Joel Stoddard, MD, discusses 5 profiles among youth suicide deaths to inform earlier prevention

Pediatric researchers from Children’s Hospital Colorado have identified five distinct classifications among youth who died by suicide, using a decade of national mortality data. The findings, published in the Journal of the American Academy of Child and Adolescent Psychiatry, highlight that nearly half of youth suicide decedents had no documented clinical contact or previously known suicide risk, underscoring limitations of current identification strategies and the need for broader prevention approaches.¹

Data-driven approach to understanding youth suicide

The research team, led by Joel Stoddard, MD, MAS, a child and adolescent psychiatrist at Children’s Colorado and associate professor of psychiatry at the University of Colorado Anschutz Medical Campus, analyzed 10 years of national suicide data to characterize shared patterns among youth decedents. Prior classification work has largely focused on adults, where profiles based on demographics, mental health conditions, substance use, and life circumstances have informed targeted interventions. Applying a similar framework to pediatric populations allowed investigators to examine pathways to suicide that may be unique to children and adolescents.

“In order to help kids now, we need to dig into the mountain of data available to us to learn about youth who are at risk of dying by suicide,” Stoddard said. “Not every child who dies by suicide has the same story. This research looks at the whole person and gives primary care providers, caregivers who work with kids and pediatric experts a greater understanding of suicide risks that are specific to youth.”

Five classifications with distinct characteristics

Using national data sources, the investigators identified at least five subgroups of youth who died by suicide, each defined by common contextual and behavioral features.

Crisis. Youth in this classification experienced an acute, often interpersonal or school-related crisis without prior documented suicidal ideation, behavior, or mental health diagnoses. These cases frequently represent a first point of contact with the health care system, such as emergency department presentation following a sudden stressor.

Disclosing. These youth had communicated suicidal thoughts to another person prior to death. The classification emphasizes the importance of recognizing and responding promptly when young people express distress, as well as ensuring awareness of available reporting and intervention resources.

Hidden. Youth in the Hidden classification had no recorded suicide risk factors and minimal interaction with the health care system. Many presented for unrelated physical concerns, such as injuries, where suicide risk was not apparent. This group was predominantly male and more likely to use firearms.

Identified. These youth experienced chronic stressors, family challenges, and frequent engagement with mental health services. Deaths in this group more commonly involved asphyxia or ingestion, and most decedents were female.

Surveillance. Youth in this category were identified through coroner or medical examiner reports with limited accompanying information. Classification often reflects gaps in reporting systems rather than known clinical or social characteristics.

Implications for screening and prevention

The Hidden and Surveillance classifications together accounted for nearly half of suicide deaths in the analysis, suggesting that reliance on clinical history alone may miss many at-risk youth. In a transcripted discussion accompanying the research, Stoddard noted that “our current methods of identifying individuals at risk may miss half the youth on a good faith effort by the medical examiners and law enforcement as much as they’re able to report to the CDC.”

The authors emphasize the importance of universal suicide risk screening across health care, school, and community settings. Validated tools, such as the Ask Suicide-Screening Questions (ASQ) toolkit developed by the National Institute of Mental Health, can support routine screening and guide follow-up when results are positive. Stoddard also addressed concerns about screening causing harm, stating that evidence does not support the idea that asking about suicide introduces risk for youth who are not already vulnerable.

Community and policy considerations

Beyond screening, the research outlines several recommended actions, including counseling on safe firearm storage, given the prevalence of firearm use across classifications. Crisis-oriented outreach programs, such as text-based support and peer disclosure systems, may help address acute stressors that precede suicide attempts. The authors also call for improved death investigation and reporting standards to strengthen surveillance data and inform prevention strategies.

Children’s Colorado has aligned the findings with broader investment in pediatric mental health, including recent philanthropic support directed toward suicide prevention initiatives. According to the investigators, integrating data-driven classifications into public health, education, and clinical practice may support earlier detection and more tailored interventions.

“Pediatric suicide rates still remain high, as one young person lost is one too many,” said Ron-Li Liaw, MD, Mental Health-in-Chief at Children’s Colorado. He added that translating research into actionable policy and clinical strategies can help reduce youth suicide and serve as a model for other states seeking to strengthen prevention efforts.

Disclosure

Stoddard reports no relevant disclosures.

References

Children's Hospital Colorado. Children’s Hospital Colorado research outlines first pediatric classifications for suicide risk in adolescents and kids. Eurekalert. January 13, 2026. Accessed January 23, 2026. https://www.eurekalert.org/news-releases/1112365