High School in Parkland, Florida.

Hopefully stronger gun safety laws will now be passed in more states and we will see fewer unintentional shootings and other tragedies that occur when kids find unsecured guns or buy their own, including AR-15 style guns.


In addition to other measures to reduce gun violence, the American Academy of Pediatrics supports safe storage and CAP laws.

What to Know About Gun Safety Laws

As we see more and more gun violence, including school shootings, something has to be done to protect our kids and keep them safe.

More on Gun Safety Laws